Slide #1 Using Data to Measure Performance in Public Health Programs: The Ryan White HIV/AIDS Program IOM Public Meeting #2 Committee to Review Data Systems for Monitoring HIV Care Faye E. Malitz, MS Director, Division of Science and Policy Department of Health and Human Services Health Resources and Services Administration HIV/AIDS Bureau
Why does HRSA/HAB have Data Slide #2 Collection & Reporting Requirements? HRSA/HAB collects & utilizes data to: Meet Federal reporting requirements established by Congress through statute Respond to congressional, Department of Health & Human Services, & other inquiries Assess the quality and outcomes of services funded by the Ryan White HIV/AIDS Program Appraise the performance of HRSA/HAB grantees and their providers; Evaluate the impact of the Program-funded services and policies Meet Federal grants management requirements 2
Overview of HRSA/HAB Data Reports Slide #3 Report Ryan White HIV/AIDS Program Services Report (RSR) AIDS Drug Assistance Program Quarterly/Annual Report (AQR) Part A Minority AIDS Initiative (MAI) Report Dental Services Report: Community-based Dental Partnership Program (CBDPP) and Dental Reimbursement Program (DRP) Allocations & Expenditure Reports (A&E) Ryan White HIV/ AIDS Program Part A, B, C, D, & F (MAI) B A F Unit of Analysis Grantee, provider, & clientlevel data ADAP Program & aggregate level client data MAI Program & aggregate level client data CBDPP Grantee and DRP applicant pre- & postdoctoral dental and dental hygiene education programs Reporting Period Annual Quarterly Annual Annual A, B, C & D Grantee Annual
Components of the Ryan White HIV/AIDS Program Services Report (RSR) Slide #4 Grantee Report includes: Grantee contact information Status of the grantee s Continuous Quality Management program (CQM) program List of all contracted service providers funded by the grantee including the types of services funded 4
Components of the Ryan White HIV/AIDS Program Services Report (RSR) Slide #5 Provider Report includes: Provider organizational characteristics Ownership status Status of the agency s clinical quality management program Types of services provided under contract Number of paid staff funded by the program HIV counseling and testing services provided 5
Slide #6 Components of the Ryan White HIV/AIDS Program Services Report (RSR) Client Report includes: Date of the first service visit at the provider s agency, Socio-demographic characteristics HIV/AIDS status Year AIDS diagnosis HIV/AIDS risk factor Date of death, if applicable Number of visits per quarter for each core medical service Receipt of AIDS Pharmaceutical Assistance (APA) program, HIP, and/or other support services
Slide #7 Components of the Ryan White HIV/AIDS Program Services Report (RSR) For clients receiving outpatient medical care, the client report documents: Receipt of risk reduction screening and counseling Date of first ambulatory care service at the provider agency Dates of all outpatient care visits to the provider agency Dates and results of all CD4 and viral load tests Receipt of PCP prophylaxis when medically indicated Prescribed HAART Screened for tuberculosis (TB) Screened for syphilis, hepatitis B, and hepatitis C in the reporting period or since HIV/AIDS diagnosis Assessed for substance abuse or mental health issues
Slide #8 HRSA/HAB Core Clinical Performance Measures Group 1 Measures ARV therapy for pregnant women CD4 T-cell count HAART Medical visits PCP prophylaxis Group 2 Measures Adherence assessment and counseling Cervical cancer screening Hepatitis B vaccination Hepatitis C screening HIV risk counseling Lipid screening Oral exam Syphilis screening Tuberculosis screening
Slide #9 HRSA/HAB Core Clinical Performance Measures Group 3 Measures Chlamydia screening Gonorrhea screening Hepatitis B screening Hepatitis/HIV alcohol counseling Influenza vaccination MAC prophylaxis Mental health screening Pneumococcal vaccination Substance use screening Tobacco cessation counseling Toxoplasma screening
Slide #10 Purpose: ADAP Quarterly Report (AQR) Monitor quarterly trends in ADAP utilization, funding, and expenditures Monitor grantee administrative policies related to program limits, cost-saving strategies, eligibility requirements, and certification/recertification of clients Monitor availability of ARVs and medications for the treatment of hepatitis B and hepatitis C Number of clients receiving the each drug at least once during the quarter Total costs for each drug purchased during the quarter
Slide #11 AQR Data Elements Client utilization by demographic characteristics Total number of unduplicated clients enrolled in ADAP at any time during the quarter: Total number of NEW clients enrolled in the ADAP Total number of unduplicated clients receiving at least one drug Total number of NEW clients receiving at least one drug Clients who received any type of insurance service (premiums, co-pays, deductibles) NEW clients who received any type of insurance service (premiums, co-pays, deductibles Total number of clients on HAART Clients served who are at less than 200 percent Federal Poverty Level (FPL)
Slide #12 Administrative processes: AQR Data Elements Program limits (e.g., enrollment caps, waiting list, capped expenditures, and drug-specific enrollment caps) Other program changes such as changes in income or medical eligibility standards, additions/deletions to program formularies Funding from sources other than the ADAP formula and supplemental grant award Expenditures for medications, dispensing and administrative costs, insurance premiums, co-pays and deductibles, ADAP Flexibility Policy Total drug costs and utilization for individual ARVs and hepatitis B and hepatitis C treatment medications
Part A Minority AIDS Initiative (MAI) Report Slide #13 Purpose of the report: Monitor how Part A grantees receiving MAI funding plan to use the funds Monitor and document program outcomes achieved through planned activities
Slide #14 Part A Minority AIDS Initiative (MAI) Report Components Using a web-based reporting systems grantees provide: Total MAI grant award amount Funds allocated/spent for grantee administration Total amount allocated for each service category Racial/ethnic communities to whom each service directed For each service provided to each racial/ethnic community: Amount budgeted/spent, including carryover from prior fiscal years Service unit definition Planned/actual service units provided Planned/actual total unduplicated number of clients Planed/actual unduplicated number of women, youth, children and infants
Slide #15 Community-Based Dental Partnership Program (CBDPP) & Dental Reimbursement Program (DRP) Dental Services Report Purpose of the report: Monitor client utilization of CBDPP and DRP services Monitor funding and payment coverage Assess staffing and training among CBDPP grantees and DRP applicants Determine unreimbursed costs for DRP applicants
Slide #16 Dental Services Report Data Elements Both CBDPP grantees and DRP applicants report: number of patients served patient demographics financial, and clinical data number and type of oral health services provided funding and payment coverage DRP applicant report: unreimbursed costs methods used to calculate unreimbursed funds.
Slide #17 Allocation and Expenditure (A & E) Reports Purpose of the report: Determine how grantees plan to allocate funds across service categories Monitor how funds are spent by service category Monitor Part A, Part B, and Part C grantee allocation and expenditures to assure adherence to the legislative requirement that 75 percent of funding must be used for core medical services
Slide #18 Allocation and Expenditure (A & E) Reports Type of data reported: Allocation report data include: grantee contact information amount of total grant award amount of the award allocated for each service category Expenditure report data include: grantee contact information amount of the total award & approved carryover expended amount of the award expended for each service
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Slide #20 Contact Information Faye Malitz Director, Division of Science and Policy HIV/AIDS Bureau 301-443-3259 fmalitz@hrsa.gov www. hab.hrsa.gov