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December 2, 2013

The Honorable Kathleen Sebelius
Department of Health and Human Services
200 Independence Avenue SW
Washington, D.C. 20201

Dear Secretary Sebelius:

We, the undersigned organizations and individuals, are writing to urge that the HHS issue clear guidance on the allowance of drug industry–provided co-payment, co-insurance, or other out-of-pocket discount cards and coupons in the Affordable Care Act’s (ACA) Health Insurance Marketplaces. As people living with, and organizations serving people with, HIV, HCV, and other life-threatening and chronic health conditions, we are alarmed by the possibility of the prohibition of these critical financial lifelines in the ACA, just as affordable health insurance for people with preexisting conditions is finally becoming a reality in the United States, thanks to the ACA.

As people whose lives are dependent on adherence to drug regimens as well as new advancements in care and treatment, we know better than most the importance of access to reliable health care and of ACA’s role in providing it. But as you are well aware, new treatment options come at a high cost under our current health care system. Access to drugs without generic equivalents is often facilitated by industry co-payment programs. While this is in no way ideal, we fear a decision to prohibit these programs under the Federal False Claims Act will create immediate and unbreachable financial barriers in ACA marketplace plans through high co-payments, co-insurances, and deductibles, in many cases requiring thousands of dollars of out-of-pocket costs up front, leaving patients without access to necessary and often lifesaving treatment.

As organizations working in communities assisting people enrolling into the ACA, our hands are tied when a critical consideration—the amount of out-of-pocket costs—is not clearly defined. It greatly complicates our ability to determine which plans best suit their needs and the plans’ affordability.

While we fully appreciate the significant federal out-of-pocket subsidies for people whose income is under 250 percent of the Federal Poverty Level, the protection provided by the out-of-pocket maximum, and the potential of the ACA to limit health care cost increases in the long term, we urge you consider the unintended consequences of suddenly removing industry-provided out-of-pocket assistance for brand-name drugs without generic equivalents from the patchwork of programs that so many people with serious and chronic conditions rely on. It could potentially threaten access to lifesaving medications for thousands of people living with HIV; bar millions of people with hepatitis C from benefiting from the new short-course curative treatment combinations; and keep countless people with cancer and other debilitating and life-threatening illnesses from the treatment they need to stay alive. We fear this will be a major setback to the goals of the ACA.

We urge you to quickly issue clear guidance on this critical issue for our communities, so that we can productively contribute to the success of the ACA.


Valerie Jarrett, Senior Advisor to President Barack Obama
Grant Colfax, Director, Office of National AIDS Policy
Laura Cheever, Associate Administrator and Chief Medical Officer, HIV/AIDS Bureau, Health Resources and Services Administration
William Schultz, General Counsel, Department of Health and Human Services
Joanne Chiedi, Principal Deputy Inspector General, Office of the Inspector General
Aaron Lopata, White House Office of Management and Budget
Caya Lewis, Counselor to the Secretary for Science and Public Health, Department of Health and Human Services
Gary Cohen, CCIIO, Deputy Administrator and Director
Mandy Cohen, CCIIO, Director, Consumer Support Group
Melissa Harris, CMS Disabled & Elderly Health Programs Group, Director, Division of Benefits & Coverage

167 Organizations Signed on:

A Positive Place, Northampton, MA

AccessHealth, Richmond, TX

ACRIA (AIDS Community Research Initiative of America), New York, NY

ACT UP Philadelphia, Philadelphia, PA

Action for Boston Community Development, Boston, MA

ADAP Advocacy Association (aaa+), Washington, DC

Advocating for Seniors, Washington, DC

Africa Bridge, Portland, OR

African American Health Program, Silver Spring, MD

African Americans Reach and Teach Health Ministry, Seattle, WA

AIDS Action Baltimore, Baltimore, MD

AIDS Action Coalition of Huntsville, Inc., Huntsville, AL

AIDS Alabama, Birmingham, AL

AIDS Foundation of Chicago, Chicago, IL

AIDS Healthcare Foundation, Ft Lauderdale, FL

AIDS Healthcare Foundation, Los Angeles, CA

AIDS Healthcare Foundation Pharmacy, Seattle, WA

AIDS Healthcare Foundation, Miami Beach, FL

AIDS Legal Council of Chicago, Chicago, IL

AIDS Legal Referral Panel, San Francisco, CA

AIDS Network of Western New York, Buffalo, NY

AIDS Partnership Michigan, Detroit, MI

AIDS Project Los Angeles, Los Angeles, CA

AIDS Research Consortium of Atlanta, Atlanta, GA

AIDS Resource Alliance, Williamsport, PA

AIDS Resource Center Ohio, Columbus, OH

AIDS Task Force of the Upper Ohio Valley, Wheeling, WV

AIDS United, Washington, DC

AIDSNET, Bethlehem, PA

ALPHA Pittsburgh, Inc., Pittsburgh, PA

American Academy of HIV Medicine (AAHIVM), Washington, DC

Association of Nurses in AIDS Care, Akron, OH

AVAC, New York, NY

Bronx Community Health Network, Inc., Bronx, NY

Brothers Reaching Others, Inc., Anniston, AL

Buddies of New Jersey, Hackensack, NJ

Building Bridges Inc., Jackson, MS

CANN, Gainesville, GA

Caring Ambassadors Program, Inc., Oregon City, OR

Cascade AIDS Project, Portland, OR

Center for Innovation in Health and Human Services, Anna Maria, FL

Central Illinois Friends of People with AIDS, Peoria, IL

CHCC- Montefiore Medical Group, Bronx, NY

CHOW Project, Honolulu, HI

Citizen’s Council for Human Rights & Salaam Legal Network, Memphis, TN

Coalition of HIV/AIDS NonProfits and Governmental Entities [CHANGE], New Orleans, LA

Community Access National Network (CANN), Washington, DC

Community health Center Association of Connecticut, Wethersfield, CT

Crossroads Clinic, Jackson, MS

Delhi Center, Santa Ana, CA

Drive for Universal Healthcare (DUH), Chicago, IL

East Tennessee Human Resources Agency, Inc., Knoxville, TN

End AIDS Now!, New York, NY

Fan Free Clinic, Richmond, VA

Fair Pricing Coalition, United States

Florida HIV/AIDS Advocacy Network, Tallahassee, FL

Florida Keys HIV Community Planning Partnership, Key West, FL

Food For Life Network, Inc., Miami, FL

Foundation for Integrative AIDS Research (FIAR), Brooklyn, NY

GCKR Inc., Castell, TX

Georgia Equality, Atlanta, GA

Glide HIV Services, San Francisco, CA

Global Justice Institute, New York, NY

GLOW (Gay, Lesbian+ of Western North Carolina), Asheville, NC

GMHC, New York, NY

Gospel Solutions, Knightdale, NC

Harm Reduction Coalition, New York, NY

HCMSG-The Hepatitis C Mentor and Support Group, Inc., New York, NY

HCV Advocate, Sacramento, CA

HCV Coalition for The Cure, San Antonio, TX

Health GAP (Global Access Project), New York, NY

HealthHIV, Washington, DC

HIV Dental Alliance, Atlanta, GA

HIV Gay Veteran, Atlanta, GA

HIV Health Reform, palm springs, CA

HIV Medicine Association, Arlington, VA

HIV Prevention Justice Alliance, New York, NY

Hope and Help, Orlando, FL

Hot Springs AIDS Resource Center, Hot Springs, AR

Housing Works, Inc., New York, NY

Hyacinth AIDS Foundation, New Brunswick, NJ

International AIDS Society (IAS), Geneva

International Foundation for Alternative Research in AIDS (IFARA), Portland, OR

L.A. Gay & Lesbian Center, Los Angeles, CA

Latino Commission on AIDS, New York, NY

Legacy Community Health Services, Houston, TX

Let’s Kick ASS, San Francisco, CA

Lifelong, Seattle, WA

Los Angeles County HIV Drug & Alcohol Task Force, Los Angeles, CA

Louisiana AIDS Advocacy Network, New Orleans, LA

Maryland Hepatitis Coalition, Baltimore, MD

MEDBANK of Maryland, Inc., Baltimore, MD

Medical AIDS Outreach of Alabama, Montgomery, AL

Mendocino County AIDS/Viral Hepatitis Network, Ukiah, CA

Metropolitan Community Churches, Sarasota, FL

Minnesota AIDS Project, Minneapolis, MN

Missouri Hepatitis C Alliance, Columbia, MO

Montefiore, Bronx, NY

Moveable Feast, Baltimore, MD

MUSC/Lowcountry AIDS Services Consumer Advisory Board, Charleston, SC

Nashville CARES, Nashville, TN

National AIDS Treatment Advocacy Project (NATAP), New York, NY

National Alliance of State and Territorial AIDS Directors (NASTAD), Washington, DC

National Black Leadership Commission on AIDS, Inc., New York, NY

National Latino AIDS Action Network (NLAAN), Washington, DC

National Minority AIDS Council, Washington, DC

National Viral Hepatitis Roundtable, Rohnert Park, CA

Nebraska AIDS Project, Omaha, NE

New Jersey Association on Correction, Trenton, NJ

New Mexico AIDS Services, Albuquerque, NM

New Mexico Consumer Advocacy Collaborative, Albuquerque, NM

Newark Community Health Centers, Inc., Newark, NJ

Nightsweats & T-cells, Co, Cleveland, OH

Northwest Florida AIDS/HIV Consortium, Pensacola, FL

North Carolina AIDS Action Network, Raleigh, NC

Northwest Health Services, St. Joseph, MO

Ohio AIDS Coalition, Columbus, OH

Okaloosa AIDS Support and Informational Services, Inc., Ft. Walton Beach, FL

One in Four Chronic Health, Clackamas, OR

Open Arms HIV/AIDS Support Group, Ferndale, MI

Open Door Clinic, Elgin, IL

Outreach Mobile Labs, Inc., BATON ROUGE, LA

Pacientes de Sida pro Politica Sana, San Juan, Puerto Rico

Pasco Aids Services Community Organization, New Port Richey, FL

PeterCares House, Greenbelt, MD

Philadelphia Fight, Philadelphia, PA

PHIVE-O (Peer HIV Education Organization), Hastings, NE

Pierce County AIDS Foundation, Tacoma, WA

Positive Health Clinic Allegheny General Hospital, Pittsburgh, PA

Positive Life Series, Palm Springs, CA

Pozitively Healthy, Washington, DC

Program for Wellness Restoration, Houston, TX

Project Inform, San Francisco, CA

Public Law Center, AIDS Legal Assistance Project, Santa Ana, CA

PWA Coalition Colorado, Denver, CO

Resource Center, Dallas, TX

Rise Up To HIV, Minneapolis , MN

Ryan White, Houston, TX

Salvadoran American National Network (SANN), los Angeles, CA

San Francisco AIDS Foundation, San Francisco, CA

Sandhills Medical Foundation, Sumter, SC

Santa Cruz Health Services Agency, Santa Cruz, CA

Southeast AIDS Training and Education Center, Atlanta, GA

South Carolina HIV/AIDS Council, Columbia, SC

South Florida You Can, Miami, FL

Southern AIDS Coalition, Birmingham, AL

Southern HIV/AIDS Strategy Initiative (SASI), Durham, NC

SPCAA Project CHAMPS, Lubbock, TX

START at Westminster, Washington, DC

Tennessee Association of People With AIDS, Nashville, TN

Test Positive Aware Network, Chicago, IL

The AIDS Institute, Washington, DC

The McGregor Clinic, Inc., Fort Myers, FL

The Women’s Collective, Washington, DC

Treatment Action Group, New York, NY

Treatment Education Network, Denver, CO

Truman Medical Center, Kansas City, MO

U of Iowa, Iowa City, IA

Unity Fellowship Church NYC, Brooklyn, NY

University of Rochester Medical Center, Rochester, NY

Valley Community Clinic, North Hollywood, CA

Voices Of Community Activists & Leaders (VOCAL-NY), Brooklyn, NY

Washington County Health Department, Hagerstown, MD

Wateree AIDS TAsk Force, Sumter, SC

Wesley Housing Development Corporation, Alexandria, VA

Western North Carolina AIDS Project, Asheville, NC

Whittier Rio Hondo AIDS Project, Whittier, CA

513 Individual Signed on:

Nathan Abernethy, Roanoke, VA

Jay Adams, Wheeling, WV

Jeton Ademaj, New York, NY

Moises Agosto, Washington, DC

Hal Allen, Mountain Home, AR

Shane Ames, Pocatello, ID

Sue Andersen, Los Angeles, CA

Rick Andrews, San Francisco, CA

Kehvin Antawn, Tucson, AZ

Mike Aquilino, Washington, DC

Jim Aquino, New York, NY

Yanira Arias, Stockton, CA

Danny Ary, Palm Springs, CA

Regina Atim, Hanover, MD

Jennifer Avril, Brooklyn, NY

Kaitlynn Ayers, Hastings, NE

Stephen Bailous, Silver Spring, MD

Alison Bain-Peachey, Arlington, VA

David Baldwin, Phoenix, KY

Anna Balla, wellington, FL

Gabrielle Barcia, Freehold, NJ

Alex Barnes, Puyallup, WA

Travis Barnhart, Topeka, KS

Jody Barnofsky, Rego Park, NY

Gilbert Barrett, Moline, IL

Ed Barron, Mendham, NJ

Jaime Bastida, long beach, CA

Stephen Batchelder, Abington, MA

Tammy Bates, Clarkston, GA

Carolyn Bayless, Berryton, KS

Monica J Baytos, Youngstown, OH

Donald Bean MD, San Diego, CA

Amanda Beck-Myers, Cincinnati, OH

David Becker, Minneapolis, MN

Christina Benavides -Morris, East Wenatchee, WA

Gary Benecke, Dallas, TX

Dena Bensen, Richmond, VA

Eric Bensen, Midlothian, VA

Stephen Bentrum, Dallas, TX

Andrea Benzacar, New York, NY

Mona Bernstein, San Francisco, CA

D. Walter Biggs, III, Spokane, WA

Frances Blau, San Francisco, CA

Donald C Bliss, San Francisco, CA

Lance Blueberry, Tallahassee, FL

Corinne Blum, Chicago, IL

Will Boemer, San Rafael, CA

Kyle Bonham, Indianapolis, IN

William Booth, Dayton, OH

Shirley Boughton, Freeport, FL

Anthony Bowden, Evansville, IN

Tony Bowman, Gulfport, FL

David Brakebill, Key West, FL

Anthony Brazier, Walnut, CA

Wanda Brendle-Moss, Winston-Salem, NC

Jean-Michel Brevelle, Edgewood, MD

Carole Brignol, Dorchester, MA

Joseph Brister, Eatontown, NJ

Kelly Brittan, Portland, OR

Timothy Broderick, Joliet, LA

Erica Brooks, Lawrenceville, GA

Mark Brooks, Dallas, TX

Edward Brophy, Santa Rosa, CA

Carol L. Brosgart, MD, Berkeley, CA

Mozell Brown, Washington, DC

Patrick Brown, Orlando, FL

Katherine Brown MD FACP AAHIVS, Seattle, WA

Jana Brumbaugh, Seattle, WA

Rita Buchanan-Gunthrop, Baltimore, MD

Katy Byrtus, Portland, OR

Jill Cadman, Rockaway, NJ

Henry Calderon Jr., Intl Falls, MN

John Caldwell, San Francisco, CA

Emily Calhoun, Pocatello, ID

Donald Cantwell, Rohnert Park, CA

Mary Capps, Roanoke, VA

George Carter, Brooklyn, NY

Edward Cavin, New Orleans, LA

Elmer Cerano, White Lake, MI

Rosalei Chacon, Santa Cruz, CA

David Chaille, Long Beach, CA

Brenda Chambers, Herriman, UT

Lee Chase, Farmington, CT

Jerry Cheney, Santa Fe, NM

Jamaica Chenoweth, Carmichael, CA

Alexander Cherubin, Omaha, NE

Ed Chitty, San Francisco, CA

Marsharee Chronicle, Lake Worth, FL

Jan Clark, Chattanooga, TN

Charlton Clay, New York, NY

Jim Clay, Portland, OR

John Clifford, Los Angeles, CA

Ron Cockrell, Omaha, NE

Craig Coelho, Riverside, RI

Robert “Bob” Coffey, Sherwood, AR

Bryan Cole Smith, Wenonah, NJ

Jeremy Coleman, Sulphur Springs, TX

Jason Collier, Lynn haven, FL

Wanda Commander, Baltimore, MD

William Cooke, New York, NY

Brian Coppedge, Lahiana, HI

Daron Corbin, Levelland, TX

Lauren Corbin, Levelland, TX

Pedro Coronado, Harlingen, TX

Nicolas Crase, Portland, OR

Karen Creary, Ft Lauderdale, FL

Thomas Crunk, San Francisco, CA

Kimberlee Cruz, Hanford, CA

Jacquelyn Cully, Denver, CO

Andrea Curran, Oakland, CA

Tom Curran, Portland, OR

William Curran, Columbus, OH

Anthony D, Amesbury, MA

Brian Datcher, Stratford, CT

Julie Davids, Brooklyn, NY

Carl Davidson, Chicago, IL

J T Davis, San Francisco, CA

Rev. Arthur L. Davis, Buffalo, NY

Barbara Dawson, Independence, MO

Eric Day, Burlington, VT

Scott DeBerg, East Troy, WI

Randolph Decker, Tucson, AZ

Mary DeGrezia, Laurel, MD

Michael Deighan, Cleveland, OH

Alexis DeJesus, New York, NY

Sergio Delgado, M.D., Orlando, FL

Matthew Denckla, San Francisco, CA

Denise Dengler, Kunkletown, PA

Margaret Denison, Corvallis, OR

Tommy Dennis, Omaha, NE

Brian DiCrocco, San Francisco, CA

Natalie Dietz, New Orleans, LA

Hannah Sarah F. Dini, New York City, NY

MIchael Discepola, SF, CA

Ronald Divito, Brooklyn, NY

Ann Dixon, North Little Rock, AR

Joseph William Dluzak, New York City, NY

Wilmide Dominique, Miami, FL

Rosemary Donnelly, Atlanta, GA

Michael Dorosh, Denver, CO

Deonte Dorsey, Cambridge, MD

Mary Dorsey, Palm Springs, CA

Margaret Dudley, San Antonio, TX

Doug Dye, Santa Barbara, CA

Edward Dzialo, San Francisco, CA

Em Elliott, Atlanta, GA

Randal Elliott, Albuquerque, NM

Tammy Elliott, Baltimore, MD

Carl Erickson, Greeley, CO

Max Erickson, St. Louis Park, MN

Lillian Escobedo, Seminole, FL

Minister Antionettea Etienne, New York, NY

Adam Fairbanks, Columbia Heights, MN

Seun Falade-Nwulia, Baltimore, MD

Mary Fanelli, New York, NY

Paul Feldman, Seattle, WA

Jucinda Fenn-Hodson, Hamden, CT

Robert Ferguson, Ann Arbor, MI

Gabe Ferreira, Sacramento, CA

Julie Fitch, New Orleans, LA

Charles Flexner, Baltimore, MD

Doug Fogal, Winchester, VA

Julie Foltz, Anderson, IN

Sandra Ford, Fort Worth, TX

Susan Forrest, Altadena, CA

LM Alaiyo Foster, Portland, OR

Larry Frampton, Nashville, TN

Matthew Franck, New Brunswick, NJ

Jana Franks, North Little Rock, AR

Eddie Fukui, New York, NY

Dr. Bambi W. Gaddist, Columbia, SC

Theresa Galvin, Brooklyn, NY

Gloria Garcia, Davis, CA

Erick Gass, West Palm Beach, FL

Benjamin Gerritz, Portland, OR

Joan Gibbs, New York, NY

Cheryl Gildner, Porterville, MI

Eric Gillespie, Garner, NC

Iliana Gilliland, Chicago, IL

Stephen Godbout, Silver Spring, MD

Ron Goldberg, New York, NY

Helen Turner Goldenberg, Dallas, TX

Gay Goodfriend, Bronx, NY

Jeffrey Goodman, Santa Monica, CA

John A Goodman Jr, New York, NY

Mary Goodspeed, Buffalo, NY

Tracy Gorden, Baytown, TX

Jeffrey Grabelle, Baltimore, MD

Kittie Grace, Hastings, NE

Nicholas Grant, San Mateo, CA

Michele Grim, Oakland, CA

Barbara Gripshover, Cleveland, OH

Howard Grossman, New York, NY

Rick Guasco, Chicago, IL

Anthony Guillaume, New York, NY

Jeffrey Gunier, San Rafael, CA

Alice Gunnison, PA-C, AAHIVM Specialist, Louisville, KY

Annette Gutierrez, Lubbock, TX

Phil Hainen, St. Albans, WV

Janet Hall, Virginia Beach, VA

Mark Hall, Maryville, TN

David Hamburger, Boston, MA

Carol Hamilton, Hillsborough, NC

Annette Hampton, San Jacinto, CA

W. David Hardy. MD, Los Angeles, CA

Lawrence Harris, Milwaukee, WI

Tige Harrison, Gainesville, FL

Richard Hassen, Los Angeles, CA

Paul Haugen, san franciscoq, CA

Elizabeth Hayden, Miami, FL

Robert Hegarty, Darlington, MD

Katharine Heika, Atlanta, GA

Otis Hemmings, Bronx, NY

Terry Hemphill, San Francisco, CA

Faith Henion, Portland, OR

Brian Henry, Charleston, WV

Wilsie Herlihy, Charleston, WV

Angel L Hernandez, Orocovis, PR

Mario Hernandez, Dallas, TX

Charles Hettinger, New York, NY

Francis Hill, Redford, MI

Cheryl Hockman, Augusta, WV

Lance Hogue, Severna Park, MD

Robert Holum, Oakland, CA

Louis Hornberger, San Francisco, CA

Susan Howell, Greenville, NC

Lisa Hudson, Fort Pierce, FL

Bob Huff, Lemon Grove, CA

Hope Hughes, Paris, TX

Joyce Hunter, Sunnyside, NY

Tabitha Hunter, Miami, FL

Thomas Hunter, Chicago, IL

Mallory Ignacio, San Jose, CA

Linda Infelise, Monroe, WA

Olga Irwin, Youngstown, OH

Edward Iwanicki, Groton, CT

Jay Izes, Bronx, NY

Edward Jackson, Anniston, AL

Goldman Jacobs, San Diego, CA

Alycia Johnaon, Candler, NC

AC Johnson, Leesburg, FL

Anthony Johnson, Fort Lauderdale, FL

Charles Johnson, Atlanta, GA

Kyle Johnson, Springdale, AR

Sean Johnson, New York, NY

T Johnson, Charleston, WV

Alice Jones, Greenwood, SC

Loren Jones, Berkeley, CA

Michael Jones, Pensacola, FL

Scott Jones, Ft. Worth, TX

Dorothy Juergensen, Indianapolis, IN

Robert Kacheroski, Minneapolis, MN

Patricia Kahn, New York, NY

Robert Kahn, Falls Church, VA

Kaleo Kaluhwia, santa cruz, CA

Drew Kawasaki, Boston, MA

Thomas Keane, Catskill, NY

Jennifer Keeler, West Branch, IA

Philip Keiser, Galveston, TX

Katherine Keller, Hayes, VA

Bruce Kellerhouse, New York, NY

Lisa Kelly, Sacramento, Ca

Tom Kelly, Cathedral City, CA

Don Kennedy, Fort Worth, TX

Steve Kerbow, Houston, TX

Kendall Kessel, Houston, TX

Ken Kidd, New York, NY

Frederick Kinney, New York, NY

Lily Kirsanow, Austin, TX

Marianne Kitson, Montgomery, NY

Brian Klein, San Francisco, CA

Elisa Klein, Chapel Hill, NC

Hilary Klein, Tacoma, WA

Thomas Klocke, Lawrence, KS

Robert Koehler, Atlanta, GA

Daniel Kopelson, Chicago, IL

Tricia Kroll, Washington, IA

Gary La Puma, Pollock Pines, CA

Wendy La Puma, Pollock Pines, CA

Charles Lacombe, Dorchester, MA

Beth Langer, Rapid City, SD

Teri Langholz, Sioux City, IA

Victoria Langston, Haltom City, TX

John Lantry, Hoboken, NJ

Scott Larned, Palm Springs, CA

Alex Laugen, Vancouver, WA

Bob Leavitt, Branford, CT

T.J. Lee, San Francisco, CA

Lonny LeFever, Conover, OH

Charles Lennox, Seattle, WA

Renondia Levy-Hite, Memphsi, TN

Lawrence Lewis, Saint Louis, MO

Mickey Lim, San Francisco, CA

Yuling Lin, San Carlos, CA

David Little, New Orleans, LA

Rebecca Litwiler, Sarasota, FL

Shanna Livermore, Pasadena, CA

Andrew Lopez, San Francisco, CA

Nelson Lopez, Houston, TX

Robin Lord Smith, Riva, MD

London Losey, St. Paul, MN

Susan Lucas, Buffalo, NY

Randall Lykens, Muncie, IN

Jon Markle, Raleigh, NC

Axel Marrero, Jersey City, NJ

Mary Marshall, Portland, OR

Ben Martinez, Dallas, TX

Leticia Martinez, Portland, OR

Valerie Martinez, Santa Fe, NM

Julio Mastro, Fresno, CA

Shanna Mattis, Atlanta, GA

Amy Mauk, Overland Park, KS

Tim McCarron, Miami, FL

Margaret McCarthy, NY, NY

Brian McCollum, Camden, NJ

Courtney McCrellias, Sioux City, IA

Joseph McDade, Ft. Lauderdale, FL

Jamie McDonald, Boise, ID

Jason McDonald, Powell, TN

Kimberly McDonald, Raleigh, NC

Edwin Mclaurin, Nashville, TN

Rachel McLean, Oakland, CA

Richard Meehan, Washington, DC

Gilberto Melo, Torrance, CA

Emily Mendes, Jupiter, FL

Mark Meyer, East Haddam, CT

Renee Meyers, Niceville, FL

Bobby Miller, San Francisco, CA

Sonji Miller, Chicago, IL

Veronica Miller, Washington, DC

George and Stephen Miller-Zauner, Glenoma, WA

Glenn Millett, Boston, MA

Mark Milton, Chicago, IL

Jaxon Mitchell, Portland, OR

Robert Modest, Chicago, IL

Cheryl Mogridge, Galveston, TX

Curtis Montgomery, Chicago, IL

Terrell Moody, Hoboken, GA

Herman Morales, Elmhurst, NY

Kelley Moreno, Auburn, CA

Rocio Moreno, El Paso, TX

Enrique Moresco, New Orleans, LA

Steve Moritz, Brooklyn, NY

Kevin Mork, Chicago, IL

James Moser, Miami, FL

Melissa Munoz, Woodland, CA

Elaine Nast, Santa Cruz, CA

John Nelson, Livingston Manor, NY

Barry Nevins, Guttenberg, NJ

John Newman, Sacramento, CA

Julie Newsome, Norfolk, VA

JD Nguyen, Tacoma, WA

Margaret Polino Nicholas, Gassaway, WV

Sylvia Niedner, Columbus, OH

Sara Nieuwoudt, Middlebury, VT

Mike Nofsinger, Tulsa, OK

Sarah Norton, Boise, ID

Juju Nsanze, New York, NY

Ramon Nunez III, Mount Vernon, NY

Kate S. O’Bannon, Baltimore, MD

Kelsey Ognibene, Charleston, WV

Mindy ONeill, Louisville, KY

Dominic Orlando, Lisle, IL

Linda Otero, York, PA

Chris Pagoota, New York, NY

Sandra Palleja MD, Bridgewater, NJ

Brian Palmer, Atlanta, GA

Scott Pando, San Francisco, CA

Steven Pejuan, Detroit, MI

Lawrence Wesley Perry, Mabelvale, AR

Susan Peterson, Henrietta, TX

Lois Petty, San Luis Obispo, CA

Thomas Phoenix, Bedminster, NJ

Shawn Picco, Seattle, WA

Jim Pickett, Chicago, IL

Guttenberg Pierre, Jr, St. Petersburg, FL

Jose Pineda, Clermont, FL

Laura Pinsky, New York, NY

Michael Pitkin, Pocatello, ID

David Plunkett, Rome, NY

Karyn Pomerantz, College Park, MD

Joseph Pool, Bull Shoals, AR

James Poppert, Omaha, NE

James Powell, Miami, FL

Naomi Prochovnick, San Francisco, CA

Mary Purcell, Stont Mountain, GA

Micah Qualls, Benton, AR

Willy Quesada, Bridgeport, CT

Demian Quesnel, San Francisco, CA

Stephen Raffanti, Nashville, TN

Deborah Rafter, Sacramento, CA

Jennifer Raiche, Woodland, CA

Lee Raines, New York, NY

Michael Emanuel Rajner, Fort Lauderdale, FL

Jigna Rao, Lawrenceville, NJ

Stacey Ravanesi, Oak Forest, IL

Zach Reau, Columbus, OH

eric reece, dallas, TX

Thomas Reed III, Washington, DC

Andrea Reedy, Indianapolis, IN

Leslie Reese, Nashville, TN

Beatrice Rehfus, Muncie, IN

Carol Renner, Morgantown, WV

Robert Reynolds, Lutz, FL

Stacy Reynolds, barboursville, WV

Terri Reynolds, Inglewood, CA

Walter Rich, San Francisco, CA

Bonnie Richardson, Chicago, IL

Betti Ridge, Bremerton, WA

Thomas Rieser, Narragansett, RI

Judith Rizzio, Portland, OR

Josh Robbins –, Nashville, TN

Eric Roberson, Chattanooga, TN

Jamie Roberts, Newnan, GA

Thomas Robertson, Graham, NC

Kevin Robinson, San Rafael, CA

Nadine Robinson, Pacifica, CA

Daniel Robison, West Hollywood, CA

Christine Rodriguez, Washington, DC

Eric Rodriguez, Woodland, CA

Robert Rogers, Little Rock, AR

Douglas Rose, Baltimore, MD

Dan Ross, Madison, WI

Jay Rouland, Oakland Park, FL

Susan Rubinstein, Easton, PA

Kathryn Ruiz, MSW, Oakland, CA

Maria Salazar, Lubbock, TX

Carol Salisbury, Lansing, MI

Stephen Sallis, San Diego, CA

Sue Saltmarsh, Chicago, IL

Elizabeth Samuels, Providence, RI

Paula Sanchez, Chicago, IL

Judith Sandeen, Hastings, NE

Simira Sanders, Woodland, CA

Victoria Sanders, Valdosta, GA

Marco Sandoval, Lawndale, CA

Luis Santiago, New York, NY

Jorge Santoscoy, Santa Ana, CA

Dudley Saunders, Los Angeles, CA

Jereme Scott, Houston, TX

Sonny Scroggins, Topeka, KS

Julie Seaver, LAKE WORTH, FL

Cathy Sencindiver, Martinsburg, WV

Debbie Sergi-Laws, Sarasota, FL

J Nathan Sherlock, Indianapolis, IN

Ed Sikov, New York, NY

Michael Silva, San Francisco, CA

Tacy Slater, Omaha, NE

Theo Smart, Xenia, OH

Jeffery Smith, Eastsound, WA

Kevin Smith, San Carlos, CA

Elizabeth Smolik, Boise, ID

Janet Soule, Harrisburg, NE

Bonetta Spratley, Sumter, SC

Ann Sprouse, Roanoke, VA

Carl Stein, San Francisco, CA

Haley Stolp, Atlanta, GA

Jason Stout, Chapel Hill, NC

Dan Sullivan, Livingston, MT

James Talley, pensacola, FL

Edward C Tarlow, Chicago, IL

Christopher Tarzia, Jersey city, NJ

Joe Tate, Castro Valley, CA

Brian Taylor RN,BSN,ACRN, Portland, OR

James Teahan, Fort Lauderdale, FL

Jessica Terlikowski, Chicago, IL

Shivani Thaker, Chicago, IL

Kelly Thibault, MIles City, MT

Patricia Thomas, Las Vegas, NV

Peter Thorsett, Oxford, OH

Thomas Tilkey, Dallas, TX

Tads Tobias, San Francisco, CA

Peter Toepfer, Chicago, IL

Jimmy Tong, San Francisco, CA

Paula Toynton, Charlotte, NC

David Tucker, Sherwood, AR

Lyndel Urbano, New York, NY

Michael Valdez, Chicago, IL

Dana Van Gorder, San Francisco, CA

Maximus Vargas, Lahiana, HI

Enid Vazquez, Chicago, IL

Roy Vazquez, Miami Gardens, FL

Sarah Venton, Chicago Heights, IL

Juan Villegas, New York, NY

Michael Vincent, Cool Ridge, WV

Giovanni Vitacolonna, Haddonfield, NJ

Alex Vitale, Portland, OR

Jay Vithalani, Somerville, MA

Sarah Walker, Baltimore, MD

Karen Walker, LPN, Paterson, NJ

Ken Warnock, Royal Oak, MI

Eddie Weathers, Reidsville, GA

Dale Weide RN, Napa, CA

Bethany Weikart, Atlanta, GA

Peggy Weil, asheville, NC

Laurie Wettstead, Chicago, IL

Paul Whitaker, Chubbuck, ID

Andrew Whitby, Landers, CA

Robert White, Saint Louis, MO

Kathy L Williams, PhD, Tulsa, OK

Michael Willis, Baltimore, MD

William Wilson, Highland Park, IL

Michael Wohlfeiler, Miami, FL

Jill Wolf, Oregon City, OR

Kathlean Wolf, Madison, WI

susan wolfson, New York, NY

Kevin Wood, Honolulu, HI

Mark Woodcock, Battleground, IN

Celeste Young, Fremont, CA

Valerie Young, San Diego, CA

Joy Zeh, Quinton, VA

Louis Zimmerman, Aurora, CO

Betty Zipkin, San Francisco, CA

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