State ADAPs function as important components of Title II service systems, yet most State ADAPs are also large and complex enough to merit their own staff resources. As of January 2002, 78 percent of the States have separate individuals (or groups of individuals) administering the Title II program and the State ADAP. Given the unique role of ADAPs in the Ryan White service delivery system, HRSA prepared the ADAP Manual to assist ADAPs with their distinct issues and requirements. The ADAP Manual is meant to complement the information provided in the Ryan White CARE Act Title II Manual. ADAP-specific information from the Title II Manual has been reproduced and, in most cases, has been expanded upon and enhanced. Other areas, such as the Section 340B Drug Discount Program, are unique to the ADAP Manual. All of the information contained in this manual is designed to assist State ADAP coordinators, Title II directors, and others involved with improving access to HIV medications for low-income individuals. Some chapters of the ADAP Manual are taken directly from the Title II Manual. For a comprehensive understanding of the Title II program, however, the two manuals should be used together. Each chapter begins with a chapter summary for quick reference. In addition, each chapter includes a list of sources used and a reference list for further information.