Part C Allocation and Expenditure forms

Health Resources and Services Administration (HRSA)
HIV/AIDS Bureau (HAB)

12/31/2007

Instructions for Preparing:
Part C Grant Program Allocations Report
Part C Grant Program Expenditures Report
PUBLIC BURDEN STATEMENT: An agency may not conduct or sponsor, and a person is not required to respond to, a collection
of information unless it displays a currently valid OMB number. The OMB control number for this project is 0915-xxxx. Public
reporting burden for this collection of information is estimated to be 7 hours per response. These estimates include the time for
reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments to HRSA Reports Clearance Officer, Health Resources and Services
Administration, Room 10-33, 5600 Fishers Lane, Rockville, MD. 20857.

INTRODUCTION
Grantees that received a fiscal year Part C award under the Ryan White HIV/AIDS Treatment
Modernization Act must submit two reports to HRSA describing 1) how these funds were allocated and 2)
how these funds were spent.1 Grantees must submit an electronic copy of each report using the MS Excel
templates provided no later than the due dates shown below:
1) Part C Grant Program Allocations Report – due 60 days after grant is awarded.
2) Part C Grant Program Expenditures Report – due 90 days after budget period ends.

GETTING STARTED
1) Log into the HRSA Electronic Handbook (EHB): Log into the EHB to locate the report that is due.
2) File formats: Both report templates were created with Excel-XP, but can be opened using an earlier

version of Excel.
3) Open, rename and save the files: Open the file you wish to work on and save it using a name that

consists of your grant number, the fiscal year, and the report name (e.g. H76HA00624 FY08
Allocations Report.xls or H76HA00624 FY08 Expenditures Report.xls). This will enable HRSA to
distinguish and track your report submissions.
a. After you open the file, click on File on your toolbar and select Save As.
b. When the dialogue box opens, click on the drop-down button next to Save In and choose the
directory location and file folder where you want to store your file. If possible, choose a location on
a secure network that is automatically and routinely backed up.
c. Point and click in the File Name box to create a new name for your file, and when you are finished
click Save.
4) Familiarize yourself with the worksheets: The workbook contains two worksheets: The report that

you complete, which can be printed as one page, and a checklist of items that should be referenced
prior to submitting your report.
The “Freeze Frame” function is turned on in your worksheet. This means the column headings will
1

Please see the Conditions of Award attached to your Notice of Grant Award.

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Health Resources and Services Administration (HRSA)
HIV/AIDS Bureau (HAB)

12/31/2007

remain visible on the screen as you move down each column entering data. When you need to go
back to the top of the worksheet at any time, click on the up/down arrows on the right side of your
screen; or, use the up/down arrows on your keyboard. To move back and forth across the columns,
click on the right or left arrows at the bottom of your screen, or use the right/left arrows on your
keyboard.
When you open the file the first time, your cursor will most likely be at the top of the worksheet. If you
are not where you need to be, use the arrows to the right of your screen or on your keyboard to locate
the correct cell; then point and click in the cell. Once you begin entering data and save your file, the
next time you open it your cursor will be in the last place you were working when you saved the file.
5) Formatting, formulas, and data restrictions: Point and click or use the arrows on your keyboard to

move the cursor into the cell where you want to begin or continue entering data. Note the following:
a) The cells are already formatted for currency. For example, if you type in 100000 and hit the enter

b)
c)
d)
e)

key, it will appear as $100,000 on your screen. Use the decimal point only if the number is not a
whole dollar amount. Amounts are rounded to the nearest dollar.
Data cannot be entered in cells that contain formulas. Those cells will calculate percentages and
totals and cannot be changed.
Data cannot be entered in blocked-out cells. Data can only be entered in cells that are empty.
Percentages will be generated as you enter amounts in each column, but will be inaccurate until
ALL amounts are entered.
Do NOT leave any blank cells. If no funds were allocated to a service/activity, then enter zero (0).

ENTERING DATA
1) Allocations Report
a) In Section A, enter the name of the grantee, the grant number, the preparer’s name, the preparer’s

phone number, and the preparer’s email address.
b) In Section B, enter the amount of your total Part C grant award.
c) In Section C, in the column titled AMOUNT, enter the amount of the total award that was allocated

to each category listed in the first column. For definitions of service categories, see Appendix A.
Do not include funds from prior fiscal years. Those funds (referred to as “Carryover”) should only
be recorded in the Expenditures Report.
d) Prior to submitting your report, click on the worksheet titled CHECKLIST. You do not need to
complete this worksheet. It is provided so that you can check so see that you have met specific
legislative spending requirements.
2) Expenditures Report
a) In Section A, enter the name of the grantee, the grant number, the preparer’s name, the preparer’s

phone number, and the preparer’s email address.
b) In Section B, enter the amount of your total Part C grant award.
c) In Section C, in the column titled AMOUNT, enter the amount of the total award that was spent on

each category listed in the first column. For definitions of service categories, see Appendix A.
d) In Section C, in the column titled PRIOR FY CARRYOVER, enter the amount of the approved
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Health Resources and Services Administration (HRSA)
HIV/AIDS Bureau (HAB)

12/31/2007

carryover funds from the prior fiscal year that were spent on each category listed in the first
column.
e) Prior to submitting your report, click on the worksheet titled CHECKLIST. You do not need to
complete this worksheet. It is provided so that you can check so see that you have met specific
legislative spending requirements.
f) Unlike in the Allocations Report, the total expenditures are not required to match your total award.
However, your carryover total should equal the amount of the requested and approved carryover
funds.

REVIEWING AND SAVING YOUR WORK
1) Preview your worksheets: Click on File and select Print Preview. Use the Zoom on your toolbar for a

close-up view. When finished, click “Close” to return to the worksheet.
2) Save your files: It is a good idea to set the defaults in Excel so that a backup will be created

automatically when you save the file with any new information. To do that, click on Tools on the toolbar
and choose Options from the drop-down menu. When the dialogue box opens, click on the General
tab and select the Always create backup check box. Click OK, and then click Save. We also suggest
saving your file periodically as you work, in case of an unexpected power or system failure. Finally,
make sure you save the file before you close it each time.

HOW TO SUBMIT THE REPORTS
Log into HRSA’s Electronic Handbook (EHB) and upload your report.
https://grants.hrsa.gov/webexternal/Login.asp

HOW THIS DATA IS USED
The allocation and expenditure information reported by Part C grantees is used by HRSA to prepare an
annual Report to Congress on the Use of Part C Funds as required, as well as to respond to inquiries from
the Congress, Department of Health and Human Services, grantees, the media and the public-at-large.

MORE INFORMATION
If you need additional assistance or have questions about the allocations and expenditures reporting
requirements, please contact your project officer.

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Health Resources and Services Administration (HRSA)
HIV/AIDS Bureau (HAB)

12/31/2007

APPENDIX A: SERVICE CATEGORY DEFINITIONS
1) Core Services
a) Outpatient/Ambulatory medical care (health services) is the provision of professional diagnostic

b)

c)

d)

e)

f)

g)

and therapeutic services rendered by a physician, physician's assistant, clinical nurse specialist, or
nurse practitioner in an outpatient setting. Settings include clinics, medical offices, and mobile
vans where clients generally do not stay overnight. Emergency room services are not outpatient
settings. Services includes diagnostic testing, early intervention and risk assessment, preventive
care and screening, practitioner examination, medical history taking, diagnosis and treatment of
common physical and mental conditions, prescribing and managing medication therapy, education
and counseling on health issues, well-baby care, continuing care and management of chronic
conditions, and referral to and provision of specialty care (includes all medical subspecialties).
Primary medical care for the treatment of HIV infection includes the provision of care that is
consistent with the Public Health Service’s guidelines. Such care must include access to
antiretroviral and other drug therapies, including prophylaxis and treatment of opportunistic
infections and combination antiretroviral therapies. NOTE: Early Intervention Services provided by
Ryan White Part C and Part D Programs should be included here under Outpatient/ Ambulatory
medical care.
NOTE: Includes all costs associated with the provision of this service, including travel.
AIDS Drug Assistance Program (ADAP treatments) is a State-administered program authorized
under Part B of the Ryan White Program that provides FDA-approved medications to low-income
individuals with HIV disease who have limited or no coverage from private insurance, Medicaid, or
Medicare.
AIDS Pharmaceutical Assistance (local) includes local pharmacy assistance programs
implemented by Part A or Part B Grantees to provide HIV/AIDS medications to clients. This
assistance can be funded with Part A grant funds and/or Part B base award funds. Local
pharmacy assistance programs are not funded with ADAP earmark funding.
Note: Part C grantees should include funds for pharmaceuticals in this category.
Oral health care includes diagnostic, preventive, and therapeutic services provided by general
dental practitioners, dental specialists, dental hygienists and auxiliaries, and other trained primary
care providers.
Health Insurance Premium & Cost Sharing Assistance is the provision of financial assistance for
eligible individuals living with HIV to maintain a continuity of health insurance or to receive medical
benefits under a health insurance program. This includes premium payments, risk pools, copayments, and deductibles.
Home Health Care includes the provision of services in the home by licensed health care workers
such as nurses and the administration of intravenous and aerosolized treatment, parenteral
feeding, diagnostic testing, and other medical therapies.
Home and Community-based Health Services include skilled health services furnished to the
individual in the individual’s home based on a written plan of care established by a case
management team that includes appropriate health care professionals. Services include durable
medical equipment; home health aide services and personal care services in the home; day
treatment or other partial hospitalization services; home intravenous and aerosolized drug therapy
(including prescription drugs administered as part of such therapy); routine diagnostics testing
administered in the home; and appropriate mental health, developmental, and rehabilitation
services. Inpatient hospitals services, nursing home and other long term care facilities are NOT
included.

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Health Resources and Services Administration (HRSA)
HIV/AIDS Bureau (HAB)

12/31/2007

h) Hospice services include room, board, nursing care, counseling, physician services, and palliative

therapeutics provided to clients in the terminal stages of illness in a residential setting, including a
non-acute-care section of a hospital that has been designated and staffed to provide hospice
services for terminal clients.
i) Mental health services are psychological and psychiatric treatment and counseling services offered
to individuals with a diagnosed mental illness, conducted in a group or individual setting, and
provided by a mental health professional licensed or authorized within the State to render such
services. This typically includes psychiatrists, psychologists, and licensed clinical social workers.
j) Medical nutrition therapy is provided by a licensed registered dietitian outside of a primary care visit
and includes the provision of nutritional supplements. Medical nutrition therapy provided by
someone other than a licensed/registered dietitian should be recorded under psychosocial support
services.
k) Medical Case management services (including treatment adherence) are a range of clientcentered services that link clients with health care, psychosocial, and other services. The
coordination and follow-up of medical treatments is a component of medical case management.
These services ensure timely and coordinated access to medically appropriate levels of health and
support services and continuity of care, through ongoing assessment of the client’s and other key
family members’ needs and personal support systems. Medical case management includes the
provision of treatment adherence counseling to ensure readiness for, and adherence to, complex
HIV/AIDS treatments. Key activities include (1) initial assessment of service needs; (2)
development of a comprehensive, individualized service plan; (3) coordination of services required
to implement the plan; (4) client monitoring to assess the efficacy of the plan; and (5) periodic reevaluation and adaptation of the plan as necessary over the life of the client. It includes clientspecific advocacy and/or review of utilization of services. This includes all types of case
management including face-to-face, phone contact, and any other forms of communication.
l) Substance abuse services outpatient is the provision of medical or other treatment and/or
counseling to address substance abuse problems (i.e., alcohol and/or legal and illegal drugs) in an
outpatient setting, rendered by a physician or under the supervision of a physician, or by other
qualified personnel.
2) Support Services*
a) Case Management (non-Medical) includes the provision of advice and assistance in obtaining

b)

c)
d)
e)

medical, social, community, legal, financial, and other needed services. Non-medical case
management does not involve coordination and follow-up of medical treatments, as medical case
management does.
NOTE: Includes all costs associated with the provision of this service, including travel.
Health education/risk reduction is the provision of services that educate clients with HIV about HIV
transmission and how to reduce the risk of HIV transmission. It includes the provision of
information; including information dissemination about medical and psychosocial support services
and counseling to help clients with HIV improve their health status.
Linguistics services include the provision of interpretation and translation services.
Medical transportation services include conveyance services provided, directly or through voucher,
to a client so that he or she may access health care services.
Outreach services are programs that have as their principal purpose identification of people with
unknown HIV disease or those who know their status so that they may become aware of, and may
be enrolled in care and treatment services (i.e., case finding), not HIV counseling and testing nor
HIV prevention education. These services may target high-risk communities or individuals.

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Health Resources and Services Administration (HRSA)
HIV/AIDS Bureau (HAB)

12/31/2007

Outreach programs must be planned and delivered in coordination with local HIV prevention
outreach programs to avoid duplication of effort; be targeted to populations known through local
epidemiologic data to be at disproportionate risk for HIV infection; be conducted at times and in
places where there is a high probability that individuals with HIV infection will be reached; and be
designed with quantified program reporting that will accommodate local effectiveness evaluation.
f) Psychosocial support services are the provision of support and counseling activities, child abuse
and neglect counseling, HIV support groups, pastoral care, caregiver support, and bereavement
counseling. Includes nutrition counseling provided by a non-registered dietitian but excludes the
provision of nutritional supplements.
g) Referral for health care/supportive services is the act of directing a client to a service in person or
through telephone, written, or other type of communication. Referrals may be made within the nonmedical case management system by professional case managers, informally through support
staff, or as part of an outreach program.
h) Rehabilitation services are services provided by a licensed or authorized professional in
accordance with an individualized plan of care intended to improve or maintain a client’s quality of
life and optimal capacity for self-care. Services include physical and occupational therapy, speech
pathology, and low-vision training.
i) Respite care is the provision of community or home-based, non-medical assistance designed to
relieve the primary caregiver responsible for providing day-to-day care of a client with HIV/AIDS.
j) Treatment adherence counseling is the provision of counseling or special programs to ensure
readiness for, and adherence to, complex HIV/AIDS treatments by non-medical personnel outside
of the medical case management and clinical setting.
*Peer Positions should be budgeted and reported under the support services they provide (i.e. a peer
health liaison position would provide peer-based health education and should be reported under the Health
Education support service category.)

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