HAB Client-Level Data Collection System

RYAN WHITE HIV/AIDS PROGRAM SERVICES REPORT
INSTRUCTION MANUAL
VERSION 1.2

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 control number. The OMB
control number for this project is ####-####, and the expiration date is mm/dd/yyyy. Public reporting
burden for this collection of information is estimated to average ## hours per respondent annually,
including 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 regarding
this burden estimate or any other aspect of this collection of information, including suggestions for
reducing this burden, to HRSA Reports Clearance Officer, 5600 Fishers Lane, Room 10-33, Rockville,
Maryland, 20857.

HIV/AIDS Bureau
Division of Science and Epidemiology
Health Resources and Services Administration
U.S. Department of Health and Human Services
5600 Fishers Lane, Room 7-90
Rockville, MD 20857

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TABLE OF CONTENTS
INTRODUCTION ......................................................................................................... 1 
ABOUT THE RYAN WHITE HIV/AIDS PROGRAM SERVICES REPORT ................................. 2 
Who is the grantee of record? ...................................................................................... 2 
Who is The service provider? ....................................................................................... 2 
What are the reporting periods? ................................................................................... 3 
Which services are reported in the RSR? .................................................................... 3 
1. Administrative and Technical Services.................................................................. 3 
2. Core Medical Services .......................................................................................... 4 
3. Support Services ................................................................................................... 6 
4. HIV Counseling and Testing Services ................................................................... 8 
How is the RSR submitted to hAB?.............................................................................. 9 
THE GRANTEE REPORT ............................................................................................10 
Grantee Information ................................................................................................... 10 
Providers Funded by Your Grant................................................................................ 11 
Providers Funded through Your Fiscal Intermediaries ............................................... 13 
THE SERVICE PROVIDER REPORT ..............................................................................15 
Provider Information ................................................................................................... 15 
HIV Counseling and Testing....................................................................................... 20 
THE CLIENT REPORT ................................................................................................22 
Reporting Client-level Data ........................................................................................ 22 
Submitting Client-level Data to HAB........................................................................... 23 
Client-level Data Fields .............................................................................................. 23 
System Variables .................................................................................................... 23 
Client Demographics ............................................................................................... 24 
Core Services.......................................................................................................... 28 
Support services...................................................................................................... 29 
Clinical Information.................................................................................................. 30 
APPENDIX A: REQUIRED CLIENT-LEVEL DATA ELEMENTS FOR RWHAP ELIGIBLE
SERVICES .................................................................................................................... 35 
GLOSSARY ..............................................................................................................38 
INDEX IN DEVELOPMENT ............................................................................................43 

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INTRODUCTION
The Ryan White HIV/AIDS Treatment Modernization Act of 2006 (Public Law 109-415,
December 19, 2006) provides the Federal HIV/AIDS programs in the Public Health Service
(PHS) Act under Title XXVI flexibility to respond effectively to the changing epidemic. Its
emphasis is on providing life-saving and life-extending services for people living with HIV/AIDS
across the country, and resources to targeted areas with the greatest need.
All Program Parts of the Ryan White HIV/AIDS Program (RWHAP) specify the Health
Resources and Services Administration’s (HRSA) responsibilities in the administration of grant
funds, the allocation of funds, the evaluation of programs for the population served, and the
improvement of the quality of care. Accurate records of the providers receiving RWHAP funding,
the services provided, and the clients served continue to be critical to the implementation of the
legislation and thus are necessary for HRSA to fulfill its responsibilities.
Previously, the HIV/AIDS Bureau (HAB) required that all RWHAP-funded grantees and their
contracted service providers report aggregate data annually using the Ryan White HIV/AIDS
Program Annual Data Report (RDR). However, aggregate data are limited in two ways:
•

•

Aggregate data lacks client identifiers and, by definition, cannot be merged and
unduplicated across service providers within a given geographic area. As a result,
grantees—and ultimately HAB—cannot obtain accurate counts of the number of
individuals the RWHAP serves.
Aggregate data cannot be analyzed in the detail required to assess quality of care, or
to sufficiently account for the use of RWHAP funds.

In order to address these deficiencies RWHAP grantees and service providers will use a new
biannual data reporting system to report information to HAB on their programs and the clients
they serve, beginning in 2009.
HAB’s goal is to build a client-level data reporting system that provides data on the
characteristics of the funded grantees, their service providers, and the clients served with
program funds. The data submitted to HRSA/HAB will be used for monitoring the outcomes
achieved on behalf of HIV/AIDS clients and their impacted families receiving care and treatment
through a Ryan White HIV/AIDS Program grantees and/or providers; monitoring the use of Ryan
White HIV/AIDS Program funds for the appropriate use to address the HIV/AIDS epidemic in the
United States; and addressing to the needs and concerns of U.S. Congress and the DHHS
Secretary concerning the HIV/AIDS epidemic and the Ryan White HIV/AIDS Program.
A Note about the Ryan White HIV/AIDS Program Data Report
HAB expects all grantees and providers to submit a 2009 Ryan White HIV/AIDS Program
Annual Data Report (RDR) during the transition to client-level reporting. For additional
information about the RDR, visit: http://datasupport.hab.hrsa.gov

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ABOUT THE RYAN WHITE HIV/AIDS PROGRAM SERVICES REPORT
The Ryan White HIV/AIDS Program Services Report (RSR) includes three components: the
Grantee Report, the Service Provider Report, and the Client Report.
The Grantee Report collects basic information about the grantee organization and the service
provider contracts that it funded during the reporting period. This report is completed by all
RWHAP Part A, Part B, Part C, Part D (including the Adolescent Initiative), and Part F (MAI)—
also referred to as Part A MAI and Part B MAI—funded grantees.
The Service Provider Report collects basic information about both the service provider agency
and the services it delivered under each of its RWHAP contracts. This report is completed by all
RWHAP service providers.
Note: Third-party administrators that process fee-for-service reimbursements to providers of
eligible services are considered a “service provider” and should report all services paid for with
RWHAP funds in the Service Provider Report.

The Client Report (client-level data) collects one de-identified record for each RWHAP client
served. Each record will include information on demographic status, HIV clinical information,
HIV-care medical and support services received at the service provider, and the client’s
encrypted unique identifier. This report is completed by all service providers that deliver—or, in
the case of third party administrators, pay for— direct client services with RWHAP funds.
Note: For the first two RSR reporting periods (January–June 2009 and January–December
2009), only service providers receiving RWHAP funds to provide outpatient/ambulatory
medical care and/or case management services (medical or non-medical) will be required to
submit a Client Report.

WHO IS THE GRANTEE OF RECORD?
The grantee of record is the official RWHAP grantee that receives Federal funding directly from
HRSA. This agency may be the same as the provider agency or may be the agency that
contracts with other agencies to provide RWHAP services.

WHO IS THE SERVICE PROVIDER?
The service provider is the agency that provides direct services to:
1. Clients and their affected family members; and/or
2. Grantees of record (e.g., Administrative and Technical Services providers).
Service providers may be directly funded through one or more Program Parts, through
subcontract(s) with official RWHAP grantees of record, or through a fiscal intermediary (an
administrative agent of the grantee of record).

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WHAT ARE THE REPORTING PERIODS?
Grantees are required to submit two RSRs:
•
•

An interim report for the period January 1 through June 30; and
An annual report for the period January 1 through December 31.

WHICH SERVICES ARE REPORTED IN THE RSR?
Grantees will report services funded under each service provider contract. Meanwhile, service
providers will report on the services delivered to clients and/or grantees. The services are
divided into four groups:
1.
2.
3.
4.

Administrative and Technical Services;
Core Medical Services;
Support Services; and
HIV Counseling and Testing Services.

1. Administrative and Technical Services
Planning or evaluation services is the systematic (orderly) collection of information about the
characteristics, activities, and outcomes of services or programs in order to assess the extent to
which objectives have been achieved, to identify needed improvements, and/or to make
decisions about future programming.
Administrative or technical support services is the provision of qualitative and responsive
“support services” to an organization. Services may include human resources, financial
management, and administrative services (e.g., property management, warehousing,
printing/publications, libraries, claims, medical supplies, and conference/training facilities).
Fiscal intermediary services is the provision of administrative services to the grantee of record
by a pass-through organization. The responsibility of these organizations may include the
following: determine the eligibility of RWHAP recipients; decide how funds are allocated to
recipients; award RWHAP funds to recipients; monitor recipients for compliance with RWHAP
specific requirements; and complete required reports.
Other fiscal services is the receipt or collection of reimbursements on behalf of health care
professionals for services rendered or other related fiduciary services pursuant to health care
professional contracts.
Technical assistance services is identifying the need for and the delivery of practical program
and technical support to the RWHAP community. These services should help grantees,
planning bodies, and affected communities to design, implement, and evaluate RWHAPsupported planning and primary care service delivery systems.
Capacity development services are a set of core competencies that contribute to an
organization’s ability to develop effective HIV health care services, including the quality,
quantity, and cost-effectiveness of such services. These competencies also sustain the
infrastructure and resource base necessary to develop and support these services. Core
competencies include: management of program finances; effective HIV service delivery,
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including quality assurance; personnel management and board development; resource
development, including preparation of grant applications to obtain resources and purchase of
supplies/equipment; service evaluation; and cultural competency development.
Quality management services is a systematic process with identified leadership,
accountability, and dedicated resources that uses data and measurable outcomes to determine
progress toward relevant, evidence-based benchmarks. Quality management programs should
focus on linkages, efficiencies, and provider and client expectations in addressing outcome
improvement, and need to be adaptive to change. The process is continuous and should fit
within the framework of other program quality assurance and quality improvement activities,
such as the Joint Commission on the Accreditation of Healthcare Organizations and Medicaid.
Data collected as part of this process should be fed back into the quality management process
to assure that goals are accomplished and outcomes are improved.
Quality management is a continuous process to improve the degree to which a health or social
service meets or exceeds established professional standards and user expectations. The
purpose of a quality management program is to ensure that: (a) services adhere to PHS
guidelines and established clinical practice; (b) program improvements include supportive
services; (c) supportive services are linked to access and adherence to medical care; and (d)
demographic, clinical, and utilization data are used to evaluate and address characteristics of
the local epidemic.

2. Core Medical Services
Core medical services are a set of essential, direct health care services provided to persons
living with HIV/AIDS and specified in the Ryan White HIV/AIDS Treatment Modernization Act.
Outpatient/ambulatory medical care includes the provision of professional diagnostic and
therapeutic services rendered by a physician, physician 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
considered outpatient settings. Services include 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 PHS’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 are
reported under outpatient/ambulatory medical care.

Local AIDS pharmaceutical assistance (APA, not ADAP) are local pharmacy assistance
programs implemented by Part A, B, or C. The Part B grantee consortium or Part A planning
council contracts with one or more organizations to provide HIV/AIDS medications to clients.
These organizations may or may not provide other services (e.g., primary care or case
management) to the clients that they serve through a RWHAP contract with their grantee.

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Programs are considered APAs if they provide HIV/AIDS medications to clients and meet all of
the following criteria:
•
•
•
•

Have a client enrollment process;
Have uniform benefits for all enrolled clients;
Have a record system for distributed medications; and
Have a drug distribution system.

Programs are not APAs if they dispense medications in one of the following situations:
•
•
•

As a result or component of a primary medical visit;
On an emergency basis (defined as a single occurrence of short duration); or
By giving money or cash vouchers to a client to procure medications.

Local APAs are similar to AIDS Drug Assistance Programs (ADAPs) in that they provide
medications for the treatment of HIV disease. However, local APAs are not paid for with Part B
funds “earmarked” for ADAP.
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.
Early intervention services for Parts A and B include counseling individuals with respect to
HIV/AIDS; testing (including tests to confirm the presence of the disease, tests to diagnose the
extent of immune deficiency, and tests to provide information on appropriate therapeutic
measures); referrals; other clinical and diagnostic services regarding HIV/AIDS; periodic
medical evaluations for individuals with HIV/AIDS; and provision of therapeutic measures.
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, co-payments, and deductibles.
Home health care is 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 includes 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.
Note: Inpatient hospital services, nursing homes, and other long-term care facilities are not
included.

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Hospice services is end-of-life care provided to clients in the terminal stage of an illness. It
includes room, board, nursing care, counseling, physician services, and palliative therapeutics.
Services may be provided in a residential setting, including a non-acute-care section of a
hospital that has been designated and staffed to provide hospice services.
Mental health services are psychological and psychiatric treatment and counseling services
for individuals with a diagnosed mental illness. These services are 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.
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.
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 followup 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 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 client-specific advocacy and review of utilization of services. This includes all types of
case management including face-to-face, phone contact, and any other forms of
communication.
Substance abuse service (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 by a physician or under the supervision of a physician, or by other qualified
personnel.

3. Support Services
Support services are a set of services needed to achieve medical outcomes that affect the HIVrelated clinical status of a person living with HIV/AIDS.
Case management services (non-medical) include the provision of advice and assistance in
obtaining medical, social, community, legal, financial, and other needed services. Non-medical
case management does not involve coordination and followup of medical treatments.
Child care services is the provision of care for the children of clients who are HIV-positive
while the clients are attending medical or other appointments or attending RWHAP-related
meetings, groups, or training. This does not include child care while the client is at work.
Pediatric developmental assessment and early intervention services are the provision of
professional early interventions by physicians, developmental psychologists, educators, and
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others in the psychosocial and intellectual development of infants and children. These services
involve the assessment of an infant or a child’s developmental status and needs in relation to
the education system, including early assessment of educational intervention services. They
include comprehensive assessment, taking into account the effects of chronic conditions
associated with HIV, drug exposure, and other factors. Provision of information about access to
Head Start services, appropriate educational settings for HIV-affected clients, and
education/assistance to schools also should be reported in this category.
Note: Only Part D programs are eligible to provide pediatric developmental assessment and
early intervention services.

Emergency financial assistance is the provision of short-term payments to agencies or the
establishment of voucher programs to assist with emergency expenses related to essential
utilities, housing, food (including groceries, food vouchers, and food stamps), and medication,
when other resources are not available. Part A and Part B programs must allocate, track, and
report these funds under specific service categories as described under 2.6 in DSS Program
Policy Guidance No. 2 (formerly Policy No. 97-02).
Food bank/home-delivered meals is the provision of actual food or meals. It does not include
finances to purchase food or meals, but may include vouchers to purchase food. The provision
of essential household supplies, such as hygiene items and household cleaning supplies, also
should be included in this item.
Health education/risk reduction is the provision of services that educate clients living with HIV
about HIV transmission and how to reduce the risk of HIV transmission. It includes the provision
of information about medical and psychosocial support services and counseling to help clients
living with HIV improve their health status.
Housing services is the provision of short-term assistance to support emergency, temporary,
or transitional housing to enable an individual or family to gain or maintain medical care.
Housing-related referral services include assessment, search, placement, advocacy, and the
fees associated with them. Eligible housing can include both housing that does not provide
direct medical or supportive services and housing that provides some type of medical or
supportive services, such as residential mental health services, foster care, or assisted living
residential services.
Legal services is the provision of services to individuals with respect to powers of attorney, donot-resuscitate orders, and interventions necessary to ensure access to eligible benefits,
including discrimination or breach of confidentiality litigation as it relates to services eligible for
funding under the Ryan White HIV/AIDS Program.
Note: these services do not include any legal services to arrange for guardianship or adoption
of children after the death of their normal caregiver.

Medical transportation services are 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 (i.e., case finding) so that they may
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become aware of, and may be enrolled in, care and treatment services. Outreach services do
not include HIV counseling and testing or HIV prevention education. These services may target
high-risk communities or individuals. 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.
Permanency planning is the provision of services to help clients/families make decisions about
the placement and care of minor children after the parents/caregivers are deceased or are no
longer able to care for them.
Psychosocial support services is the provision of support and counseling activities, child
abuse and neglect counseling, HIV support groups, pastoral care, caregiver support, and
bereavement counseling. It includes nutrition counseling provided by a non-registered dietitian,
but it excludes the provision of nutritional supplements.
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 non-medical case management system by professional case managers, informally
through support staff, or as part of an outreach program.
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.
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 living with
HIV/AIDS.
Substance abuse services (residential) is the provision of treatment to address substance
abuse problems (including alcohol and/or legal and illegal drugs) in a residential health service
setting (short-term).
Note: Part C programs are not eligible to provide substance abuse services (residential).

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.

4. HIV Counseling and Testing Services
The delivery of HIV counseling and testing may include antibody tests, rapid tests, ELISA, and
Western Blot administered by health professionals to determine and confirm the presence of
HIV infection. HIV counseling may include discussions of the benefits of testing, including the
medical benefits of diagnosing HIV disease in the early stages and of receiving early
intervention primary care; legal provisions relating to confidentiality, including information about
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any disclosures authorized under applicable law; the availability of anonymous counseling and
testing; and the significance of the results, including the potential for developing HIV disease.
Counseling and testing do not include tests to measure the extent of the deficiency in the
immune system, because these tests are fundamental components of comprehensive primary
care. This service category also excludes mental health counseling/therapy, substance abuse
counseling/treatment, and psychosocial support services. These services are listed separately.
HIV counseling and testing are funded as components of Early Intervention Services for Parts A
and B. HIV counseling and testing are required components of a Part C program. Part D funds
may be used to support these services.

HOW IS THE RSR SUBMITTED TO HAB?
Grantee Report. HRSA requires grantees to submit post-award reports, including the RSR,
online using the HRSA Electronic Handbooks (EHBs), a Web-based grants administration
system. The EHBs are located at https://grants.hrsa.gov/webexternal.
Service Provider Report. Service providers will complete this report online. Service providers
that also are grantees of record (receive funding directly from HAB) will access and submit this
report online through the EHBs (https://grants.hrsa.gov/webexternal). All other service providers
will access and submit the RSR through the RSR Web system at
https://performance.hrsa.gov/hab/RegLoginApp/Admin/Login.aspx.
Navigating the RSR Reporting System
Navigation buttons appear at the bottom of each page of the online forms within the RSR
system. Use the “Next” and “Previous” buttons to save any edits you have made in one or
more fields and to navigate forward and backwards through the report. The “Save” button will
save your edits without changing the page. Use the “Cancel” button to undo any edits you
have made to one or more fields since the last save.

Client Report (client-level data). Service providers will submit this report as an electronic
upload file using a standard XML format from within the provider report. For additional
information, see “Submitting Client-level Data to HAB” on page 23.

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THE GRANTEE REPORT
Each grantee of record will complete a separate grantee report for each RWHAP grant it
receives from HRSA. For example, an agency with only a Part C grant will complete one
grantee form; an agency with a Part C and a Part D grant will complete two grantee forms—one
for its Part C grant and another for its Part D grant.

GRANTEE INFORMATION
If the information is available to HAB, selected items will be prepopulated in the Grantee Report.
Items that are “display only” are prepopulated and cannot be modified directly within the RSR.
Instead, the grantee must update these items in the EHBs.
1.

Grantee of record address (display only):
This item shows the grantee address
information stored in the Electronic
Handbooks (EHBs). To edit this information,
grantees need to update their agency
information in the EHBs.

2.

DUNS number (display only):
This item shows the DUNS number of the
grantee of record that is stored in the EHBs.
To edit this information, grantees need to
update their agency information in the EHBs.

3.

Contact information of person
completing this form (display only):
This item shows the contact information
stored in the EHBs for the person
completing this form. To edit this
information, grantees must update their user
information in the EHBs.

4.

Select the status of your agency’s clinical
quality management program for
assessing HIV health services. (Select only
one.)
Every RWHAP is required to have a clinical
quality management program to assess the
extent to which HIV health services provided
to patients by medical providers and/or
medical case managers under the grant are
consistent with the most recent Public Health
Service guidelines for the treatment of
HIV/AIDS. (For further information on quality
management of the RWHAP, refer to the
Technical Assistance Manual available at
http://hab.hrsa.gov/tools.htm.)
Indicate whether your agency:
• has established a new program to
manage the clinical quality of RWHAP
services during the reporting period;
•

has a previously established clinical
quality management program; or

•

has recently updated an existing program
with new quality standards.

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FIGURE 1. RSR Grantee Report Online Form
Screenshot of the "Grantee Information" Section

Once you’ve updated, entered, and/or verified the data on the Grantee Information page, select
the “Next” button to save the data and advance to the next page in the Grantee Report,
“Providers Funded by Your Grant.”

PROVIDERS FUNDED BY YOUR GRANT
Grantees will view, update, and verify a list of their service provider contracts that were active
during the reporting period. For the purpose of the Ryan White Data Report, contracts include
formal contracts, memoranda of understanding, or other agreements. A service provider
contract that was active during the reporting period is a contract under which:
1. Services were delivered by the service provider during the reporting period; and/or
2. Any portion of the contract period falls within the reporting period.

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FIGURE 2. RSR Grantee Report Online Form
Screenshot of the "Providers Funded by Your Grant" Section

Review the list of service provider contracts that were active during the given reporting period. If
a contract is missing from the list, add the new provider contract using the ADD PROVIDER
CONTRACT link located beneath the table on the left side of the screen. This link will open a
second browser window with a search form that can be used to select a provider from a
RWHAP provider directory. If the service provider you have contracted with is not listed in the
directory, contact Ryan White Data Support to have the provider added to the directory in the
RSR system. To remove a provider contract, click the Remove icon next to the provider’s name.
After reviewing and updating your provider contract list. Verify the contact information for your
providers. To edit a provider’s address, select the “Edit” icon. This link will open another browser
window where you can update the providers contact information.
Next, verify your providers’ contract information by reviewing the data in the following fields. The
data in these fields may be edited at anytime.
•

•
•

Contract Reference (optional): An optional feature that you may want to use if you
have multiple contracts with one of your service providers under a single grant. You
can assign a contract reference number (or name) for each of the contracts to make
it easier for you and your provider to identify each particular contract.
Contract Start and End Date: Enter the start date and end date of the selected
contract. Keep in mind that the contract period may begin before and/or extend
beyond the reporting period dates.
Amount: Enter the total amount of funding allocated for the selected contract.

For each contract, grantees are required to specify the services the provider is authorized to
deliver under the contract. Select the “Services” link to open another screen (see Figure 3).
Select all of the services the agency has been contracted to provide under this agreement. After

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saving the services pages, simply close the browser window to return to the “Providers Funded
by Your Grant” page of the Grantee Report.

FIGURE 3. RSR Grantee Report Online Form
Screenshot of Core Medical Services List

After reviewing and updating, if necessary, the information for each contract, check the box in
the “Completed” column (see Figure 2). Select the “Next” button to save the data and advance
to the final page in the Grantee Report, “Providers Funded Through Your Fiscal Intermediaries.”

PROVIDERS FUNDED THROUGH YOUR FISCAL INTERMEDIARIES
Grantees have a responsibility to monitor all recipients of their RWHAP funds to ensure
agencies are using the funds in accordance with program requirements. Grantees of record that
contract with another agency to provide fiscal intermediary services (i.e., that use another
organization to award and/or monitor the use of its RWHAP funds) are responsible for
submitting the list of the service provider contracts funded by its grant through a fiscal
intermediary (FI) service provider. For each contract awarded by a fiscal intermediary service
provider, grantees will indicate the services that their Program Part funded under that contract.

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FIGURE 4. RSR Grantee Report Online Form
Screenshot of the "Providers Funded through your Fiscal Intermediaries" Section

To update the list of providers funded through your fiscal intermediaries:
Select a contract for fiscal intermediary services from the list box near the top of the page. The
list of providers contracts will change based on your selection and the provider funded through
the selected FI service contract will be listed.
Review and update the service provider contracts under the selected FI provider to ensure that
all contracts that were active during the reporting period are listed. For the purpose of the Ryan
White Data Report, contracts include formal contracts, memoranda of understanding, or other
agreements. A service provider contract that was active during the reporting period is a contract
under which:
•
•

Services were delivered by the service provider during the reporting period; and/or
Any portion of the contract period falls within the reporting period.

If a contract is missing from the list, add the new provider contract using the ADD PROVIDER
CONTRACT link located beneath the table on the left side of the screen. This link will open a
second browser window with a search form that can be used to select a provider from a
RWHAP provider directory. If the service provider you have contracted with is not listed in the
directory, contact Ryan White Data Support to have the provider added to the directory in the
RSR system. To remove a provider contract, click the Remove icon next to the provider’s name.
After reviewing and updating your provider contract list. Verify the contact information for your
providers. To edit a provider’s address, select the “Edit” icon. This link will open another browser
window where you can update the providers contact information.
Next, verify your providers’ contract information by reviewing the data in the following fields. The
data in these fields may be edited anytime.
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•

•
•

Contract Reference (optional): An optional feature that you may want to use if you
have multiple contracts with one of your service providers under a single grant. You
can assign a contract reference number (or name) for each of the contracts to make
it easier for you and your provider to identify each particular contract.
Contract Start and End Date: Enter the start date and end date of the selected
contract. Keep in mind that the contract period may begin before and/or extend
beyond the reporting period dates.
Amount: Enter the total amount of funding allocated for the selected contract.

For each contract, grantees are required to specify the services the provider is authorized to
deliver under the contract. Select the “Services” link to open another browser window with the
list RWHAP-eligible (see Figure 3). Select all of the services the agency has been contracted to
provide under this agreement. After saving the services pages, simply close the browser
window to return to the “Providers Funded by Your Grant” page of the Grantee Report.
After review and updating, if necessary, all information for each contract, check the box in the
“Completed” column (see Figure 4). Select the “Save” button to save the data and then close
the Grantee Report.
Note: The Grantee Report cannot be submitted to HAB until all of the grantee’s providers have
successfully submitted their Provider and Client–level reports (if applicable).

THE SERVICE PROVIDER REPORT
All agencies that provide direct services to clients and their affected family members and/or
grantees of record will submit a Provider Report online. The report includes information from all
program Parts under which the agency is funded.

PROVIDER INFORMATION
If the information is available to HAB, selected items will be prepopulated in the Provider Report.
Items that are “display only” are prepopulated and cannot be modified directly within the Ryan
White Services Reporting System (RSR System).

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FIGURE 5. RSR Provider Report Online Form
Screenshot of Provider Information Section (Questions 1–7)

1.

2.

3.

Provider Address
To edit this information, providers need to
update their agency profile in the RSR
System. Grantees that also are service
providers should update their agency profiles
in both the EHBs and the RSR System.
Contact information of person completing
this form
To edit this information, providers need to
update their user profile in the RSR System.
Grantees that also are service providers
should update their user profiles in both the
EHBs and the RSR System.
Provider Type (select only one):
Select the provider type that best describes
the agency. If “Other facility” is selected, you
must provide a description.
Hospital or university-based clinic includes
ambulatory/outpatient care departments or
clinics, emergency rooms, rehabilitation
facilities (physical, occupational, speech),
hospice programs, substance abuse treatment
programs, sexually transmitted diseases
(STD) clinics, HIV/AIDS clinics, and inpatient
case management service programs.

Publically funded community health center
includes community health centers, migrant
health centers, rural health centers, and
homeless health centers.
Publicly funded community mental health
center is a community-based agency, funded
by local, State, or Federal funds, that provides
mental health services to low-income people.
Other community-based service
organization (CBO) includes non-hospitalbased organizations, AIDS service and
volunteer organizations, private nonprofit
social service and mental health
organizations, hospice programs (home and
residential), home health care agencies,
rehabilitation programs, substance abuse
treatment programs, case management
agencies, and mental health care providers.
Health department includes State or local
health departments.
Substance abuse treatment center is an
agency that focuses on the delivery of
substance abuse treatment services.

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Public/state is an organization funded
by a State government entity and
operated by State government
employees. A State health department
is an example of a State publicly owned
organization.

Solo/group private medical practice
includes all health and health-related private
practitioners and practice groups.
Agency reporting for multiple fee-forservice providers is an agency that reports
data for more than one fee-for-service
provider (e.g., State operating a
reimbursement pool).

Public/federal is an organization
funded by the Federal government and
operated by Federal Government
employees. A Federal agency is an
example of a Federal publicly owned
organization.

PLWHA coalition includes organizations of
People Living with HIV/AIDS (PLWHA) that
provide support services to individuals and
families affected by HIV and AIDS.

Private, nonprofit is an organization
owned and operated by a private, not
for-profit, non-religious-based entity,
such as a nonprofit health clinic.

VA facility is a facility funded through the
United States Department of Veterans
Affairs.
4.

5.

Did your organization receive funding
under Section 330 of the Public Health
Service Act (PHSA) (funds Community
Health Centers, Migrant Health Centers,
and Healthcare for the Homeless)?
Indicate (yes, no, unknown) if you received
funding under Section 330 of the Public
Health Service Act (PHSA) during the
reporting period. Section 330 of the PHSA
supports the development and operation of
community health centers that provide
preventive and primary health care services,
supplemental health and support services,
and environmental health services to
medically underserved areas/populations.

Private, for-profit is an organization
owned and operated by a private entity,
even though the organization may
receive government funding. A privately
owned hospital is an example of a
private, for-profit organization.
Other facility includes facilities other than
those listed above.
Unincorporated is an agency that is not
incorporated. Other is an agency other than
those listed above.
b. For private, nonprofit organizations
only: Is your organization faith-based?
If you selected “private, nonprofit” as the
ownership status, indicate if your agency
received funding as a faith-based
organization (that is, one operated by a
religiously affiliated entity, such as a Catholic
hospital).

Ownership Status
a. Type of ownership (select only one):
Select the category that best describes
your agency’s ownership status.
Public/local is an organization funded
by a local government entity and
operated by local government
employees. Local health departments
are examples of local publicly owned
organizations.
Public/state is an organization funded
by a State government entity and
operated by State government
employees. A State health department is
an example of a State publicly owned
organization.

6.

During this reporting period, did your
organization receive Minority AIDS
Initiative (MAI) funds?
Indicate (yes, no, unknown) whether your
organization received MAI funds during the
given reporting period.

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7.

Enter the amount of RWHAP Part A, B, C, D,
or F (MAI) funds expended on oral health care
during the reporting period.
Do not include Dental Reimbursement Program
(DRP) or Community-Based Dental Partnership
Program (CBDPP) funds.

8.

Indicate if your organization
expended RWHAP funds to provide
services to the grantees listed.

This list of contracts displayed on this page of the report is created with information provided by
RWHAP grantees (see Figure 6). The contract reference is an optional feature for your grantee
to use if it has multiple contracts with your agency under a single grant. Using contract
references may help you and your grantee track specific contracts as you complete your
Provider Report. A contract reference will only appear if your grantee has designated one. For
the purpose of the Ryan White Data Report, “contracts” include formal contracts, memoranda of
understanding, or other agreements.
Grantee/contract information. The list of grantees/contracts is prepopulated based on
information provided by grantees on their grantee report. If a contract is missing from this list,
ask your grantee of record to add the contract to its grantee report.

FIGURE 6. RSR Provider Report Online Form
Screenshot of Provider Information Section (Questions 8 - 11)

Services. Indicates the services delivered under this contract during the reporting period. To do
this, select the “Services” link to open another browser window (see Figure 7 for an example)
with the list of RWHAP-eligible services. Note: You may only report services that you are
contracted to provide by the grantee under this agreement. If a service category is missing, ask
your grantee of record to add the service to the contract. If you were contracted to provide a
particular service but did not deliver it to any clients during the reporting period, don’t check the
box for that service.

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FIGURE 7. RSR Provider Report Online Form
Screenshot of the Administrative & Technical Services List

After saving the services pages, simply close the browser window to return to the Service
Provider Report.
Note: If your agency indicates that it only provides administrative and technical services under
all contracts, STOP HERE. You are not required to complete the remainder of this report.

After reviewing and updating, if necessary, the information for each contract, select the “Save”
button to save the edited data and continue with the next item in the Provider Report.
9.

Which of the following categories
describes your agency (select all that
apply):
Note: The fourth and fifth options in this list
are mutually exclusive. Providers may select
the first, second, and/or third options; the
fourth option; OR the fifth.

3. Solo or group private health care practice
in which more than 50% of the clinicians
are racial/ethnic minority group members
4. Other provider that has historically served
racial/ethnic minority clients but does not
meet any of the criteria above
5. Other type of agency of facility

1. An agency in which racial/ethnic minority
group members make up more than 50%
of the agency’s board members.
2. Racial/ethnic minority group members
make up more than 50% of the agency’s
professional staff members in direct HIV
services.

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10. Report the number of paid staff, in fulltime equivalents (FTEs), who were
funded by the Ryan White HIV/AIDS
Program during the given reporting
period:
You may enter up to two decimal places.
Enter a “zero” if there are no paid staff.
How to calculate FTEs
Step 1: Count each staff member who
works full-time (at least 35–40 hours per
week) on RWHAP as one FTE. Full-time
employees who regularly work overtime
should not be counted as more than one
FTE. If a percentage of each staff
member’s time is being funded by Parts A,
B, C, D, and/or F (MAI), you can simply
add the percentages to calculate the total.
For example: Physician .50 FTE, Nurse
Practitioner 1.0 FTE, Dentist .20 FTE,
Case Manager .75 FTE, C&T 1.0 FTE =
3.45 FTEs.
Step 2: Identify the staff members who do
not work full time on HIV/AIDS care (e.g.,
part-time employees or full-time employees
who spend only a portion of their time in
HIV/AIDS care), and sum the weekly hours
they spend in HIV/AIDS care. Divide this
number by your agency’s definition of full
time (e.g., 35 or 40 hours per week).

11. Select the status of your agency’s clinical
quality management program for
assessing HIV health services. (Select
only one.)
Every RWHAP is required to utilize a clinical
quality management program to assess the
extent to which HIV health services that
medical providers and/or medical case
managers provide patients are consistent
with the most recent Public Health Service
guidelines for the treatment of HIV/AIDS.
(For further information on quality
management of the RWHAP, refer to the
Technical Assistance Manual available at
http://hab.hrsa.gov/tools.htm.)
Indicate whether your agency:
1. established a new program to manage
the clinical quality of Ryan White
HIV/AIDS Program services during the
reporting period,
2. has a previously established clinical
quality management program, or
3. has recently updated an existing
program with new quality standards.

Step 3: Add the FTEs calculated in steps 1
and 2. This sum is the number of FTEs you
should report.

After reviewing and updating, if necessary, the information on this page of the Service Provider
Report, select the “Next” button to save the data and advance to the next page in the Service
Provider Report, “HIV Counseling and Testing” (see Figure 8).

HIV COUNSELING AND TESTING
If a grantee indicated that your agency was contracted to provide HIV counseling and testing
services during the given reporting period, your agency must complete this section.

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FIGURE 8. RSR Provider Report Online Form
Screenshot of the HIV Counseling and Testing Section

12. Number of individuals tested for HIV:
Indicate the number of people tested using an
FDA-approved test during the reporting
period.
13. Of those tested (Item 12 above), number
who tested NEGATIVE?
The number that tested negative for HIV
during the reporting period.
14. Number who tested NEGATIVE (Item 13
above) and received posttest counseling:
Of the number indicated in Item 13, report how
many received HIV-posttest counseling.

15. Of those tested (Item 12 above), number
who tested POSITIVE?
Of the total number tested, indicate how many
tested POSITIVE for HIV during the reporting
period.
16. The number who tested POSITIVE (Item 15
above) and received posttest counseling:
Of the number specified in Item 15, indicate
how many received HIV-posttest counseling
immediately following the test or returned for
counseling at a later date.
17. Of those tested POSITIVE (Item 15 above),
number referred to HIV medical care:
Of the total number who tested positive for
HIV, indicate how many were referred to HIV
medical care.

Select the “Next” button to save the data and advance to the final page in the Service Provider
Report, the “Imports” page (see Figure 9).

FIGURE 9. RSR Provider Report Online Form
Screenshot of the File "Imports" Screen

Agencies required to submit a Service Provider Report have the option of importing an XML
Provider File into the RSR system as an alternative to manual data entry of the Service Provider
Report. The XML Provider File includes the data required to populate:
•
•
•

Items 3–7 and 9–11: the provider’s organizational data;
Item 8: the services provided with Ryan White funds under each agreement; and
Items 12–17: HIV counseling and testing data.

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Note: The Service Provider Report cannot be submitted to the grantee until the XML Client File
is imported into the RSR System. Select the “Import XML Client File” button to open another
browser window and follow the on-screen instructions to locate and submit the XML file, You
may upload an XML Client File multiple times; however, after initial file upload, all subsequent
file uploads will overwrite the existing file in the RSR system.

Following upload of the XML Client File, select “Save” and close the Provider Report.

THE CLIENT REPORT
A client report must be submitted by all agencies that provide RWHAP-funded core medical or
support services directly to clients. Grantees may decide on a case-by-case basis to require a
provider to submit its own client data. Alternatively, grantees may submit the client data on
behalf of the provider.

REPORTING CLIENT-LEVEL DATA
The client report will contain one de-identified record for each client who received a RWHAPfunded core medical service or support service during the reporting period. (The types of
clients—infected, indeterminate, and affected—that may be served by the Ryan White HIV/AIDS
Program are defined in the glossary.) The data elements reported per client will depend upon
the specific RWHAP-funded service(s) the client received at your agency. See the chart of
Required Client-Level Data Elements for RWHAP Eligible Services in Appendix 1 to determine
the minimum client-level data elements that will be reported for a client based on the RWHAPfunded service(s) he or she received.
Example:
A service provider organization receives RWHAP funding to provide outpatient/ambulatory
medical care services, medical case management services, and several support services
including linguistic services, housing services, and medical transportation services.
Client 1 receives outpatient/ambulatory medical services, medical case management services,
and medical transportation services. The record for client 1 will report:
• data for all demographic data elements
• data for all clinical services data elements
• the number of visits in each quarter for outpatient/ambulatory medical care
services
• the number of visits in each quarter for medical case management services
• the client received medical transportation services during the applicable quarter(s)
Client 2 receives only housing services and linguistic services. The record for client 2 will
report:
• data for selected demographic data elements (e.g. race, ethnicity, age, housing
status)
• the client received housing services during the applicable quarter(s)
• the client received linguistic services during the applicable quarter(s)

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SUBMITTING CLIENT-LEVEL DATA TO HAB
The Client Report (client-level data set) must be uploaded in the required XML format. XML
(eXtensible Markup Language) is a standard, simple, and widely adopted method of formatting
text and data so that it can be exchanged across all of the different computer platforms,
languages, and applications.
Providers need to extract the client-level data elements from their systems and into the proper
XML format before they can be uploaded to the HAB server. Several software applications for
managing and monitoring HIV clinical and supportive care—including CAREWare, LabTracker,
Aries, AIRS, Casewatch Millennium, and Sage—will be able to export the data in the required
XML format. No special action will be required to generate the XML file. However, if your
organization uses a custom-built data collection system, you will need to write a program that
extracts the data from your custom system and insert it into an XML file that conforms to the
rules of the RSR XML schema. The schema can be obtained from HAB at
http://hab.hrsa.gov/manage/CLD.htm. Note: Technical support will be available to providers with
custom systems through the HAB Web site and from HAB project officers.

CLIENT-LEVEL DATA FIELDS
This section outlines the data fields that will be submitted in the XML file. HAB used the Privacy
Rule’s safe harbor method of de-identification as a guide when determining the client-level data
elements to be reported by RWHAP service providers. The information being reported in the
selected client-level data elements cannot be used alone or in combination to re-identify specific
Ryan White clients.
Note: The item numbers listed below correspond to the items listed in the “Data Element for
Client-level Data Export” document available at http://hab.hrsa.gov/manage/CLD.htm.

System Variables
The XML file will contain three system fields which are prepopulated in the XML file.
SV1

Reporting Period
January 1 through June 30 (interim report)
January 1 through December 31 (annual report)
Note: Information that is not available when the interim report is submitted may be included in
the annual report. However, grantees and providers will not be able to amend data submitted
in the annual report.

SV2

Unique Provider ID
This is automatically generated when the provider is created in the RSR Web system.
For providers that were entered in the Ryan White Data Report Web system, the
provider ID in the RSR Web system will not change. This information is prepopulated by
the RSR Web system.

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SV3

Unique Client ID
The Unique Client ID (UCI) is a unique 11-character alphanumeric code that distinguishes one
Ryan White client from all others and is the same for the client across all provider settings. The
UCI is derived from the first and third letters of a client’s first and last name, their date of birth
(MM/DD/YY), and a code for gender (1=male 2=female 3=Transgender). For example, for the
client Julius Ceasar born on March 15, 1980, the UCI would be JLCA0315801. A 12th character
can be added if a provider needs to distinguish between two clients that may in fact have the
same UCI. Providers will use a program, provided by HAB, to encrypt the UCI at their site, before
sending the encrypted UCI as part of the Client Report to HAB. ONLY the encrypted UCI gets
reported in the uploaded client data, not the unencrypted UCI.
Note: The method used to encrypt the UCI does not allow for decryption, thus securing the
client’s privacy.

Client Demographics
1.

Incarcerated—the client will not be continuing
in the agency’s program because he/she is
serving a criminal sentence in a Federal,
State, or local penitentiary, prison, jail,
reformatory, work farm, or similar correctional
institution (whether operated by the
government or a contractor).

Date of client’s first service visit at this
provider’s agency
Indicate this date in the form MM/DD/YYYY.
This date may or may not be the date the
client first received a Ryan White-funded
service. If only the month and year are
collected, enter “01” as the day of the client’s
first visit (i.e., MM/01/YYYY).

Relocated—the client has moved out of the
agency’s service area and will not continue to
receive RWHAP services at the agency’s
location.

You are not expected to resort to
unreasonable measures to locate this
information in your files. If you are unable to
identify the first date of service, please report
the earliest date available in your records.
2.

Deceased
Unknown—the client has been “lost to care.”
Note: Each individual agency must determine
its own guidelines for classifying a client as
“lost to care.”

What was the client’s vital/enrollment
status at the end of the reporting period?
Active—the client will be continuing in
program.
Referred—the client was referred to another
program or services and will not continue to
receive services at this agency. Also select
this category if the client was discharged from
a program because they became selfsufficient and no longer need Ryan White
Program-funded services.
Removed—client was removed from
treatment due to violation of rules.

3.

If the client is reported as “deceased” in
Item 2, indicate date of death
(MM/DD/YYYY) if known.

4.

Client’s year of birth
Indicate the client’s birth year in the form
YYYY, if known.
Note: Even though only the year of birth will
be reported to HAB, providers should collect
the client’s full date of birth. The client’s birth
month and day are used to generate the UCI.

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Reporting Client Race and Ethnicity
Office of Management and Budget (OMB) Revisions to the Standards for the Classification of
Federal Data on Race and Ethnicity provides a minimum standard for maintaining, collecting,
and presenting data on race and ethnicity for all Federal reporting purposes. The standards
were developed to provide a common language for uniformity and comparability in the collection
and use of data on race and ethnicity by Federal agencies.
The standards have five categories for data on race: American Indian or Alaska Native, Asian,
Black or African American, Native Hawaiian or Other Pacific Islander, and White. There are two
categories for data on ethnicity: “Hispanic or Latino,” and “Not Hispanic or Latino.” The racial
category descriptions, defined in October 1997, are required for all Federal reporting, as
mandated by the OMB. For more information go to:
http://www.whitehouse.gov/omb/fedreg/1997standards.html
HAB is required to use the OMB reporting standard for race and ethnicity. However, service
provider agencies should feel free to collect race and ethnicity data in greater detail. If the
agency chooses to use a more detailed collection system, the data collected should be
organized so that any new categories can be aggregated into the standard OMB breakdown.
Race and Ethnicity Data Collection
Ryan White HIV/AIDS Program providers are expected to make every effort to obtain and
report race and ethnicity, based on each client’s self-report. Self-identification is the preferred
means of obtaining this information. Providers should not establish criteria or qualifications to
use to determine a particular individual's racial or ethnic classification, nor specify how
someone should classify himself or herself.

5.

Ethnicity
Indicate the client’s ethnicity based on his/her
self-report.
Hispanic or Latino—A person of Cuban,
Mexican, Puerto Rican, South or Central
American, or other Spanish culture or origin,
regardless of race. The term "Spanish origin"
can be synonymous with "Hispanic or Latino."
Not Hispanic or Latino—A person who does
not identify his/her ethnicity as “Hispanic or
Latino.”
Unknown indicates the client’s ethnicity is
unknown or was not reported.

6.

Race (Select one or more)
Indicate the client’s race based on his/her selfreport. Note: Multiracial clients should select
all categories that apply.
American Indian or Alaska Native—A
person having origins in any of the original
peoples of North and South America
(including Central America), and who
maintains tribal affiliation or community
attachment.
Asian—A person having origins in any of the
original peoples of the Far East, Southeast
Asia, or the Indian subcontinent including, for
example, Cambodia, China, India, Japan,
Korea, Malaysia, Pakistan, the Philippine
Islands, Thailand, and Vietnam.

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Black or African American—A person
having origins in any of the black racial groups
of Africa.
Native Hawaiian or Other Pacific Islander––
A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other
Pacific Islands.
White—A person having origins in any of the
original peoples of Europe, the Middle East, or
North Africa.
Unknown—indicates the client’s racial
category is unknown or was not reported.
7.

Current Gender
Indicate the client’s gender (the socially and
psychologically constructed, understood, and
interpreted set of characteristics that describe
the current sexual identity of an individual)
based on his/her self-report.
Male—an individual with strong and persistent
identification with the male sex.
Female—an individual with strong and
persistent identification with the female sex.
Transgender—An individual whose gender
identity is not congruent with his or her
biological gender, regardless of the status of
surgical and hormonal gender reassignment
processes. Sometimes the term is used as an
umbrella term encompassing transsexuals,
transvestites, cross-dressers, and others. The
term transgender refers to a continuum of
gender expressions, identities, and roles,
which expand the current dominant cultural
values of what it means to be male or female.
Unknown indicates the client’s gender
category is unknown or was not reported.

8.

If the client is reported as “transgender” in
Item 7, indicate the subgroup, if known:
o Male to Female
o Female to Male

9.

10. Indicate the client’s housing status at the
end of the reporting period.
Stable Permanent Housing includes:
o Renting and living in an unsubsidized
room, house or apartment
o Own and live in an unsubsidized house or
apartment
o Unsubsidized permanent placement with
families or other self-sufficient
arrangements
o Housing Opportunities for Persons with
AIDS (HOPWA)-funded housing
assistance, including Tenant-based Rental
Assistance (TBRA) or Facility-Based
Housing Assistance, but not including the
Short-term Rent, Mortgage and Utility
(STRMU) Assistance Program
o Subsidized, non-HOPWA, house or
apartment, including Section 8, the HOME
Investment Partnerships Program, and
Public Housing
o Permanent housing for formerly homeless
persons, including Shelter Plus Care, the
Supportive Housing Program (SHP), and
the Moderate Rehabilitation Program for
SRO Dwellings (SRO Mod Rehab)
o Institutional setting with greater support
and continued residence expected
(psychiatric hospital or other psychiatric
facility, foster care home or foster care
group home, or other residence or longterm care facility)
Temporary Housing includes:
o Transitional housing for homeless people
o Temporary arrangement to stay or live with
family or friends
o Other temporary arrangement such as a
Ryan White Program housing subsidy
o Temporary placement in an institution
(e.g., hospital, psychiatric hospital, or other
psychiatric facility, substance abuse
treatment facility, or detoxification center)
o Hotel or motel paid for without emergency
shelter voucher

Report the client’s income in terms of the
percent of the Federal poverty level at the
end of the reporting period.
o
o
o
o
o

Equal to or below the Federal poverty level
101–200% of the Federal poverty level
201–300% of the Federal poverty level
> 300% of the Federal poverty level
Unknown/unreported

If your organization collects this information
early in the reporting period, it is not
necessary to collect this information again at
the end of the reporting period (although
changes should be documented.) Report the
latest information on file for each client.

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Unstable Housing Arrangements include:
o Emergency shelter, a public or private
place not designed for, or ordinarily used
as, a regular sleeping accommodation for
human beings, including a vehicle, an
abandoned building, a bus/train/subway
station/airport, or anywhere outside
o Jail, prison, or a juvenile detention facility
o Hotel or motel paid for with emergency
shelter voucher
Unknown indicates the client’s housing status
is unknown or was not reported.
Definitions are based on:
1. Housing Opportunities for Persons With
AIDS (HOPWA) Program, Annual
Progress Report (APR), Measuring
Performance Outcomes, form HUD40110-C.
2. McKinney-Vento Act, Title 42 US Code,
Sec. 11302, General definition of
homeless individual.
11. Indicate the geographic unit code of the
client’s residence at the end of the
reporting period.
The geographic unit code is the initial three
digits of a U.S. Postal Service Zip code. For
example, “200” is the geographic unit code for
a client living in an area represented by the
five digit Zip code “20001.” Note: Providers
should report a geographic unit code of “000”
for clients with a Zip code beginning with the
following three digits: 022, 036, 059, 102, 203,
555, 556, 692, 821, 823, 830, 831, 878, 879,
884, 893, 987, or 994.
If the client’s housing is “Unstable,” enter the
geographic unit code of the place he or she
considers his or her residence or “home
base.” Home base for a person who is
homeless or has an unstable living
arrangement is the place where s/he returns
regularly and presently intends to remain,
including an emergency shelter, a public or
private place not designed for, or ordinarily
used as, a regular sleeping accommodation
for human beings, including a vehicle, an
abandoned building, bus/train/subway
station/airport, or anywhere outside. It also
can be a place the person returns to regularly
where he or she can receive messages and
be contacted.

12. Indicate the HIV/AIDS status of the client at
the end of the reporting period.
HIV-negative (affected)—Client has tested
negative for HIV; is an affected partner or
family member of an individual who is HIVpositive; and has received at least one
RWHAP-funded support service during the
reporting period.
HIV-positive, not AIDS—Client has been
diagnosed with HIV but has not advanced to
AIDS.
HIV-positive, AIDS status unknown—Client
has been diagnosed with HIV. It is not known
whether the client has advanced to AIDS.
CDC-defined AIDS—Client is an HIV-infected
individual who meets the CDC AIDS case
definition for an adult or child. Note: Once a
client has been diagnosed with AIDS, he or
she always is counted in the CDC-defined
AIDS category regardless of changes in CD4
counts. For additional information, see:
http://www.cdc.gov/ncphi/disss/nndss/casedef/
aidscurrent.htm
HIV-indeterminate (infants only)— An infant
whose HIV status is not yet determined but
was born to an HIV-infected mother.
Unknown—A client who is not an infant and
whose HIV/AIDS Status is unknown or was
not reported.
13. If the response to Item 12 is “CDC-defined
AIDS,” indicate the year (YYYY) of the
client’s AIDS diagnosis, if known.
14. What is the client’s risk factor for HIV
infection (select one or more):
Men who have sex with men (MSM) cases
include men who report sexual contact with
other men (i.e., homosexual contact) and men
who report sexual contact with both men and
women (i.e., bisexual contact).
Injection drug user (IDU) cases include
clients who report use of drugs intravenously
or through skin-popping.
Hemophilia/coagulation disorder cases
include clients with delayed clotting of the
blood.

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Heterosexual contact cases include clients
who report specific heterosexual contact with
an individual with, or at increased risk for, HIV
infection (e.g., an injection drug user).
Receipt of transfusion of blood, blood
components, or tissue cases include
transmission through receipt of infected blood
or tissue products given for medical care.
Mother with/at risk for HIV infection
(perinatal transmission) cases include
transmission from mother to child during
pregnancy. This category is exclusively for
infants and children infected by mothers who
are HIV-positive or at risk.
Other indicates the client’s exposure category
is known, but not listed above.
Unknown indicates the client’s exposure
category is unknown or was not reported.
15. Report the client’s sources of health
insurance during the reporting period
(select all that apply):
Private means health insurance plans such as
BlueCross/BlueShield, Kaiser Permanente,
and Aetna.

Medicare is a health insurance program for
people 65 years of age and older, some
disabled people under 65 years of age, and
people with End-Stage Renal Disease
(permanent kidney failure treated with dialysis
or a transplant).
Medicaid is a jointly funded, Federal-State
health insurance program for certain lowincome and needy people.
Other public means other Federal, State,
and/or local government programs providing a
broad set of benefits for eligible individuals.
Examples include State-funded insurance
plans, military health care (CHAMPUS), State
Children’s Insurance Program (SCHIP), Indian
Health Services, and Veterans Health
Administration.
No insurance means the client did not have
insurance to cover the cost of services at any
time during the reporting period, the client selfpays, or services are covered by RWHAP
funds.
Other insurance means client has an
insurance type other than those listed above.
Unknown means the primary source of
medical insurance is unknown and not
documented.

Core Services
For each RWHAP client, report the number of visits per quarter for each RWHAP-funded core
medical service. If a RW client received a core medical service that was not funded through
your RW contract, do not report on that service for the client. If a RW client received a core
medical service that your organization funds through multiple sources, including RW and nonRW funds, report the number of visits per quarter for that core medical service, unless your
data system can discern that the client’s visits were paid for with non-RW funds. Note: For each
day, only one service visit per category may be counted.
16. Indicate the number of
Outpatient/ambulatory medical care
service visits the client received per
quarter during the reporting period.

17. Indicate the number of Oral health care
service visits the client received per
quarter during the reporting period.

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18. Indicate the number of Early Intervention
Services (Part A and B) service visits the
client received per quarter during the
reporting period.
19. Indicate the number of Home health care
service visits the client received per
quarter during the reporting period.
20. Indicate the number of Home and
community-based health service visits the
client received per quarter during the
reporting period.
21. Indicate the number of Hospice service
visits the client received per quarter during
the reporting period.
22. Indicate the number of Mental health
service visits the client received per
quarter during the reporting period.

24. Indicate the number of Medical case
management (including treatment
adherence) service visits the client
received per quarter during the reporting
period.
25. Indicate the number of Substance abuse
service (outpatient) visits the client
received per quarter during the reporting
period.
26. Indicate (Yes/No/Unknown) if the client
received Local AIDS Pharmaceutical
Assistance (Not ADAP) at any time during
each quarter.
27. Indicate (Yes/No/Unknown) if Health
Insurance Premium funding were provided
for the client at any time during each
quarter.

23. Indicate the number of Medical nutrition
therapy service visits the client received
per quarter during the reporting period.

Support services
For each RW client, report on whether or not a support service was received for each RWfunded support service. If a RW client received a support service that was not funded through
your RW contract, do not report on that service for the client. If a RW client received a support
service that your organization funds through multiple sources, including RW and non-RW funds,
report on whether or not the client received that support service, unless your data system can
discern that the client’s receipt of service was paid for with non-RW funds. Note: For each day,
only one service visit per category may be counted.
28. Indicate (Yes/No/Unknown) if the client
received Case management (non-medical)
services at any time during each quarter.

32. Indicate (Yes/No/Unknown) if the client
received Food bank/home- delivered meals
services at any time during each quarter.

29. Indicate (Yes/No/Unknown) if the client
received Child care services at any time
during each quarter.

33. Indicate (Yes/No/Unknown) if the client
received Health education/ risk reduction
services at any time during each quarter.

30. Indicate (Yes/No/Unknown) if the client
received Developmental assessment/early
intervention services at any time during
each quarter. (Part D only.)

34. Indicate (Yes/No/Unknown) if the client
received Housing services at any time
during each quarter.

31. Indicate (Yes/No/Unknown) if the client
received Emergency financial assistance
services at any time during each quarter.

35. Indicate (Yes/No/Unknown) if the client
received Legal services at any time during
each quarter.

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36. Indicate (Yes/No/Unknown) if the client
received Linguistic services at any time
during each quarter.
37. Indicate (Yes/No/Unknown) if the client
received Transportation services at any
time during each quarter.
38. Indicate (Yes/No/Unknown) if the client
received Outreach services at any time
during each quarter.
39. Indicate (Yes/No/Unknown) if the client
received Permanency planning services at
any time during each quarter.
40. Indicate (Yes/No/Unknown) if the client
received Psychosocial support services at
any time during each quarter.

41. Indicate (Yes/No/Unknown) if the client
received a Referral for health care/
supportive services at any time during
each quarter.
42. Indicate (Yes/No/Unknown) if the client
received Rehabilitation services at any
time during each quarter.
43. Indicate (Yes/No/Unknown) if the client
received Respite care services at any time
during each quarter.
44. Indicate (Yes/No/Unknown) if the client
received Substance abuse services
(residential) at any time during each
quarter.
45. Indicate (Yes/No/Unknown) if the client
received Treatment adherence counseling
services at any time during each quarter.

Clinical Information
Outpatient/ambulatory medical care providers report clinical data for clients whose status is HIVpositive or indeterminate. Data provided in this section will help HAB prove that, nationally, the
program is meeting patient care requirements as set forth in:
1.
2.
3.
4.

The 2006 Ryan White HIV/AIDS program legislation;
HAB’s Government Performance and Results Act (GPRA) measures;
HAB’s Performance Assessment Rating Tool (PART) measures; and
HAB’s HIV/AIDS Core Clinical Performance Measures for Adults & Adolescents.

Ultimately, information provided in this section will help HAB ensure that Ryan White clients
receive a consistent level of service across all provider settings.

46. HIV risk reduction screening/counseling
Indicate (yes/no/unknown) if HIV risk reduction
screening and/or counseling was provided to
the client during this reporting period.

47. First outpatient/ambulatory care visit
List the date of the client’s first
outpatient/ambulatory care visit at this
provider agency. Notes: (1) This visit may
have occurred before the start of the reporting
period. (2) This visit may or may not be an
RWHAP-funded visit. If the full date is not
available, report the month and year of the
first visit and the day as”01” (i.e.,
MM/01/YYYY).

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48. Outpatient/ambulatory care visit dates
Report all dates (MM/DD/YYY) of the client’s
outpatient/ambulatory care visits in this
provider’s HIV care setting with a clinical care
provider. A clinical care provider is a
physician, physician's assistant, clinical nurse
specialist, or nurse practitioner certified in his
or her jurisdiction with prescribing privileges.
49. CD4 Cell Counts
Report the value and test date for all CD4
count tests administered to the client during
the reporting period. The CD4 cell count
measures the number of T-helper
lymphocytes per cubic millimeter of blood. It is
a good predictor of immunity. As CD4 cell
count declines, the risk of developing
opportunistic infections increases. The test
date is the date the client’s blood sample is
taken.
50. Viral Load Counts
Report the value and test date for all viral load
tests administered to the client during the
reporting period. Viral load is the quantity of
HIV RNA in the blood and is a predictor of
disease progression. Test results are
expressed as the number of copies per
milliliter of blood plasma. The test date is the
date the client’s blood sample is taken.
51. PCP Prophylaxis
o
o
o
o
o

Yes
No
Not medically indicated
No, client refused
Unknown

PCP prophylaxis is drug treatment to prevent
Pneumocystis cariini pneumonia (PCP)—the
most common infection in people with HIV and
a major cause of mortality, yet almost entirely
preventable and treatable. Indicate if clients
were prescribed a PCP prophylaxis at any
time during the reporting period. Note: Select
“yes” if the client began or was continuing a
prophylactic regimen during the reporting
period.

For additional information about PCP
prophylaxis, see:
http://hab.hrsa.gov/special/measure03.htm
http://www.hrsa.gov/performancereview/proph
ylaxis.htm
http://wonder.cdc.gov/wonder/prevguid/m0001
409/m0001409.asp
52. Was the client prescribed HAART at any
time in this reporting period?
Yes
No, not medically indicated
No, not ready (as determined by clinician)
No, client refused
No, intolerance, side effect, toxicity
No, HAART payment assistance
unavailable
o No, other reason
o Unknown

o
o
o
o
o
o

HAART is highly active antiretroviral therapy,
an aggressive anti-HIV treatment including a
combination of three or more drugs with
activity against HIV whose purpose is to
reduce viral load to undetectable levels. Note:
Report “yes” if the client began or was
continuing on HAART during the reporting
period.
53. Indicate if the client was screened for
tuberculosis (TB) during the reporting
period.
o
o
o
o

Yes
No
Not medically indicated
Unknown

Tuberculosis screening is the use of physical
examinations and tests (such as PPD skin
tests, blood tests, X-rays, and sputum tests) to
determine latent or active infection by
mycobacterium tuberculosis bacteria. For
additional information about tuberculosis, visit:
http://www.cdc.gov/tb/pubs/TBfactsheets.htm.

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54. If the response to Item 53 is ”no” or “not
medically indicated,” indicate if the client
has been screened for TB since his/her HIV
diagnosis.
o
o
o
o

Yes
No
Not medically indicated
Unknown

HAB understands that it may place an
unreasonable burden on providers to
determine whether certain clients were
screened for tuberculosis since their diagnosis
and advises providers to report whatever data
may be reasonably obtained.
55. Has the client been screened for syphilis
during this reporting period?
o
o
o
o

Yes
No
Not medically indicated
Unknown

Syphilis is a sexually transmitted disease
(STD) that can be diagnosed by examining
material from a chancre (infectious sore) using
a dark-field microscope or with a blood test.
Additional information may be obtained at
http://www.cdc.gov/std/syphilis/default.htm
56. Has the client been screened for hepatitis
B during this reporting period?
o
o
o
o

57. If the response to Item 56 is ”no” or “not
medically indicated,” indicate if the client
has been screened for hepatitis B since
his/her HIV diagnosis.
o
o
o
o

Yes
No
Not medically indicated
Unknown

HAB understands that it may place an
unreasonable burden on providers to
determine whether certain clients were
screened for hepatitis B since their diagnosis
and advises providers to report whatever data
may be reasonably obtained.
58. Has the client completed the vaccine
series for hepatitis B?
o
o
o
o

Yes
Not medically indicated
No
Unknown

The hepatitis B vaccine series is a sequence
of shots that stimulate a person’s natural
immune system to protect against HBV.
Note: If the client is in the process of
completing a hepatitis B vaccination series,
report “no” for the reporting period; you will
indicate that the client has completed the
series in subsequent reports.

Yes
No
Not medically indicated
Unknown

Hepatitis B is a serious infection caused by
the hepatitis B virus (HBV). If it goes
undiagnosed and untreated it can cause
permanent liver damage. A screening blood
test can determine a diagnosis. For additional
information, please see:
http://www.cdc.gov/ncidod/diseases/hepatitis/
b/index.htm.

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59. Has the client been screened for hepatitis
C during this reporting period?
o
o
o
o

Yes
No
Not medically indicated
Unknown

Hepatitis C screening is the use of physical
examinations and tests, such as anti-HCV
tests, HCV RIBA tests, HCV-RNA tests, and
Viral Load or Quantitative HCV tests, to
detect the presence of the HCV virus and/or
antibodies indicating exposure to the HCV
virus.
60. If the response to Item 59 is ”no” or “not
medically indicated,” indicate if the client
has been screened for hepatitis C since
his/her HIV diagnosis.
o
o
o
o

Yes
No
Not medically indicated
Unknown

HAB understands that it may place an
unreasonable burden on providers to
determine whether certain clients were
screened for hepatitis C since their diagnosis
and advises providers to report whatever data
may be reasonably obtained.
61. Was the client screened for substance use
(alcohol and drugs) during the reporting
period?
o
o
o
o

Yes
No
Not medically indicated
Unknown

Substance use screening is a quick, simple
way to identify clients who need further
assessment or treatment for substance use
disorders. Screening may include biomarkers
(e.g., positive drug screen or liver disease)
and client reports of consumption patterns.

62.

Was a mental health screening conducted
for the client during this reporting period?
o
o
o
o

Yes
No
Not medically indicated
Unknown

Mental health screenings include the use of
brief structured instruments or commonly
used questionnaires to assess potential
mental health problems. Screenings are
designed to determine whether the client
presents signs or symptoms of a mental
health problem and if the client should be
referred to a mental health professional.
Screens are not diagnostic tools and,
although typically administered by a mental
health professional, may be administered by
trained health care professionals in other
medical/clinical disciplines.
63. For HIV+ women only: Did the client
receive a Pap smear during this reporting
period?
o
o
o
o
o

Yes
No
Not medically indicated
Not applicable
Unknown

A Pap smear or screening is a way to
examine cells taken from a woman's cervix. It
can detect cell changes that may be precancerous as well as hidden, small tumors
that may lead to cervical cancer.
64. For HIV+ women only: Was the client
pregnant during the reporting period?
o
o
o
o

Yes
No
Not applicable
Unknown

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65. For HIV+ women only: If the response to
Item 64 is “yes,” indicate when the client
entered prenatal care.
o
o
o
o
o
o

First trimester
Second trimester
Third trimester
At time of delivery
Not applicable
Unknown

Women whose pregnancies did not result in a
live birth should be reported in the “Not
applicable” category.

66. For HIV+ women only: If the response to
Item 64 is “yes,” indicate if the client was
prescribed antiretroviral therapy to prevent
maternal-to-child transmission (vertical) of
HIV.
o
o
o
o

Yes
No
Not applicable
Unknown

Women whose pregnancies did not result in a
live birth should be reported in the “Not
applicable” category.

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APPENDIX A: REQUIRED CLIENT-LEVEL DATA ELEMENTS FOR RWHAP ELIGIBLE SERVICES

Rational Codes:
1.
Necessary for identifying new clients
2.
2006 Ryan White Legislation requirement
3.
Necessary to assess RWHAP performance as required for GPRA
4.
Necessary to assess RWHAP performance as required for PART
5.
Necessary to assess RWHAP performance as required for HAB
Core Clinical Performance Measures Tier 1 Group 1
6.
Necessary to assess RWHAP performance as required for HAB
Core Clinical Performance Measures Tier 1 Group 2
7.
Necessary to assess RWHAP performance as required for HAB
Core Clinical Performance Measures Tier 1 Group 3

8.
9.
10.
11.
12.
13.

Necessary to track enrollment or vital status over the course of the
reporting period
Informs the denominator of other items
Used to identify important population subgroups
Used to measure and assess the extent of out-of-service area
utilization.
Used to determine areas of eligibility.
Accountability, use of funds

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APPENDIX A

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APPENDIX A

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GLOSSARY
Active client

An individual who was a client when the reporting period ended and is expected to
continue in the program during the next reporting period.

ADAP

AIDS Drug Assistance Program—A State-administered program authorized under
Part B of the Ryan White HIV/AIDS Program that provides FDA-approved
medications to low-income individuals with HIV/AIDS disease who have limited or no
coverage from private insurance, Medicaid, or Medicare.

Affected client

A family member or partner of an infected client who receives at least one Ryan
White HIV/AIDS Program support service during the reporting period.

AIDS

Acquired immune deficiency syndrome—A disease caused by the human
immunodeficiency virus.

ARV

Antiretroviral—A substance that fights against a retrovirus, such as the human
immunodeficiency virus (HIV).

CDC

Centers for Disease Control and Prevention—The U.S. Department of Health and
Human Services agency that administers HIV/AIDS prevention programs, including
the HIV Prevention Community Planning process, among others. The CDC is
responsible for monitoring and reporting infectious diseases, administers AIDS
surveillance grants, and publishes epidemiologic reports such as the HIV/AIDS
Surveillance Report.

Client

(See infected client, affected client, active client, or indeterminate client.)

Clinical Care Provider

A physician, physician's assistant, clinical nurse specialist, or nurse practitioner
certified in his or her jurisdiction with prescribing privileges.

Combination therapy

Two or more drugs or treatments used together to achieve optimum results against
HIV/AIDS. For more information on treatment guidelines, visit
http://www.aidsinfo.nih.gov/guidelines.

Confidential information

Information such as name, gender, age, and HIV status, that is collected on the client
and whose unauthorized disclosure could cause the client unwelcome exposure,
discrimination, and/or abuse.

Consortium/HIV Care Consortium

An association of one or more public, and one or more nonprofit private, health care,
and support service providers, people with HIV/AIDS, and community-based
organizations operating within areas determined by the State to be most affected by
HIV disease. The consortium agrees to use Part B grant assistance to plan, develop,
and deliver (directly or through agreement with others) comprehensive outpatient
health and support services for individuals with HIV disease. Agencies constituting
the consortium are required to have a record of service to populations and
subpopulations with HIV/AIDS.

Continuum of care

An approach that helps communities plan for, and provide, a full range of emergency
and long-term service resources to address the various needs of people living with
HIV/AIDS (PLWHA).

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Contract

For the purposes of the Ryan White Data Report, contracts include formal contracts,
memoranda of understanding, or other agreements.

Core Medical Services

A set of essential, direct health care services provided to persons with HIV/AIDS and
specified in the Ryan White HIV/AIDS Treatment Modernization Act.

DSP

Division of Science and Policy—The division within HRSA’s HIV/AIDS Bureau that
serves as the principal source of program data collection and evaluation, the
development of innovative models of care (Special Programs of National Significance,
or SPNS), and the focal point for coordination of program performance activities and
development of policy guidance.

EMA/TGA

Eligible Metropolitan Area/Transitional Grant Area—The geographic area eligible to
receive Part A Ryan White HIV/AIDS Program funds. The boundaries of the
EMA/TGA are defined by the Census Bureau. Eligibility is determined by AIDS cases
reported to the CDC. Some EMAs include just one city and others are composed of
several cities and/or counties. Some EMAs extend across more than one State.

Exposure category

(See risk factor)

Family centered

A model in which systems of care under Ryan White Part D are designed to address
the needs of PLWHA and affected family members as a unit, by providing or
arranging for a full range of services. The family structures may range from the
traditional, biological family unit to nontraditional family units with partners, significant
others, and unrelated caregivers.

Fee-for-service

The method of billing for health services whereby a physician or other health service
provider charges the payer (whether it be the patient or his/her health insurance plan)
separately for each patient encounter or service rendered.

GPRA

The Government Performance and Results Act—Enacted in 1993, the law requires
Federal agencies to establish standards measuring their performance and
effectiveness. HRSA has set both long-term and annual measures to assess the
performance of Ryan White HIV/AIDS Program services.
http://www.whitehouse.gov/omb/mgmt-gpra/gplaw2m.html

Grantee of record

The official Ryan White HIV/AIDS Program grantee that receives Federal funding
directly from the Federal government (HRSA). A grantee also may be a provider if it
provides direct services in addition to administering its grant.

HAART

Highly active antiretroviral therapy—An aggressive anti-HIV treatment including a
combination of three or more drugs with activity against HIV whose purpose is to
reduce viral load to undetectable levels.

HAB

HIV/AIDS Bureau— The Bureau within the Health Resources and Services
Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)
that is responsible for administering the Ryan White HIV/AIDS Program. Within HAB,
the Division of Service Systems administers Part A, Part B, and the AIDS Drug
Assistance Program (ADAP); the Division of Community-Based Programs administers
Part C, Part D, and the HIV/AIDS Dental Reimbursement Program; and the Division
of Training and Technical Assistance administers the AIDS Education and Training
Centers (AETC) Program. The Bureau’s Division of Science and Policy administers
the SPNS Program, HIV/AIDS evaluation studies, and the Ryan White HIV/AIDS
Program Data Report.

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High-risk insurance pool

A State health insurance program that provides coverage for individuals who are
denied coverage due to a preexisting condition or who have health conditions that
would normally prevent them from purchasing coverage in the private market.

HIP

Health Insurance Program—a program of financial assistance for eligible individuals
living with HIV to enable them to maintain continuity of health insurance or to receive
medical benefits under a health insurance program. This includes premium payments,
risk pools, co-payments, and deductibles.

HIV disease

Any signs, symptoms, or other adverse health effects due to the human
immunodeficiency virus.

HOPWA

Housing Opportunities for People With AIDS—A program administered by the U.S.
Department of Housing and Urban Development (HUD) that provides funding to
support housing for PLWHA and their families.
http://hab.hrsa.gov/history/webterms.htm#H

HRSA

Health Resources and Services Administration—The U.S. Department of Health and
Human Services (DHHS) agency that is responsible for directing national health
programs that improve the Nation’s health by assuring equitable access to
comprehensive, quality health care for all. HRSA works to improve and extend life for
people living with HIV/AIDS, provides primary health care to medically underserved
people, serves women and children through State programs, and trains a health
workforce that is both diverse and motivated to work in underserved communities.
HRSA administers the Ryan White HIV/AIDS Program.

Indeterminate client

An infant whose HIV status is not yet determined but who was born to an HIV-infected
mother.

Infected client

An individual who is HIV-positive and receives at least one Ryan White HIV/AIDS
Program-funded service during the reporting period.

Inpatient setting

This includes hospitals, emergency rooms and departments, and residential facilities
where clients typically receive food and lodging as well as treatments.

Institution

This includes residential, health care, and correctional facilities.
Residential facilities include supervised group homes and extended treatment
programs for alcohol and other drug abuse or for mental illness.
Health care facilities include hospitals, nursing homes, and hospices.
Correctional facilities include jails, prisons, and correctional halfway houses.

MAI

Minority AIDS Initiative—See Part F (MAI).

Not Medically Indicated

A determination made by a clinical care provider that a service, procedure, or
treatment is not medically necessary. Medically necessary health care services are
procedures used by a prudent medical care provider to diagnosis or treat an illness,
injury, disease or its symptoms in a manner that is (a) in accordance with generally
accepted standards of medical practice; or (b) clinically appropriate in terms of type,
frequency, extent, site, and duration, and considered effective for a patient’s illness,
injury, or disease; and (c) not primarily for the convenience of the patient or treating
clinical care provider.

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OI

Opportunistic infection—An infection or cancer that occurs in individuals with weak
immune systems due to HIV, cancer, or immunosuppressive drugs such as
corticosteroids or chemotherapy. Kaposi’s Sarcoma (KS), Pneumocystis cariini
pneumonia (PCP), toxoplasmosis, and cytomegalovirus are all examples of such
infections.

OMB

Office of Management and Budget—The office within the executive branch of the
Federal Government that prepares the President’s annual budget, develops the
Federal Government’s fiscal program, oversees administration of the budget, and
reviews government regulations.

Outpatient setting

A hospital, clinic, medical office, or other place where clients receive health care
services but do not stay overnight.

PART

Program Assessment Rating Tool—A diagnostic tool used to assess the performance
and management of Federal programs. For the Ryan White HIV/AIDS Program,
annual goals and outcome measures include, for example, improving access to
health care by increasing the proportion of people living with HIV who receive medical
care and treatment; and improving health outcomes by expanding health care to
underserved, vulnerable, and special needs populations.
http://www.whitehouse.gov/omb/part/

Part A

The part of the Ryan White HIV/AIDS Program that provides direct financial
assistance to designated EMAs/TGAs that have been the most severely affected by
the HIV epidemic. The purpose of these funds is to deliver or enhance HIV-related
core medical and support services to people living with HIV/AIDS and their affected
partners and family members.

Part B

The part of the Ryan White HIV/AIDS Program that authorizes the distribution of
Federal funds to States and territories to improve the quality, availability, and delivery
of core medical and support services for individuals living with HIV/AIDS and their
affected partners and family members. The Ryan White HIV/AIDS Program
emphasizes that such care and support is part of a coordinated continuum of care
designed to improve medical outcomes.

Part C

The part of the Ryan White HIV/AIDS Program that provides support for early
intervention services, including preventive, diagnostic, and therapeutic services for
people living with HIV/AIDS and their affected partners and family members. This
support includes a comprehensive continuum of outpatient HIV primary care services
including: HIV counseling, testing, and referral; medical evaluation and clinical care;
other primary care services; and referrals to other health services.

Part D

The part of the Ryan White HIV/AIDS Program that supports coordinated familycentered outpatient care for women, infants, children, and youth with HIV/AIDS and
their affected partners and family members. The Adolescent Initiative is a separate
grant under the Part D program that is aimed at identifying adolescents who are HIVpositive and enrolling and retaining them in care.

Part F (MAI)

Minority AIDS Initiative—A national HHS initiative that provides special resources to
reduce the spread of HIV/AIDS and improve health outcomes for people living with
HIV disease within communities of color. This initiative was enacted to address the
disproportionate impact of the disease in such communities. It was formerly referred
to as the Congressional Black Caucus Initiative because of that body's leadership in
its development. This is also known as Part A MAI and Part B MAI.

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PHSA

Public Health Service Act

PLWHA

People living with HIV/AIDS

PLWHA coalition

Organizations of people living with HIV/AIDS that provide support services to
individuals and families infected with and/or affected by HIV and AIDS.

Primary health care service

Any preventive, diagnostic, or therapeutic health service received on an outpatient
basis by a client who is HIV-positive. Examples include medical, subspecialty care,
dental, nutrition, mental health, or substance abuse treatment, medical case
management, and pharmacy services; radiology, laboratory, and other tests used for
diagnosis and treatment planning; and counseling and testing.

Provider agency/ service provider

The agency that provides direct services to clients (and their families). A provider
agency may receive funds as a grantee (such as under Parts C and D) or through a
contractual relationship with a grantee funded directly by HRSA’s Ryan White
HIV/AIDS Program.

RDR

Ryan White HIV/AIDS Program Annual Data Report

Reporting period

A 6-month period, January 1 through June 30; or 12-month period, January 1 through
December 31, of the calendar year.

Risk factor or risk
behavior/exposure category (See
also Transmission Category)

Behavior or other factor that places an individual at risk for disease. For HIV/AIDS,
this includes such factors as male-to-male sexual contact, injection drug use, and
commercial sex work.

RSR

Ryan White HIV/AIDS Program Services Report

RWHAP

Ryan White HIV/AIDS Program

RWHAP-funded service

A service paid for with Ryan White HIV/AIDS Program funds.

The Ryan White HIV/AIDS
Treatment Modernization Act of
2006

The Federal legislation created to address the health care and service needs of
people living with HIV/AIDS (PLWHA) disease and their families in the United States
and its territories. The law has changed how Ryan White funds can be used, with an
emphasis on providing life-saving and life-extending services for people living with
HIV/AIDS.

SPNS

Special Projects of National Significance—A health services demonstration, research,
and evaluation program funded under Part F of the Ryan White HIV/AIDS Program.
SPNS projects are awarded competitively.

Support services

A set of services needed to achieve medical outcomes that affect the HIV-related
clinical status of a person living with HIV/AIDS.

Transmission category

A grouping of disease exposure and infection routes. In relation to HIV disease,
exposure groupings include injection drug use, men who have sex with men,
heterosexual contact, perinatal transmission, and so forth.

Unique Client Identifier (UCI)

A unique alphanumeric code that distinguishes one Ryan White client from all others
and is the same for the client across all provider settings.

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INDEX in development
AIDS Drug Assistance Program (ADAP), 30, 32
Clients
indeterminate, 33
EIS (Early Intervention Services) Program (Part
C), 6
EMAs/TGAs (Eligible Metropolitan Areas/
Transitional Grant Areas), 31, 34
Health Insurance Program (HIP), 32
HIV counseling and testing, 9
Medicaid, 5, 30
Medicare, 30
Minority AIDS Initiative (MAI), 33
Part A, 6, 8, 31, 32, 34
Part B, 8, 30, 31, 32, 35
Part C, 9, 32, 35, 36
Part D, 8, 31, 32, 35, 36
Provider agency, 36
Reporting period, 30, 33, 36
Service Provider, 31, 36
Services
case management services
medical, 7, 9, 36
non-medical, 7, 9
child care, 8
EIS (Parts A and B), 6
emergency financial assistance, 8
food bank/home-delivered meals, 8

health education/risk reduction, 8
Health Insurance Premium & Cost Sharing
Assistance, 6
home and community-based health
services, 7
home health care, 7
hospice services, 7
housing services, 8
legal services, 8
medical nutrition therapy, 7
medical transportation, 8
mental health, 7, 8, 36
oral health care, 6
outpatient/ambulatory medical care, 6
outreach, 8, 9
pediatric developmental assessment and
early intervention, 8
permanency planning, 9
psychosocial support, 7, 8, 9
referral for health care/supportive
services, 9, 35
rehabilitation services, 9
respite care, 9
substance abuse services
outpatient, 7
residential, 9
treatment adherence counseling, 7, 9

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