The AIDS Drug Assistance Program (ADAP) was initiated in the early 1990s as part of the Ryan White CARE Act, which was designed to "provide emergency assistance to localities that are disproportionately affected by the Human Immunodeficiency Virus epidemic and to ... provide for the development, organization, coordination, and operation of more effective and cost efficient systems for delivery of essential services to individuals and families with HIV disease" (Public Law 101-381). The implementation of the Ryan White CARE Act is based on 4 titles and 3 targeted components: Title I provides emergency assistance to high-impact epicenters of the early epidemic through local HIV Health Services Planning Councils; Title II funding goes to states for provision of health care and support services, health insurance continuation, and prescription drugs via ADAP, which constitutes more than one-half of