AIDS Drug Assistance Program (ADAP) Emergency Relief Funds (ERF) | Apply Online

Opportunity Summary:

The AIDS Drug Assistance Program (ADAP) Emergency Relief Funds (ERF) grant opportunity (HRSA-17-037) is a discretionary grant offered by the U.S. Department of Health and Human Services through the Health Resources and Services Administration (HRSA), specifically the HIV/AIDS Bureau (HAB) within the Division of State HIV/AIDS Programs (DSHAP). It sits under the Ryan White HIV/AIDS Program (RWHAP) Part B framework and is designed to help states and territories keep their ADAP programs stable and responsive when medication access is at risk due to financial pressure, rising client need, or other cost drivers.

At its core, ADAP ERF funding is meant to prevent, reduce, or eliminate ADAP waiting lists. The emphasis on waiting lists reflects the reality that ADAP is often the safety net that ensures low-income people with HIV can access life-saving antiretroviral therapy and related medications when they do not have adequate insurance coverage. The program recognizes that even short interruptions in treatment can have serious health consequences and can increase the risk of HIV transmission, so the overall policy goal is to keep eligible clients enrolled and receiving medications without delay.

Applicants must be able to clearly demonstrate that they need extra resources beyond their usual ADAP funding to avoid or address a waiting list. HRSA does not treat this as automatic or formula-based funding; instead, applications are reviewed for evidence of need, and the strength of that need-based justification drives award decisions. An external Objective Review Committee (ORC) evaluates applications using published criteria in the funding opportunity announcement, and the review process places priority on proposals that directly address waiting lists. In practice, that means jurisdictions that currently have a waiting list, or can show they are at imminent risk of one, are positioned as the highest urgency cases, particularly when they can document client impact and a credible plan to resolve the issue quickly.

A key feature of this opportunity is that it supports not only direct list reduction, but also cost-containment and cost-saving strategies intended to keep ADAP solvent and prevent future rationing. The announcement explicitly mentions measures such as providing health insurance assistance, which can be a way to move clients from direct medication purchasing into more sustainable coverage arrangements (for example, helping pay premiums, deductibles, or copays where allowable and cost-effective). The underlying idea is to stretch limited ADAP dollars while maintaining or improving access to medications and care, using strategies that reduce per-client costs over time and lower the chance that a jurisdiction will have to start a waiting list during budget stress.

The ERF initiative has a historical context that explains why it continues to exist even after waitlists were eliminated. HRSA first awarded these funds in August 2010 when many states and territories had ADAP waiting lists. By the time this particular announcement was published, HRSA reported that all waiting lists had been eliminated due to effective use of ERF and related actions. Even so, HRSA continued the ERF initiative to maintain the infrastructure in jurisdictions that previously had waiting lists and to ensure new lists do not return. In other words, ERF is positioned as a preventive stabilization tool as much as an emergency remedy, helping jurisdictions preserve the administrative and financial mechanisms that keep ADAP access uninterrupted.

The announcement also sets clear expectations based on a jurisdiction's current waiting list status. States and territories that did not report an existing waiting list to HRSA are expected to use any ERF award specifically to prevent a waiting list, primarily through cost-cutting or cost-saving steps such as implementing or expanding health insurance assistance programs. By contrast, states and territories that have recently imposed a new ADAP waiting list are required to use all awarded ERF funds to remove clients from the waiting list. They must also immediately report the waiting list to HRSA, reinforcing the program's emphasis on transparency and rapid response when access problems emerge.

Administratively, the opportunity is categorized as a grant under the health activity category and is associated with CFDA number 93.917. The eligible applicant category in the listing is labeled as "Others (see text field entitled Additional Information on Eligibility for clarification)," which typically signals that eligibility is defined in the full FOA text rather than fully captured in the summary record, and in this case the program focus is clearly on states and territories that administer ADAP under RWHAP Part B. The posting shows a creation date of September 15, 2016, with an original closing date of November 17, 2016. The listing also notes an expected 59 awards and an award ceiling of 0, which generally indicates the maximum award amount is not set as a fixed cap in the public summary and is instead determined by available funds, applicant need, and HRSA's award methodology.

Overall, this grant opportunity is best understood as HRSA's mechanism for preventing disruptions in access to HIV medications through ADAP. It targets jurisdictions that can document financial or operational pressure that could lead to rationing, and it funds concrete actions that either immediately eliminate a waiting list or reduce the likelihood that one will occur, including strategic cost-containment tools like health insurance assistance. The program's stated priority is straightforward: keep people with HIV from being placed on ADAP waiting lists and protect continuity of medication access across states and territories.

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