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pdf2016 ANNUAL
RYAN WHITE
HIV/AIDS PROGRAM
SERVICES REPORT (RSR)
INSTRUCTION MANUAL
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
0915-0323, and the expiration date is 6/30/2017. Public reporting burden for
this collection of information is estimated to average 12 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, MD 20857.
HIV/AIDS Bureau
Division of Policy and Data
Health Resources and Services Administration
U.S. Department of Health and Human Services
5600 Fishers Lane, Room 7C-26
Rockville, MD 20857
2016 RSR Instruction Manual
WHAT’S NEW FOR 2016
(Last Updated: September 8, 2016)
The 2016 RSR Instruction Manual uses new terms that keep the RSR manual in line with OMB vocabulary
standards. The term “recipient” has replaced the term “grantee” (or “grantee of record”), and the term
“subrecipient” has replaced “subgrantee” (or “subcontractor”). The terms “grantee” and “subrecipient” are
used in the manual whenever instructions apply to an organization’s funding relationship with HRSA or
another organization. The term “provider” (or “service provider”) is still used in the manual when the
instructions apply to any organization (recipient or subrecipient) that provides direct services to clients.
Information that has changed from the 2015 RSR manual is highlighted so it is easy to find.
WHAT’S NEW FOR 2017
(Last Updated: September 8, 2016)
The 2017 RSR Instruction Manual will contain updated RWHAP service definitions. The new definitions
will be uniform across all HAB reports and communications. These service definition changes address PCN
#16-02, which replaces PCN #10-02, effective FY2017. These new service definitions will:
• Make services categories consistent with RWHAP statutes,
• Clarify service categories and program guidance, and
• Align all service categories across all HAB documents, products, and activities.
To prepare for the changes to service definitions, HAB presented a Webinar on February 4, 2016. The
presentation can be found at: https://careacttarget.org/library/rwhap-services-eligible-individuals-andallowable-uses-funds-policy-clarification-notice-16
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2016 RSR Instruction Manual
TABLE OF CONTENTS
What’s New for 2016 ............................................................................................................................................................................................... i
What’s New for 2017 ............................................................................................................................................................................................... i
Background ................................................................................................................................................................................................................ 1
Recipient/Subrecipient Reporting Requirements ..................................................................................................................................... 2
Recipient AND Subrecipient RELATIONSHIPS ............................................................................................................................................ 3
Recipient/Subrecipient Exemptions ............................................................................................................................................................... 4
Ryan White HIV/AIDS Program Services ...................................................................................................................................................... 6
Administrative and Technical Services ..................................................................................................................................................... 6
Core Medical Services ....................................................................................................................................................................................... 7
Support Services ............................................................................................................................................................................................... 10
HIV Counseling and Testing Services ....................................................................................................................................................... 14
Checking the Client-level Data XML File ...................................................................................................................................................... 15
RSR Recipient Report .......................................................................................................................................................................................... 16
The Grantee Contract Management System(GCMS) .......................................................................................................................... 16
Instructions for Completing the Recipient Report..............................................................................................................................16
RSR Service Provider Report ............................................................................................................................................................................ 24
Instructions for Completing the Provider Report ............................................................................................................................... 24
RSR Client-level Data ........................................................................................................................................................................................... 32
Importing the Client-level Data XML File to the Provider Report ................................................................................................ 32
Client-Level Data Elements .......................................................................................................................................................................... 33
Appendix A. Required Client-level Data Elements for RWHAP Services ........................................................................................ 58
Glossary ..................................................................................................................................................................................................................... 60
Index ...........................................................................................................................................................................................................................65
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2016 RSR Instruction Manual
BACKGROUND
(Last Updated: September 8, 2016)
The Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87, October 30, 2009) gives
Federal HIV/AIDS programs in the Public Health Service (PHS) Act under Title XXVI the 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 “parts” of the Ryan White HIV/AIDS Program (RWHAP) specify the Health Resources and Services
Administration’s (HRSA) responsibilities in the administration and allocation of grant funds, evaluation of
programs for the population served, and improvement in quality of care. Accurate records of subrecipients
receiving RWHAP funding, services provided, and clients served continue to be critical to implementing the
legislation and thus are necessary for HRSA to fulfill its responsibilities.
Previously, the HIV/AIDS Bureau (HAB) required all RWHAP-funded recipients and their contracted
service providers (or “subrecipients”) to report aggregate data annually using the RWHAP Annual Data
Report (RDR). However, aggregate data are limited in two ways:
1. Aggregate data lack client identifiers and, by definition, cannot be merged and unduplicated across
subrecipients within a given geographic area. As a result, recipients—and ultimately HAB—cannot
obtain accurate counts of the number of people RWHAP serves.
2. Aggregate data cannot be analyzed in the detail required to assess quality of care or to sufficiently
account for the use of RWHAP funds.
To address these issues, RWHAP recipients and subrecipients began using a new data reporting system in
2009, the Ryan White HIV/AIDS Program Services Report (RSR).
HAB’s goal is to have a client-level data reporting system that provides data on the characteristics of the
funded recipients, their subrecipients, and the clients served. The data you submit will be used to do the
following:
• Monitor the outcomes achieved on behalf of HIV/AIDS clients and their affected families receiving care
and treatment through RWHAP recipients and/or subrecipients;
• Address the disproportionate impact of HIV in communities of color by assessing organizational
capacity and service utilization in minority communities;
• Monitor the use of RWHAP for appropriately addressing the HIV/AIDS epidemic in the United States;
• Address the needs and concerns of Congress and the Department of Health and Human Services (HHS)
concerning the HIV/AIDS epidemic and RWHAP; and
• Monitor progress toward achieving the goals identified in the National HIV/AIDS Strategy.
HAB has taken every measure possible, including the implementation and use of an encrypted Unique
Client Identifier (eUCI), to limit data collection to only the information that is “reasonably necessary to
accomplish the purpose” of the RSR.
HAB also understands how important the data reported can be to each RWHAP as each assesses its client
service needs and establishes practical outcome measures for its programs. HAB considers these data the
property of the recipient and will not share the data with other recipients without the permission of the
reporting recipient.
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2016 RSR Instruction Manual
RECIPIENT/SUBRECIPIENT REPORTING
REQUIREMENTS
(Last Updated: September 8, 2016)
Federal regulations explicitly state that grant recipients have a responsibility to monitor their funded
subrecipients to ensure they are using their Federal grant program funds in accordance with program
requirements.1
Title 45 CFR 92.40, monitoring and reporting program performance; monitoring by grantees:
Grantees are responsible for managing the day-to-day operations of grant and
subgrant supported activities. Grantees must monitor grant and subgrant supported
activities to assure compliance with applicable Federal requirements and that
performance goals are being achieved. Grantee monitoring must cover each program,
function, or activity.
Title 45 CFR 74.51, monitoring and reporting program performance:
Recipients are responsible for managing and monitoring each project, program,
subaward, function or activity supported by the award. Recipients shall monitor
subawards to ensure that subrecipients have met the audit requirements as set forth
in §74.26.
The Federal regulations go on to affirm that grantees are required to maintain, as set forth in 45 CFR Sec.
74.47:
a system for contract administration . . . to ensure contractor conformance with the
terms, conditions and specifications of the contract and to ensure adequate and
timely follow-up of all purchases . . . [Grantees] shall evaluate contractor
performance and document, as appropriate, whether contractors have met the
terms, conditions, and specifications of the contract.
Likewise, HRSA, HHS, and Congress hold HAB responsible for monitoring and reporting the program
performance of its recipients and its subrecipients, the RWHAP service providers. HAB has established the
following reporting requirements for recipients of RWHAP funds accordingly.
Additional information on a covered entity’s use or disclosure of protected health information without the
written authorization of the individual to a public health authority can be found in 45 CFR 164.512 at:
http://www.gpo.gov/fdsys/pkg/CFR-2011-title45-vol1/pdf/CFR-2011-title45-vol1-sec164-512.pdf
The rules and requirements that govern the administration of HHS grants are set forth in the regulations found in
Title 45, Code of Federal Regulations (CFR), Part 74—Uniform Administrative Requirements for Awards and
Subawards to Institutions of Higher Education, Hospitals, Other Nonprofit Organizations, and Commercial
Organizations; and Part 92—Uniform Administrative Requirements for Grants and Cooperative Agreements to State,
Local, and Tribal Governments.
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2016 RSR Instruction Manual
RECIPIENT AND SUBRECIPIENT
RELATIONSHIPS
(Last Updated: September 8, 2016)
Recipients and subrecipients work together to quickly and easily submit the RSR. Below are illustrations
and definitions of recipient and subrecipient relationships.
A recipient-provider, which is a
service provider that also is a
recipient, must complete a
Recipient Report and a Provider
Report. A recipient-provider of
core medical or support services
must also upload client-level data.
A service organization that has a
contract with a recipient is
considered a first-level subrecipient.
A first-level subrecipient must
complete a Provider Report and, if it
provides core medical or support
services, upload client-level data.
Occasionally,
recipients will
use an
administrative
agent to award
and/or monitor
the use of their
RWHAP funds.
In this
situation, the
administrative
agent (or fiscal
intermediary
service
provider) is the
recipient’s first-level subrecipient. When the
recipient’s first-level subrecipient
(administrative agent or fiscal intermediary
provider) enters into a contract with another
provider to use the recipient’s funds to deliver
services, that provider is considered a secondlevel subrecipient to the recipient. A secondlevel subrecipient must complete a Provider
Report and, if it provides core medical or
support services, upload client-level data.
If a service
organization is
a multilevel
provider (a
second-level
subrecipient to
one recipient
and a first-level
subrecipient to
another
recipient), it
must complete
a single
Provider Report
and, if it
provides core
medical or support services, upload client-level
data. The provider must include client data for
all of its RWHAP contracts.
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RECIPIENT/SUBRECIPIENT
EXEMPTIONS
Service organizations may be exempt* from completing their own Provider Report and Client Report at the
recipient’s discretion if any of the following apply to them:
• They submit only vouchers or invoices for payment (e.g., a taxicab company that only provides
transportation services);
• They do not see clients on a regular and sustained basis (e.g., on an emergency basis only);
• They offer services to clients on a “fee-for-service” basis;
• They provide only laboratory services to clients;
• They received less than $10,000 in RWHAP funding during the reporting period;
• They see a small number (1–25 patients) of RWHAP clients;
• They did not provide services during the reporting period (January 1–December 31);
• They are no longer funded by the recipient; and/or
• They are no longer in business.
*HAB recommends that an exempted subrecipient has the reason and approval for an exemption in writing from its
recipient.
Exempting a subrecipient from submitting a Provider Report or Client Report does not exempt the
recipient from collecting and submitting data for that subrecipient. If a recipient exempts a subrecipient,
the recipient must ensure that the subrecipient’s data are reported to HAB. See page 20 for instructions on
marking a subrecipient as exempt in the RSR system. You may:
• Complete a Provider Report and upload client-level data in the exempted subrecipient’s name (do not
select the “Exempt” check box);
• Report the exempted subrecipient’s data with your agency’s RSR data (all recipient’s must select the
“Exempt” box); or
• If the first-level subrecipient will include the second-level subrecipient’s data in its (the first level
subrecipient’s) Provider Report, the recipient WILL select the “Exempt” checkbox for the second-level
subrecipient.
• However, not all subrecipients are eligible to receive a reporting exemption:
• Recipient-providers may not be given an exemption.
• Multilevel subrecipients may not be given an exemption.
• A multiply funded subrecipient may be given an exemption only if all of its recipients agree to the
exemption.
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FREQUENTLY ASKED QUESTIONS
about Recipient/Subrecipient Relationships and Reporting Requirements
I have several subrecipients that delivered services to RWHAP-eligible clients during the
reporting period. I have decided to give one of them an exemption from submitting an RSR
Provider Report and client-level data. How should I report the data for the exempt
subrecipient?
If you exempt a subrecipient from submitting an RSR Provider Report and client-level data, HAB
expects you to report its data. You may complete the subrecipient’s RSR Provider Report and upload
client-level data into the subrecipient’s report, or you may direct your first-level subrecipient to
complete the report on a second-level subrecipient’s behalf. If you or your first-level subrecipient
will be completing the report, DO NOT indicate that the subrecipient is exempted from reporting.
Note: First-level subrecipients cannot access a second-level subrecipient’s report if the first-level
subrecipient is not (1) a recipient AND (2) also funds the subrecipient.
Alternatively, you may report the exempted subrecipient’s data with your agency’s RSR data. In this
instance, you WILL select the exempt option in your Recipient Report. See page 20 for instructions
on marking a subrecipient as exempt in the RSR system.
What if a subrecipient receiving funding from multiple Program Parts is given an exemption
from reporting by one recipient but not another?
Subrecipients must be exempted from reporting by all of their recipients. If your subrecipient has
other recipients, you will need to coordinate with the other recipient(s) to ensure that all recipients
have indicated that the subrecipient is exempted. If one or more of a subrecipient’s recipients does
not agree to exempt the subrecipient, the subrecipient will still need to complete the RSR Provider
Report.
I have a subrecipient that has been exempted by all recipients that fund the agency. Why is
there a report in “Not Started” status for the agency?
If a subrecipient has been exempted by all recipients that fund the agency, all recipients will still be
required to submit a “blank” report for the agency. See page 24 for instructions.
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2016 RSR Instruction Manual
RYAN WHITE HIV/AIDS PROGRAM
SERVICES
(Last Updated: September 8, 2016)
RWHAP funds are intended to support only the HIV-related needs of clients. All services provided to HIVpositive, HIV-indeterminate (infants <2 years only), and HIV-affected clients must always promote the
medical outcomes of the infected client.
The services are divided into four groups:
• Administrative and technical services;
• Core medical services;
• Support services; and
• HIV counseling and testing services.
Administrative and Technical Services
Planning or evaluation services are the systematic (orderly) collection of information about the
characteristics, activities, and outcomes of services or programs 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 are the provision of quality and responsive support
services to an organization. These 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 are the provision of administrative services to the recipient of record by a
pass-through organization. The responsibilities of these organizations may include determining the
eligibility of RWHAP recipients, deciding how funds are allocated to recipients, awarding RWHAP funds to
recipients, monitoring recipients for compliance with RWHAP-specific requirements, and completing
required reports.
Other fiscal services are 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 identify the need for and the delivery of practical program and technical
support to the RWHAP community. These services should help recipients, planning bodies, and
communities affected by HIV and AIDS to design, implement, and evaluate RWHAP-supported planning and
primary care service-delivery systems.
Capacity development services are services to develop a set of core competencies that in turn help
organizations foster effective HIV health care services, including the quality, quantity, and costeffectiveness 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, including quality assurance, personnel management, and board
development; resource development, including preparation of grant applications to obtain resources and
purchase supplies/equipment; service evaluation; and development of cultural competency.
Quality management services comprise systematic processes with identified leadership, accountability,
and dedicated resources using data and measurable outcomes to determine progress toward relevant,
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2016 RSR Instruction Manual
evidence-based benchmarks. Quality management programs should focus on linkages, efficiencies, and
subrecipient and client expectations in addressing outcome improvement, and they need to adapt to
change. The process is continuous and should fit in the framework of other program quality assurance and
quality improvement activities, such as the Institute for Healthcare Improvement, 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
improved.
Quality management is a continuous process to improve how 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 (1) services adhere to PHS guidelines and established clinical practice; (2) program
improvements include supportive services; (3) supportive services are linked to access and adherence to
medical care; and (4) demographic, clinical, and utilization data are used to evaluate and address
characteristics of the local epidemic. For further information on quality management, please refer to the
resources available at http://hab.hrsa.gov/deliverhivaidscare/qualitycare.html.
Core Medical Services
The definitions below do not account for
changes related to policy notice 16-02,
which is effective for FY2017. The reporting
period is 1/1/2017 to 12/31/2017.
Core medical services are specified in the Ryan White HIV/AIDS Treatment Extension Act of 2009. They are
a set of essential, direct health care services provided to RWHAP clients who are HIV positive or HIV
indeterminate (infants <2 years only), with one exception. HIV-negative clients may receive HIV counseling
and testing (HC&T) services under Early Intervention Services for Parts A and B; HC&T data are reported in
the Provider Report.
When reporting RWHAP-eligible services, keep in mind the following:
1. Providers that deliver core medical services are required to upload
client-level data.
2. RWHAP core medical services may not be provided anonymously.
3. Early Identification of Individuals with HIV/AIDS (EIIHA) activities
should be reported under the service category with the definition that
best describes the service provided.
Outpatient/ambulatory medical care includes the provision of professional diagnostic and therapeutic
services directly to a client by a physician, physician assistant, clinical nurse specialist, nurse practitioner,
or other health care professional certified in his or her jurisdiction to prescribe antiretroviral (ARV)
therapy in an outpatient setting. These 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, wellbaby 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 ARV and
other drug therapies, including prophylaxis and treatment of opportunistic infections and combination ARV
therapies.
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2016 RSR Instruction Manual
Early Intervention Services provided by RWHAP Part C
and Part D are reported under outpatient/ambulatory
medical care.
AIDS Drug Assistance Program (ADAP) is a State-administered program authorized under Part B of
RWHAP that provides FDA-approved medications to low-income people with HIV/AIDS disease who have
limited or no coverage from private insurance, Medicaid, or Medicare. Program funds may also be used to
purchase health insurance for eligible clients and for services that enhance access to, adherence to, and
monitoring of drug treatments.
Part B recipients and subrecipients should not
report ADAP data in the RSR, including services
provided with ADAP flexibility funding.
Local AIDS pharmaceutical assistance (APA, not ADAP) includes local pharmacy assistance programs
implemented by Part A or Part B recipients to provide HIV/AIDS medications to clients. This assistance can
be funded with Part A grant funds or Part B base award funds. These organizations may or may not provide
other services (e.g., outpatient/ambulatory medical care or case management) to the clients they serve
through a RWHAP contract with their recipient.
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 vouchers to a client to procure medications.
Local APAs are similar to 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 a dental health care
professional licensed to provide health care in the State or jurisdiction, including general dental
practitioners, dental specialists, and dental hygienists, as well as licensed and trained dental assistants.
Early intervention services (EIS) for Parts A and B include counseling individuals with respect to
HIV/AIDS; testing (including tests to confirm the presence of the disease, to diagnose the extent of immune
deficiency, and 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.
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2016 RSR Instruction Manual
When reporting RWHAP eligible services, keep in mind the following:
1. EIIHA activities should be reported under the service category with
the definition that best describes the service provided.
2. EIS provided by RWHAP Part C and Part D are reported under
outpatient/ambulatory medical care.3. Part A and Part B recipients
that fund EIS must also check HC&T services for at least one service
provider.
Although HC&T activities are an integral part of EIS, HIV-negative clients who receive HC&T services under
EIS for Parts A and B should be reported only in the RSR Provider Report. This includes data on people with
preliminary positive or invalid rapid HIV tests and negative confirmatory HIV tests.
Health insurance premium and cost-sharing assistance, also referred to as Health Insurance Program
(HIP), is the provision of financial assistance for eligible individuals living with HIV 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.
Data on health insurance premium and cost-sharing assistance
funded through ADAP should NOT be reported in the RSR. These
data are reported in a separate ADAP data report.
Home health care is the provision of services in the home by licensed health care professionals, 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.
Inpatient hospital services, nursing homes, and other
long-term care facilities are not included as home and
community-based health services.
Hospice services are end-of-life care provided to clients in the terminal stage of an illness. They include
room, board, nursing care, counseling, physician services, and palliative therapeutics. Services may be
provided in a residential setting, including a nonacute care section of a hospital that has been designated
and staffed to provide hospice services. A physician must certify that a patient is terminal, defined under
Medicaid hospice regulations as having a life expectancy of 6 months or less. Counseling services provided
in the context of hospice care must be consistent with the definition of mental health counseling. Palliative
therapies must be consistent with those covered under respective State Medicaid programs.
Mental health services are psychological and psychiatric treatment and counseling services for
individuals with a diagnosed mental illness. They 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.
Such professionals typically include psychiatrists, psychologists, and licensed clinical social workers.
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2016 RSR Instruction Manual
Mental health services provided to HIVaffected clients should be reported as
psychosocial support services.
Medical nutrition therapy, including nutritional supplements, is provided by a licensed, registered
dietitian outside of an outpatient/ambulatory medical care visit. The provision of food may be provided
pursuant to the recommendation of a health care professional (i.e., physician, physician assistant, clinical
nurse specialist, nurse practitioner) and a nutritional plan developed by a licensed, registered dietician.
Nutritional counseling services and nutritional supplements not provided by a licensed, registered dietician
shall be considered a support service and be reported under psychosocial support services and food
bank/home-delivered meals, respectively. Food not provided pursuant to a health care professional’s
recommendation and a nutritional plan developed by a licensed, registered dietician should also be
considered a support service and is reported under food bank/home-delivered meals.
Medical case management services (including treatment adherence) are a range of client-centered
services that link clients with health care, psychosocial, and other services provided by trained
professionals, including both medically credentialed and other health care staff. The coordination and
follow up of medical treatments are 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 needs and personal support systems of the client and other key
family members. 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, at least every 6 months, 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 meetings, telephone calls, and any other forms of
communication. This service includes referrals for additional services to other service providers. If you
provide referrals as part of this service, please do not indicate this in the clinical data section unless the
referral was provided as part of an OAMC service. Similarly, if you provide adherence counseling as part of
this service, please do not indicate this in the clinical data section unless it was provided as part of an
OAMC service.
Voicemails left for clients are not
reportable as Medical case
management service visits.
Substance abuse services (outpatient) are 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. They include limited
support of acupuncture services to HIV-positive clients, provided the client has received a written referral
from his or her primary health care provider and the service is provided by certified or licensed
practitioners and/or programs, wherever State certification or licensure exists.
Support Services
Support services are a set of services needed to achieve medical outcomes that affect the HIV-related
clinical status of a person living with HIV/AIDS. Support services may be provided to HIV-positive and HIVindeterminate clients (infant <2 years only) as needed. Support services may also be provided to HIVaffected clients. However, the services provided to HIV-affected clients must always support a medical
outcome for the HIV-positive client or HIVindeterminate client (infant <2 years only).
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2016 RSR Instruction Manual
When reporting RWHAP-eligible services, keep in mind the following:
1. Providers that deliver support services are required to upload clientlevel data.
2. RWHAP support services may not be provided anonymously.
NOTE: This includes outreach services.
3. EIIHA activities should be reported under the service category with
the definition that best describes the service(s) provided.
Case management services (non-medical) include advice and assistance in obtaining medical, social,
community, legal, financial, and other needed services. Non-medical case management does not involve
coordination and follow-up of medical treatments. If you provide referrals as part of this service, please do
not indicate this in the clinical data section unless the referral was provided as part of an OAMC service.
Child care services are care for the children of clients who are HIV positive while the clients are attending
medical or other appointments, or RWHAP-related meetings, groups, or training. These services do not
include child care while the client is at work.
Pediatric developmental assessment and early intervention services are professional early
interventions by physicians, developmental psychologists, educators, and others for the psychosocial and
intellectual development of infants and children. They involve the assessment of an infant or 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-infected clients, and
education/assistance to schools also should be reported in this category.
Only Part D programs are eligible to provide
pediatric developmental assessment and
early intervention services.
Emergency financial assistance is the provision of one-time or short-term payments to agencies or the
establishment of voucher programs when other resources are not available to help with emergency
expenses related to essential utilities, housing, food (including groceries, food vouchers, and food stamps),
transportation, and medication. 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).
It is expected that all other sources of funding in the community for emergency assistance will be
effectively used and that any allocation of RWHAP funds for these purposes will be the payer of last resort,
and for limited amounts, use, and periods of time. Continuous provision of an allowable service to a client
should be reported in the applicable service category.
Food bank/home-delivered meals involves 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, should also be included in this
item. The provision of food or nutritional supplements by someone other than a registered dietician should
be included in this item as well.
Food vouchers provided as an ongoing service to a client should be reported in this service category. Food
vouchers provided on a one-time or intermittent basis should be reported in the emergency financial
assistance category.
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Health education/risk reduction activities educate clients living with HIV about how HIV is transmitted
and how to reduce the risk of 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.
Health education/risk reduction services can only be delivered to individuals
who are HIV positive. These services cannot be delivered anonymously. Clientlevel data must be reported for every person who receives these services.
Housing services are 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 provides some type of medical or supportive services (such as residential substance
abuse or mental health services, residential foster care, or assisted living residential services) and housing
that does not provide direct medical or supportive services but is essential for an individual or family to
gain or maintain access to and compliance with HIV-related medical care and treatment.
Housing funds cannot be in the form of direct cash payments to recipients for services and cannot be used
for mortgage payments. Short-term or emergency assistance is understood as transitional in nature and for
the purposes of moving or maintaining an individual or family in a long-term, stable living situation.
Therefore, such assistance cannot be permanent and must be accompanied by a strategy to identify,
relocate, and/or ensure the individual or family is moved to, or capable of maintaining, a long-term, stable
living situation. For more information, see the policy “The Use of Ryan White HIV/AIDS Program Funds for
Housing Referral Services and Short-term or Emergency Housing Needs” at
http://hab.hrsa.gov/manageyourgrant/policiesletters.html.
Legal services are services to people with respect to powers of attorney, do-not-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 RWHAP.
Legal services to arrange for guardianship or adoption of children after the death of their primary caregiver
should be reported as a permanency planning service.
Linguistic services include interpretation (oral) and translation (written) services, provided by qualified
people as a component of HIV service delivery between the provider and the client, when such services are
necessary to facilitate communication between the provider and client and/or support the delivery of
RWHAP–eligible services.
Medical transportation services are conveyance services provided, directly or through a voucher, to a
client to enable him or her to 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 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. Broad activities such as providing leaflets at a subway stop, a poster at
a bus shelter, or tabling at a health fair would not meet the intent of the law. These services should 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, targeted to populations known
through local epidemiologic data to be at disproportionate risk for HIV infection, conducted at times and in
places where there is a high probability of reaching individuals with HIV infection, and designed with
quantified program reporting that will accommodate local effectiveness evaluation.
RWHAP outreach services cannot be delivered
anonymously. Client-level data must be reported
for every person who receives this service.
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Permanency planning includes services to help clients/families make decisions about the placement and
care of minor children after their parents/caregivers have died or are no longer able to care for them. It
includes the provision of social service counseling or legal counsel regarding (1) drafting of wills or
delegating powers of attorney and (2) preparing custody options for legal dependents, including standby
guardianship, joint custody, or adoption.
Psychosocial support services are support and counseling activities, child abuse and neglect counseling,
HIV support groups, pastoral care, caregiver support, and bereavement counseling. Nutrition counseling
services provided by a nonregistered dietitian are reported in this service category.
Nutritional services and nutritional supplements provided by a licensed, registered dietician are
considered a core medical service and should be reported as Medical nutrition therapy. The provision of
food and/or nutritional supplements by someone other than a registered dietician should be reported in
the Food bank/home-delivered meals service category.
Referral for health care/supportive services is the act of directing a client to a service in person or in
writing, by telephone, or through another type of communication. These services are provided outside of
an outpatient/ambulatory medical care, medical case management, or nonmedical case management
service visit.
Referrals for health care/supportive services provided by outpatient/ambulatory medical care providers
should be reported under the outpatient/ambulatory medical care service category. Referrals for health
care/supportive services provided by case managers (medical and nonmedical) should be reported in the
appropriate case management service category—medical case management or non-medical case
management.
Rehabilitation services are 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. These include physical and occupational therapy, speech pathology, and low-vision training.
Respite care is 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) includes treatment to address substance abuse problems
(including alcohol and/or legal and illegal drugs) in a residential health service setting (short-term care).
They include limited support of acupuncture services to HIV-positive clients, provided the client has
received a written referral from his or her primary health care provider and the service is provided by
certified or licensed practitioners and/or programs, wherever State certification or licensure exists.
Part C programs are not eligible to
provide substance abuse services
(residential).
Treatment adherence counseling includes counseling or special programs provided outside of a medical
case management or outpatient/ambulatory medical care visit by non-medical personnel to ensure
readiness for, and adherence to, complex HIV/AIDS treatments. Treatment adherence counseling provided
during an outpatient/ambulatory care service visit should be reported under the outpatient/ambulatory
medical care service category. Likewise, treatment adherence counseling provided during a medical case
management visit should be reported in the medical case management service category.
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HIV Counseling and Testing Services
HIV counseling and testing is the use of an FDA-approved test 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 any disclosures authorized under applicable law; 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 outpatient/ambulatory medical care.
This service category also excludes mental health counseling/therapy, substance abuse
counseling/treatment, and psychosocial support services. These services are reported separately.
HIV counseling and testing are components of EIS for Parts A and B but are reported in the Provider Report
in the HIV Counseling and Testing section. They are required components of a Part C program. Part D funds
may also be used to support these services.
HIV counseling and testing activities
are reported in the Provider Report
as aggregate data.
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CHECKING THE CLIENT-LEVEL DATA
XML FILE
(Last Updated: September 8, 2016)
The Check Your XML Feature allows subrecipients to confirm the XML file complies with RSR client-level
data schema and to review data quality prior to the submission of client-level data. Subrecipients are also
able to check their client-level data to identify any data validations that need to be addressed before
submission. The Check Your XML feature is available to users before the RSR Recipient Report opens.
For detailed instructions on how to access and use the Check Your XML feature, refer to the materials
available on the TARGET Center website at https://careacttarget.org/library/check-your-xml-feature-rsr.
Instructions on how to import client-level data can be found on page 32 of this manual.
Uploading client-level data in the Check Your XML feature DOES
NOT meet the requirement for data reporting. A client-level
data file must be uploaded using the “import client-level data”
link in the RSR Provider Report to meet the reporting requirement.
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RSR RECIPIENT REPORT
(Last Updated: September 8, 2016)
Each recipient of record completes a separate Recipient Report for each RWHAP grant the recipient
receives from HRSA. For example:
• An agency with only a Part A grant will complete one Recipient Report.
• An agency with a Part C grant and a Part D grant will complete two Recipient Reports—one for its Part
C grant and another for its Part D grant.
The Grantee Contract Management System (GCMS)
All RWHAP contract information is stored in the Grantee Contract Management System (GCMS). The GCMS uses
information from your previous RSR submissions, the Consolidated List of Contracts (CLC) and/or Program
Terms Report (PTR) to populate your RSR Recipient Report with all the elements necessary to complete the
RSR, such as subrecipient relationships and funded services. You will not be required to synchronize any
changes to the RSR Recipient Report if the subrecipient and service information populated from the GCMS are
correct. However, if the data that populates in the Recipient Report are incorrect, edit the information in the
GCMS and integrate your changes into your RSR via the Synchronize step on the Program Information page of
the RSR Recipient Report.
Instructions on how to synchronize information
into your RSR Recipient Report can be found on
page 20 of the manual.
Instructions for Completing the Recipient Report
Step One: Access the GCMS
(Recipients and Recipient-providers only): Log in to the HRSA electronic handbooks (EHBs) site at
https://grants.hrsa.gov/webexternal and navigate to your Performance Reports. There are several methods
of accessing the RSR Report in the EHBs interface. You can find a video as well as slides to assist you with
this on the Target Center website: https://careacttarget.org/library/overview-hrsa-electronic-handbooksgrantees. Start at slide 26.
• “Grants” tab, also on the top-left side of the screen. This will take you to a list of all of the grants with which
you are affiliated. Select the “grants folder” link for the grant with an RSR due and find the “Performance
Reports” link under the Submission heading. Find your 2016 RSR Deliverable, and click “Start” or “Edit.” On
the left side of the screen, under the navigation panel, select “Search Contracts.”
• “Tasks” tab at the top-left side of the screen. This will take you to a list of your current deliverables. If your
RSR is due soon, you’ll find it on the list of deliverables. Find your 2016 RSR Deliverable, and click “Start” or
“Edit.” On the left side of the screen, under the navigation panel, select “Search Contracts.”
If you need help navigating the EHBs to
find your annual RSR, call the HRSA
Contact Center at 1-877-464-4772.
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Step Two: Verify your contracts in the GCMS
In the GCMS enter the date range for your submission as the search criteria. For example, for the 2016 RSR,
enter “1/1/2016” in the Range Start Date field and “12/31/2016” in the Range End Date Field.
Contracts listed in the GCMS should match the actual agreements you have in place with your
subrecipients. For the purpose of the RSR, contracts include formal contracts, memoranda of
understanding, or other agreements. Each subrecipient listed and the corresponding services they are
funded to provide will be copied into your RSR Recipient Report when it is created.
You will need the following information for each of your contracts:
Contract Information
1. Contract Start Date: Enter the start date by typing into the box or selecting the date from the calendar.
2. Contract End Date: Enter the end date by typing into the box or selecting the date from the calendar.
3. Enter the Contract Reference number (if applicable): This item is for your reference and is not
required for you to be able to enter the contract.
4. Is this agency serving as a consortia, fiscal intermediary provider, administrative agent, or lead agency
for this contract? Select “Yes” or “No.” If you select “Yes,” specify consortia, fiscal intermediary
provider, administrative agent, or lead agency in question 4b that appears after you select “Yes.”
5. Is this agency a subcontractor or second-level provider? Select “Yes” or “No.” If you select “Yes,” select
the provider’s fiscal intermediary from the drop down menu in question 5b.
Service Information
6. Does this agency provide direct client services? Select “Yes” or “No.”
7. If applicable, select the administrative and technical services that are funded for this contractor. Select
all that apply:
•
•
•
•
Planning and evaluation
Administrative or technical support
Fiscal intermediary support
Other fiscal services
• Technical assistance
• Capacity development
• Quality management
8. If applicable, indicate the core medical and essential support services that are funded for this contract
by selecting the “Update Services” button. A screen will pop up with the list of services. Enter the
award amount(s) for each service that the subrecipient was funded to deliver, regardless of whether
the subrecipient actually used the funding. To review the service definitions, refer to page 6.
Once you have entered all the information into the contract, click the “Done Updating Services” link.
Then click “Save” at the bottom of the main page.
The GCMS does not capture funding
amounts allocated to administrative
and technical services.
After you have verified that all contracts listed are correct, you are ready to complete the RSR
Recipient Report.
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Editing Contracts in the GCMS
If you need to make modifications to your list of service provider contracts displayed, click the
“Edit/Remove” link at the right side of the table to open the desired contract. Make the edits, and click
“Save.”
The GCMS will populate multiple HAB deliverables in the
future. Only delete a contract from the GCMS if you no longer
have a contract in place during the reporting period. If a
specific contract is exempt from RSR reporting, use the exempt feature in
the RSR Recipient Report. See page 4 for exemption instructions.
Adding Contracts in the CGMS
If a contract is missing for one of your subrecipients, you will need to add a new contract:
1. Click the “Add Contract” button below the search results table.
2. Search for the organization by registration code, name, or City/State.
3. Locate the subrecipient in the results table, and click “Add” under the action column.
4. Complete questions 1-8.
Ensure all contracts within the
submission period are accurate and
present in the GCMS before
proceeding to Step Three.
If you need help locating/adding a
subrecipient to the GCMS, call Data
Support at 1-888-640-9356 or e-mail
[email protected].
Step Three: Open and complete your RSR Recipient Report
Once all contracts from the submission period are in the GCMS, under the inbox heading in the left navigation
menu, select the “Recipient Report” link. Create or open your Recipient Report by clicking the envelope icon
under the “Action” column. You will be redirected to the RSR Recipient Report General Information Page.
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General Information
Figure 1. RSR Recipient Report Online Form: Screenshot of the “General Information” Section
Items 1–3 show the information on the Recipient report prepopulated from your notice of award (NOA).
These fields are editable, and you should also update your agency’s information on your NOA:
1. Official Mailing Address
a. Street
b. City
c. State
d. Zip Code
2. Organization Identification
a. EIN
b. DUNS
3. Contact information of person completing this form (fillable item). This will be the primary contact
person with regards to RSR matters.
a. Name
d. Fax
b. Title
e. Email
c. Phone
4. Select the status of your agency’s clinical quality management program for assessing HIV health
services (select only one):
• Clinical quality management program initiated this reporting period;
• Previously established clinical quality management program;
• Previously established program with new quality standards added this reporting period; or
• Not applicable.
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Every RWHAP agency that provides core medical is required to have a clinical quality management
program to assess how 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, refer to the resources
available at http://hab.hrsa.gov/deliverhivaidscare/qualitycare.html.
5. (Part C & D Recipients Only) Indicate whether your agency received Minority AIDS Initiative (MAI)
funding during the reporting period. If your agency did receive MAI funding, specify the most recent
percentage designation for the reporting period.
Click “Save” on the bottom right of the page.
Program Information
Figure 2. RSR Recipient Report Online Form: Screenshot of the “Program Information” Section
On the left navigation panel, select “Program Information.” Review the list of your service providers that
were active during the reporting period.
• Select the “Expand/Collapse” icon to view the services you funded for each subrecipient. The list should
display all of the services that were funded, regardless of whether the subrecipient actually delivered
the service.
• If you need to exempt a subrecipient from reporting, check the box in the “Exempt” column on the right
of the Program Information page, and enter a brief explanation for the exemption. Please Note: If a
subrecipient has other recipients in addition to you, all of their recipients must use the “Exempt” check
box for the subrecipient to be considered exempt from reporting. If one or more recipient(s) choose
not to exempt the subrecipient, then the Provider Report must be completed and should include data
for all programs. Refer to page 4 for a list of exemption criteria.
• If all of the information displayed is correct, click “Save” at the bottom of the page, and move on to Step
4 (Validate and Certify your RSR Recipient Report).
Synchronizing Changes to Your RSR Recipient Report
If you edit contracts in the GCMS after you start your Recipient Report, you must synchronize the changes.
To access the “Synchronize” feature, click “Program Information” in the left navigation panel. You will see a
Warning message that contains links for each subrecipient with contract edits.
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Figure 3. RSR Recipient Report Online Form: Screenshot of the “Program Information” Section
with Synchronization Warning
• Click on either the link in the Warning message box or the icon in the Warning column to open the
synchronization screen. As a note: If you added a new subrecipient contract in the GCMS, you will not
see that subrecipient in your list. Click the link with the subrecipient name in the Warning at the top of
the page.
• Review the list of changes you made to the subrecipient contract(s). To accept the changes and update
the data in your Recipient Report, click “Synchronize” at the bottom of the page. This step must be
completed for each subrecipient triggering the synchronization warning.
• You must synchronize your Recipient Report to incorporate any changes that you made in the GCMS.
Changes are not visible to subrecipients until they have been synchronized.
6. Once you have synchronized and reviewed all subrecipients in the “Program Information” section,
check the box at the bottom of the page indicating that you certify the information is accurate, and click
“Save.”
Step Four: Validate and certify your RSR Recipient Report.
Once your Recipient Report is complete and correct, validate your Recipient Report by selecting the
Validate link in the menu on the left. Allow the system to validate for a few minutes, and then refresh the
page by selecting Validate again. If your Recipient Report triggers a validation error, you must revise your
Recipient Report. You cannot certify your Recipient Report with errors.
Indicate that you have completed data entry for your RSR Recipient Report by clicking “Certify” in the
menu on the left. Enter a comment in the text box, and check the box under the comment box indicating
that you certify that the information is accurate. Recipients should make an effort to certify their RSR
Recipient Reports as soon as possible after the RSR Web System opens. Subrecipients cannot submit their
RSR Provider Report and client-level data until their recipient(s) certify their RSR Recipient Report(s).
You will need to request a decertification if you
need to make edits to your Recipient Report
Program Information after it has been certified.
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Step Five: Accepting Provider’s Reports (after subrecipients have submitted
their report)
When your subrecipient(s) have submitted their RSR Provider Report and client-level data, it is your
responsibility to review the reports.
• Navigate to each subrecipient’s RSR by using the Provider Report inbox or searching for the
subrecipient using the search feature in the left navigation menu. Open the Provider Report by selecting
the envelope icon in the “Action” column.
• Review:
–
–
–
–
Provider Report,
Upload Confirmation Report validation
Completeness Report
Validation comments the subrecipient has made
• Then use the links on the left to either “Submit/Accept” or “Return for Changes.”
• (For Exempted Subrecipients Only): If all recipients have exempted a subrecipient, “Create” the
Provider Report, and use the “Submit/Accept” link to submit a blank provider report.
Your RSR Recipient Report will not advance to “Submitted” status until you have accepted ALL of your
providers’ reports.
If you have multiple grants, such as a Part C and Part D grant, you must accept the report from both grant
folders before the Provider Report will advance to “Submitted” status.
If you need help completing your Recipient
Report or reviewing your provider’s reports,
contact RWHAP Data Support at 1-888-640-9356
or [email protected].
FREQUENTLY ASKED QUESTIONS
about the RSR Recipient Report
My subrecipient is multiply funded. Does it have to submit multiple RSR Provider Reports?
No. Subrecipients only submit one RSR Provider Report, even if they are multiply funded. Their RSR
Provider Report should include data for all of their RWHAP funds.
We are a Part C and Part D recipient; we are also a Part A subrecipient. We do not have Part C
or Part D subrecipients. We use all of our funds to deliver HIV counseling and testing, core
medical, and support services. What components of the RSR do I have to complete?
To complete your RSR, submit two RSR Recipient Reports, one for your Part C grant and another for
your Part D grant. Complete one RSR Provider Report that includes data on all the services your
agency is funded to deliver. Finally, submit client-level data that includes one record for each client
that received a service visit during the reporting period.
One of my subrecipients receives funds to provide ADAP services only. Will this subrecipient
submit an RSR?
No. This subrecipient is not required to submit an RSR. When a contract is created for a subrecipient,
at least one non-ADAP service must be specified. Recipients should exclude subrecipients (and/or
subrecipients’ contracts) that are exclusively funded to provide only ADAP services from their
Recipient Reports.
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Our organization contributes Part A EMA/TGA funds and/or Part B Base Funds for ADAP.
Should I include a contract with the State (or its ADAP contractor) on my contract list?
Yes, a contract should be entered into the GCMS for the respective contract period. The State (or its
ADAP contractor) may be exempted from reporting on the Program Information section of the RSR
Recipient Report.
I am a recipient and have a contract with a fiscal intermediary. Do I list second-level
subrecipient services in the fiscal intermediary contract?
No. You must create a contract for the fiscal intermediary in the GCMS. On question 4 of the contract,
you will indicate that the subrecipient is a fiscal intermediary. Then, create a separate contract for
the second-level subrecipient. Under question 5 in the GCMS, you will indicate “Yes,” and select the
fiscal intermediary that funds the organization.
The services listed for one of my subrecipients are not correct. Where can I edit the services?
You can make modifications to the contract in the GCMS. Select “Search Contracts” to enter the
GCMS, search and select the subrecipients, make updates as necessary, and synchronize your report.
As a reminder, verify contracts BEFORE starting the Recipient Report to avoid the need to
synchronize the data.
I have already certified my Recipient Report, and I am no longer able to make any changes.
What do I need to do?
You are not able to make changes to your Recipient Report while it is in “Certified” status. You will
need to “request decertification” using the link on the left navigation panel. Once your request is
approved, you will be able to make changes, re-validate, and re-certify your report. Please contact
Data Support at 1-888-640-9356 or [email protected] for assistance with
requesting a decertification.
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RSR SERVICE PROVIDER REPORT
(Last Updated: September 8, 2016)
An organization that provides Ryan White Program funded services to Persons Living with HIV/AIDS
(PLWHA) could fill any and all of the roles noted on page 6. At the same time, it might be:
• A recipient-provider,
• A subrecipient provider, or
• A second-level subrecipient provider.
For the purposes of the Provider Report, all of these entities are referred to as “providers.” They all provide
client-level data about their services (unless exempted).
The Provider Report is a collection of basic information about both the provider and the services the
provider delivered under each of its RWHAP contracts.
All agencies that provide RWHAP-funded services must complete one Provider Report using the RSR Web
System. Multiply funded providers will include information from all Program Parts under which the agency
is funded in one Provider Report.
Unless exempted, all provider agencies are expected to complete their own reports to confirm that their
data accurately reflect their program and the quality of care their agency provides. A full explanation of
exempting provider is in the section Recipient/Subrecipient Reporting Requirements on page 2.
Instructions for Completing the Provider Report
Step One: Open the Provider Report.
Recipient-providers: If you are a recipient-provider, you must access the RSR Web System via the EHBs.
To access the RSR system, log in to the EHBs at https://grants.hrsa.gov/webexternal and navigate to your
Performance Reports. There are several methods of accessing the RSR in the EHBs interface, including
through the following:
• The “Grants” tab, also on the top-left side of the screen. This will take you to a list of all of the grants
with which you are affiliated. Select the “grants folder” link for the grant with an RSR due and find the
“Performance Reports” link under the Submission heading. Find your 2016 RSR Deliverable, and click
“Edit.” On the left side of the screen, under the Inbox heading, select “Provider Report.” Use the
envelope icon in the Action column to access your Provider Report.
• The “Tasks” tab at the top-left side of the screen. This will take you to a list of your current deliverables.
If your RSR is due soon, you’ll find it on the list of deliverables. Find your 2016 RSR Deliverable, and
click “Edit.” On the left side of the screen, under the Inbox heading, select “Provider Report.” Use the
envelope icon in the Action column to access your Provider Report.
If you need help navigating the EHBs
to find your annual RSR, call the HRSA
Contact Center at 1-877-464-4772.
Providers Only: To access the RSR system, go to
https://performance.hrsa.gov/hab/RegLoginApp/Admin/Login.aspx. Enter your username and password,
and click “Log In.” If you have submitted the report in the past, you do not need to reregister in the system.
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If you are a new RSR system user, then you will need your agency’s registration code to create a user name
and password. You will automatically be taken to the first page of your Provider Report
To get your registration code, contact your
recipient or Data Support at 1-888-640-9356. If you
need help logging into or registering to use the
RSR system, call the HRSA Contact Center at 1-877-464-4772.
Step Two: Complete the Provider Report
On the left navigation panel, there is a section called Provider Report Navigation. There are five
links in this section: General Information, Program Information, Service Information, HC&T
Information, and Import Client-level Data. You will need to complete each of these sections before
validating and submitting the report.
General Information
Confirm the following information. This information is populated from your organization’s profile. Use the
“Update” link highlighted in red below to modify as needed.
Figure 4. RSR Provider Report Online Form: Screenshot of “General Information”
Organization Details:
• Organization Name (editable for service provider only organizations)
• Tax ID/EIN
• DUNS
• Mailing Address
Provider Profile Information
Subrecipient Type (select only one): Select the provider type that best describes your agency.
• 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.
• Publicly 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.
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2016 RSR Instruction Manual
• Other community-based service organization includes nonhospital-based organizations; HIV/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.
• Solo/group private medical practice includes all health and health-related private practitioners and
practice groups.
• Agency reporting for multiple fee-for-service providers is an agency that reports data for more
than one fee-for-service provider (e.g., a State operating a reimbursement pool).
• People Living with HIV/AIDS (PLWHA) coalition includes organizations that provide support
services to individuals and families affected by HIV and AIDS.
• VA facility is a facility funded through the U.S. Department of Veterans Affairs.
• Other provider type is an agency that does not fit the agency types listed above. If you select “Other
facility,” you must provide a description.
Section 330 funding received: funds community health centers, migrant health centers, and health
care for the homeless? Section 330 of the Public Health Service Act (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. Indicate if you received such funding during the reporting period.
• Yes
• No
• Unknown
Ownership Type (select only one):
• 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.
• Public/Federal is an organization funded by the Federal Government and operated by Federal
Government employees. A VA hospital is an example of a Federal publicly owned organization.
• Private, nonprofit is an organization owned and operated by a private, not-for-profit entity, such as a
nonprofit health clinic.
• Private, for-profit is an organization owned and operated by a private entity, even though it may
receive government funding. A privately owned hospital is an example.
• Unincorporated is an agency that is not incorporated.
• Other is an agency other than those listed above.
Faith-Based Organization (Indicate whether your organization considers itself faith based):
• Yes
• No
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Categories that best describes the agency’s racial/ethnic characteristics. Select all that apply:
• Agency in which racial/ethnic minority group members make up more than 50% of the agency’s board
members.
• Agency in which more than 50% of the professional staff members in direct HIV services are
racial/ethnic minority group members.
• Solo or group private health care practice in which more than 50% of the clinicians are racial/ethnic
minority group members.
• Other “traditional” provider that has historically served racial/ethnic minority clients but does not
meet any of the criteria above.
• Other type of agency or facility.
Providers may report any and all the first, second, and/or third response if they apply. If none of these
apply, choose either the fourth response OR the fifth response.
Service Delivery Sites: If the providers deliver client services, at least one service delivery site should be
listed. Review the information in the table for accuracy. Use the “Edit” link to make changes to site
information and modify delivered services at each agency. Use the “Add a Site” button to add additional
service delivery sites.
Figure 5. RSR Provider Report Online Form: Screenshot of the “Service Delivery Sites”
Follow the on-screen prompts to enter the information into the “Add/Edit a New Service Delivery Site”
screen. The Hours of Operation field is a text field, so you can enter anything, such as “By appointment
only,” to complete this item. Once you have entered all the required information, select “Save” at the bottom
of the screen.
Program Information
1) Contact Information of person responsible for this submission. Verify that the contact
information is correct, and make any necessary changes.
2) Report the number of paid staff, in full-time equivalents (FTEs), funded by RWHAP 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
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.
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If a percentage of each staff member’s time is being funded (e.g., part-time employees or full-time
employees who spend only a portion of their time in HIV/AIDS care), simply add the percentages to
calculate the total. For example: An agency uses program funds to support two physicians, one full time
(1.0 FTE) and another part time (0.50 FTE); a nurse practitioner full time (1.0 FTE); a dentist part time
(0.20 FTE); and two case managers, one part-time (0.75 FTE) and another full-time (1.0 FTE). This agency
would report 4.45 FTEs in Item 10 of its Service Provider Report.
3) Select the status of your agency’s clinical quality management program for assessing HIV
core medical services (select only one):
• Clinical quality management program initiated this reporting period;
• Previously established clinical quality management program;
• Previously established program with new quality standards added this reporting period; or
• Not applicable.
Every RWHAP is required to use such a 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 PHS
guidelines for the treatment of HIV/AIDS. For further information on quality management, please refer to
the resources available at http://hab.hrsa.gov/deliverhivaidscare/qualitycare.html. After reviewing and
updating the information on this page of the Service Provider Report (if necessary), save the data and
advance to the “HIV Counseling and Testing” section of the Provider Report.
Funding Source Certification
4) This item lists all of your agency's sources of RWHAP funding. Verify that this list is accurate by
checking the box under the funding source table. If a funding source is missing or services listed
are inaccurate, contact your recipient and ask it to add your agency to its list of contractors. If a
recipient that did not fund your organization is listed, contact RWHAP Data Support for assistance.
Figure 6. RSR Provider Report Online Form: Screenshot of the “Funding Source Certification”
At the bottom of the page is a check box where you certify that the funding sources are correct. If
they are correct, click the check box.
Service Information
5) Review the services funded by your recipient(s). This is populated from the services indicated as
funded by your recipient(s) in its Recipient Report(s). This list includes ALL RWHAP funding
sources that are covered by the RSR. Your agency should select any service category that was
delivered using Ryan White funds during the reporting period. If a service category is missing,
contact the appropriate recipient.
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HC&T Information
If your agency used Ryan White Program funding to provide HC&T services during the given reporting
period, you must complete this section. Report ALL individuals who received the service at your agency
during the reporting period, regardless of funding source. You will still complete this section if Ryan White
funds are only used for staff salaries.
If you provide HC&T services as part of your EIIHA
activities or under EIS for Parts A and B service
category, report your HC&T data in this section.
6) Did your organization use RWHAP funds to provide HIV Counseling and Testing services
during the reporting period? Indicate “Yes” or “No.”
7) Number of individuals tested for HIV: Indicate the number of people tested using an FDAapproved test during the reporting period.
8) Of those tested, number that tested NEGATIVE: The number that tested NEGATIVE for HIV
during the reporting period.
9) Number who tested NEGATIVE and received post-test counseling: Of the number indicated in
Item 8, the number who received HIV post-test counseling.
10) Of those tested, number that tested POSITIVE: Of the total number tested, indicate how many
tested positive for HIV during the reporting period.
11) The number who tested POSITIVE and received post-test counseling: Of the number specified
in Item 10 indicate how many received HIV-post-test counseling immediately following the test or
returned for counseling at a later date.
12) Of those who tested POSITIVE, number referred to HIV medical care: Of the total number who
tested positive for HIV, indicate how many were referred to HIV medical care.
Step Three: Complete the Client Level Data Report: Import Client-level data
(if applicable).
If you provide core medical or support services, you must upload a client-level data file to complete your
Provider Report. The Client Report is a collection of RWHAP client records that must be submitted in a
properly formatted client-level data XML (eXtensible Markup Language) file. To learn how to upload the
client-level data XML file, see page 32.
Step Four: Validate your RSR Provider Report and client-level data.
Validate your Provider Report by clicking “Validate” on the left navigation panel in the Provider Report
Actions section.
If you have questions about a specific
data validation check, contact Data
Support at 1-888-640-9356.
Your Validation Results may return three types of report validations: Errors, Warnings, or Alerts.
• Errors must be corrected before you can submit your Provider Report. If the errors are triggered by the
Provider Report, you must correct the information entered. If the errors are triggered by the clientlevel data, the data file must be corrected and re-uploaded to the system. Be sure to clear the old file by
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using the “Clear Clients” feature in the left navigation menu before uploading the corrected data file.
When you have finished updating your data, validate your report again.
• Warnings should be corrected if possible or a comment must be entered explaining the data. To submit
your Provider Report with warnings, write a comment for all of the warnings that cannot or should not
be fixed by clicking the “Add Comments” link under the action column in your validation report. Do not
include personal health information (PHI) when entering warning comments.
• Alerts are informative and intended to help you identify potential issues in your data collection and
reporting processes. You can submit your report with alerts.
Your client-level data file contains PHI that includes, but is not limited to, client names, addresses, DOB,
SSN, dates of service, and URNs generated for your organization’s client-level data XML file. To ensure
client confidentiality, you must be compliant with all relevant Federal regulations. You must protect this
information the same way you protect all client data. For additional information, visit the HHS Office of Civil
Rights Health Information Privacy Web page. Do not disclose sensitive information in your reporting
comments. Refer to http://www.hhs.gov/ocr/privacy for additional information about client confidentiality
and privacy.
Step Five: Submit your data.
When you are satisfied that your report is complete, submit the Provider Report and client-level data by
clicking on “Submit” in the left navigation menu and following the instructions on your screen.
Your RSR Provider Report will proceed to either “Review” or “Submitted” status. If your report advances to
“submitted” status, you are done. If your report advances to “Review” status, one or more recipients must
review and accept the report before it will advance to “Submitted” status. If you have questions about the
status of your RSR, contact Data Support at 1-888-640-9356.
FREQUENTLY ASKED QUESTIONS
about the RSR Provider Report
Do providers receiving funding from multiple Program Parts complete multiple Provider
Reports?
No. Each subrecipient will submit only one Provider Report including data from all Program Parts
under which the agency is funded.
Are providers with whom we do not have formal contracts required to submit data?
For the purpose of the RSR, “contracts” include formal contracts, memoranda of understanding, or
other agreements. Data must be reported for all providers that delivered Ryan White services.
Do providers need to submit a Provider Report and client-level data if they do not serve any
clients, submit only vouchers, only serve clients on a fee-for-service basis, or receive a small
amount of funding from my grant?
All providers listed on your contract lists will be required to complete an RSR Provider Report
unless all of the provider’s recipients have marked it as exempted. Data are still required of all
providers that delivered Ryan White services. Please refer to page 4 to review how to report for an
exempted provider.
Do second-level providers have to submit Provider Reports?
Yes, both first- and second-level providers need to complete Provider Reports. Second-level
providers will see the name of their recipient and the name of their fiscal intermediary, the agency
through which it receives funding, in their contracts list.
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I have a lot of providers and have set an early submission deadline so I have time to review
their submissions. But one of my providers is multiply funded, and the other recipient told
my provider that it does not need to submit its data until HAB’s recommended submission
deadline. I really need my provider to submit its data early. What do I do?
Contact your provider’s other recipient(s), preferably before the report submission period begins, to
coordinate your deadlines. Taking the time up front to agree on the submission deadlines that all the
provider’s recipients will enforce will help ensure a smooth submission process. If your provider is
also a recipient be sure to negotiate an early submission deadline that is agreeable to both of you.
Project Officers can be helpful in these decisions and can suggest due dates for Recipient Reports.
How do I report a service that I delivered that does not appear in my Provider Report?
If you receive Ryan White funds to deliver a service that is not populated in your Provider Report,
you will need to contact your recipient to add the service(s) on its Recipient Report. If you did not
receive RWHAP funds to deliver the service, you should not mark it in your Provider Report.
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RSR CLIENT-LEVEL DATA REPORT
(Last Updated: September 8, 2016)
Client-level data must be submitted for all providers who used RWHAP funds to provide core medical or
support services directly to clients during the reporting period. Unless exempted from reporting, all
provider agencies must to complete their own reports to confirm that their data accurately reflect their
program and the quality of care their agency provides. A full explanation of exempting providers can be
found in the section Recipient/Subrecipient Reporting Requirements on page 2.
Importing the Client-level Data XML File to the
Provider Report
To generate an XML file, providers need to extract the client-level data from their systems into the proper
XML format before the data can be submitted to HAB. Several software applications for managing and
monitoring HIV clinical and supportive care are able to export the data in the required XML format. A list of
RSR-ready vendor systems that can generate the RSR client-level data XML file can be found on the TARGET
Center Web site at https://careacttarget.org/content/vendor-status-and-contact-information-0. If your
organization uses a custom-built data collection system, you have two options:
1. Write a program that extracts the data from it, 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
https://careacttarget.org/library/xml-file-all-things-xml . This list is updated every year.
2. Use TRAX to create your client-level data XML file. TRAX was created to help recipients and providers
that do not use CAREWare, a Provider Data Import (PDI), or other RSR-ready vendor system to create
their client-level Data XML file.
If you need help generating or modifying
your XML file, contact the DART Team at
[email protected].
To upload a client-level data XML file, open your RSR Provider Report. From within the RSR Provider
Report, click the “Import Client-level Data” link in the Provider Report Navigation menu on the left. Then,
follow the on-screen instructions.
Each file uploaded into the RSR system goes through a schema validation check. This check is automatically
performed by the RSR system when a file is uploaded. If the file is noncompliant, the user’s file will be
rejected by the RSR system, and a complete list of error messages will be displayed. Users can download
the list as a text file and use it to fix the client-level data in their source system.
Providers should generate and review the Data Completeness Report and Upload Confirmation Report
from the left navigation menu before submitting the data.
Data files must be uploaded to the RSR Provider
Report. Uploading to the Check Your XML feature
does not meet the reporting requirements.
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Client-Level Data Elements
The client report should contain one record for each client who was eligible and who received RWHAP core
medical services or support services during the reporting period. The data elements reported per client are
determined by the specific RWHAP services that your agency is funded to provide. See the chart in
Appendix A. Required Client-level Data Elements for RWHAP Services on page 58 to determine which clientlevel data elements to report for a client. The 2016 client-level data elements and response options have
not changed from the 2014 RSR.
Up to 64 data elements may be reported for each client. The data elements include the following:
• The client’s encrypted Unique Client Identifier (eUCI);
• The client’s demographic information;
• The core medical and support services the client received; and
• The client’s clinical information if he or she received outpatient/ambulatory medical care services.
This section outlines the data fields that may be submitted in the client-level data XML file. Each description
includes the following:
Element ID: Each data element has been assigned a value for convenient referencing between this
document and the RSR Data Dictionary available at https://careacttarget.org/library/xml-file-all-things-xml .
RSR Client-Level Data Element: A brief description of the client-level data element being collected.
XML Variable Name: The data elements have been assigned a variable name in the RSR data dictionary. It
is the method by which the data are labeled in the RSR client-level data XML file. The variable name is
provided for convenient referencing between this document and the RSR data dictionary.
Required for clients with service visits in the following categories: The data elements that must be
reported for your clients are based on the type of service they received. You are required to report the data
element for clients who meet your eligibility criteria.
Description: A detailed discussion, if required, of the variable and responses that may be reported for the
variable. This section defines the responses allowed for the data element.
Frequently asked questions about this data element: Where applicable, answers are provided to the
questions recipients and providers ask the most about the data element.
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System Variables
RSR system’s unique provider registration code SV3
XML Variable Name:
RegistrationCode
Description:
The Unique Provider Registration Code is automatically generated when the provider is entered into
the RSR web system provider directory. It is the same code that providers use when they create an
account in the RSR web system.
Client’s encrypted Unique Client Identifier SV4
XML Variable Name:
ClientUci
Required for clients with service visits in the following categories:
All core medical and support services.
Description:
To protect client information, an encrypted UCI(eUCI) is used for reporting Ryan White client data.
Using eUCIs allows HAB to de-duplicate the clients and obtain a more accurate count of the clients
RWHAP services.
Note: Your client-level data file contains PHI that includes, but is not limited to, client names,
addresses, DOB, SSN, dates of service, and URNs generated for your organization’s client-level data
XML file. To ensure client confidentiality, you must be compliant with all relevant Federal
regulations. You must protect this information the same way you protect all client data. For
additional information, visit the HHS Office of Civil Rights Health Information Privacy Web page. Do
not disclose sensitive information in your reporting comments. Refer to
http://www.hhs.gov/ocr/privacy for additional information about client confidentiality and privacy.
To learn more about the eUCI, including rules on how to
construct the UCI before encryption, view the resources
available on the TARGET Center website at
https://careacttarget.org/library/encrypted-unique-client-identifiereuci-application-and-user-guide.
Guidelines for Collecting and Recording Client Names
Recipients should develop business rules/operating procedures outlining the method by which client
names should be collected and recorded. For example:
• Enter the client’s entire name as it normally appears on documentation such as a driver’s license, birth
certificate, passport, or Social Security card.
• Follow the naming patterns, practices, and customs of the local community or region (e.g., for Hispanic
clients living in Puerto Rico, record both surnames in the appropriate order).
• Avoid using nicknames (e.g., do not use Becca if the client’s first name is Rebecca).
• Avoid using initials.
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Recipients should instruct providers and staff how to enter their client’s names. This is especially true
when clients receive services from multiple providers in a network. To avoid false duplicates, client names
must be entered in the same way at each provider location so that the client has the same eUCI.
FREQUENTLY ASKED QUESTIONS
about this data element
What if I am missing data elements that compose the eUCI?
If you are missing data elements required for the eUCI, you should do everything possible to obtain
those data elements. It is required for each client. This effort will improve not only the quality of data
linking but also case management and patient care.
Demographic Data
Up to 16 demographic data elements may be reported for each client. You can determine which
demographic data elements are required for a particular client by looking at Appendix A. Required Clientlevel Data Elements for RWHAP Services on page 58.
Client’s vital enrollment status at the end of this reporting period 2
XML Variable Name:
EnrollmentStatusID
Required for clients with service visits in the following categories:
• Outpatient/ambulatory medical care services
• Medical case management
• Nonmedical case management
Description:
This is the client’s vital enrollment status at the end of the reporting period. These are the response
categories for this data element:
• Active—The client will be continuing in the program.
• Referred or Discharged—The client was referred to another program for services and will not
continue to receive services at this agency. Also select this category if the client was
discharged from a program because he or she became self-sufficient and was no longer
eligible to receive RWHAP services, the client voluntarily leaves your program, or the client
refuses to participate.
• Removed—The client was removed from treatment due to violation of rules.
• Incarcerated—The client will not be continuing in the agency’s program because he or 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).
• 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.
• Deceased
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FREQUENTLY ASKED QUESTIONS
about this data element
How do I report a client who is no longer receiving services?
Each agency must determine its own guidelines for classifying a client’s vital enrollment status. If a
client is no longer active at the end of the reporting period, choose one of the alternate response
options. HAB recommends that these policies be in writing and applied at all providers within a
recipient agency. HAB understands that different grant recipients may have different policies in the
same geographic area.
What if a client falls into more than one category (e.g., active and incarcerated)?
If the client received services during the reporting period and you expect the client to continue to
receive services from your program, report the client as “Active.” If the client did not and/or will not
continue in your agency’s program, choose the category that explains why the client is no longer
active.
Client’s year of birth 4
XML Variable Name:
BirthYear
Required for clients with service visits in the following categories:
All core medical and support services.
Description:
This is the client’s birth year. 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 year, month and day are used to
generate the UCI. The value must be on or before all service dates for the client. This is a variable
that is used for the eUCI. The RSR System will reject any XML file with client records that do not
include the client’s year of birth.
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. In addition, identification of ethnic and racial
subgroups is required for the categories of Hispanic/Latino, Asian, and Native Hawaiian/Pacific Islander.
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 providers
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 must be organized so that any new categories can be
aggregated into the standard OMB breakdown.
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RWHAP 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
should they specify how someone should classify himself or herself.
Client’s self-reported ethnicity 5
XML Variable Name:
EthnicityID
Required for clients with service visits in the following categories:
All core medical and support services.
Description:
The client’s ethnicity based on his or her self-report.
These are the response category options:
• Hispanic/ Latino/ or Spanish origin—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.” If a client identifies as Hispanic/Latino/a
or Spanish origin, choose all Hispanic subgroups that apply in ID 68.
• Non-Hispanic/Latino/a or Spanish origin—A person who does not identify his or her ethnicity
as “Hispanic or Latino.”
Client Report Hispanic Subgroup 68
XML Variable Name:
HispanicSubgroupID
Required for clients if EthnicityID is Hispanic/Latino(a) or Spanish origin with service visits
in the following categories:
All core medical and support services.
Description:
If the response to ID 5, client’s self-reported ethnicity, is “Hispanic/ Latino/a or Spanish origin,”
indicate the client’s Hispanic subgroup (choose all that apply).
These are the response category options:
• Mexican, Mexican American, Chicano/a
• Puerto Rican
• Cuban
• Another Hispanic, Latino/a or Spanish origin
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Client’s self-reported race 6
XML Variable Name:
RaceID
Required for all clients with service visits in the following categories:
All core medical and support services.
Description:
This is the client’s race based on his or her self-report. 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. If a client identifies as Asian, choose all
Asian subgroups that apply in ID 69.
• 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. If a client identifies as Native
Hawaiian/Pacific Islander, choose all Native Hawaiian/Pacific Islander subgroups that apply in
ID 70.
• White—A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.
Client Report Asian Subgroup 69
XML Variable Name:
AsianSubgroupID
Required for clients if RaceID is Asian with service visits in the following categories:
All core medical and support services.
Description:
If the response to ID 6, client’s self-reported race, is “Asian,” indicate the client’s Asian subgroup
(choose all that apply).
These are the response category options:
• Asian Indian
• Chinese
• Filipino
• Japanese
• Korean
• Vietnamese
• Other Asian
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Client Report Native Hawaiian/Pacific Islander (NHPI) Subgroup 70
XML Variable Name:
NHPISubgroupID
Required for clients if RaceID is Native Hawaiian/Pacific Islander with service visits in the
following categories:
All core medical and support services.
Description:
If the response to ID 6, client’s self-reported race, is “Native Hawaiian or Other Pacific Islander,”
indicate the client’s Native Hawaiian/Pacific Islander subgroup (choose all that apply).
• Native Hawaiian
• Guamanian or Chamorro
• Samoan
• Other Pacific Islander
Client’s current self-reported gender 7
XML Variable Name:
GenderID
Required for clients with service visits in the following categories:
All core medical and support services.
Description:
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 or her self-report. Gender cannot be missing; one of the options below must be reported for
current gender. This is a variable that is used for the eUCI.
• Male— An individual with strong and persistent identification with the male gender.
• Female— An individual with strong and persistent identification with the female gender.
• 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.
Client’s self-reported transgender status 8
XML Variable Name:
TransgenderID
Required for clients with service visits in the following categories:
All core medical and support services.
Description:
If the client is reported as “transgender” in ID 7, report:
• Male to Female
• Female to Male
• Unknown
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Client Sex at Birth 71
XML Variable Name:
SexAtBirthID
Required for clients with service visits in the following categories:
All core medical and support services.
Description:
The biological sex assigned to the client at birth.
• Male
• Female
Client’s annual household income category 9
XML Variable Name:
PovertyLevelID
Required for clients with service visits in the following categories:
• Outpatient/ambulatory medical care services
• Medical case management
• Nonmedical case management
Description:
This is the client’s income in terms of the percent of the Federal poverty level at the end of the
reporting period. The response categories for this data are:
• Below 100% of the Federal poverty level
• 100–138% of the Federal poverty level
• 139–200% of the Federal poverty level
• 201–250% of the Federal poverty level
• 251–400% of the Federal poverty level
• 401–500% of the Federal poverty level
• More than 500% of the Federal poverty level
If your organization collects this information early in the reporting period, it is not necessary to
collect it again at the end of the reporting period (although changes should be documented). Report
the latest information on file for each client.
There are two slightly different versions of the Federal poverty measure—the poverty thresholds
(updated annually by the U.S. Bureau of the Census) and the poverty guidelines (updated annually
by HHS). For more information on poverty measures and to see the 2015 HHS Poverty Guidelines, go
to http://aspe.hhs.gov/poverty/index.shtml.
If your agency already uses the poverty thresholds to calculate this data
element, continue to use the poverty thresholds to report these data.
Otherwise, HAB recommends (and prefers) that you use the poverty
guidelines to collect and report these data.
Calculating a Client’s Income Percentage of the Federal Poverty Measure
To determine a client’s income percentage of the Federal poverty measure using HHS Federal
poverty guidelines (FPG), follow these five easy steps:
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1. Count the client’s family size. Family size is the number of family members who live together.
An individual living alone (or with only nonrelatives) counts as a family of one.
2. Add up the family income. Family income is the sum of income of all family members who live
together. It includes pretax money (or “cash”) income (earnings; unemployment
compensation; Social Security; public assistance; veteran payments; survivor benefits; pension
or retirement income; interest; dividends; rents; royalties; income from estates, trusts,
educational assistance, alimony, child support, assistance from outside the household, and
other miscellaneous sources). It excludes noncash benefits (e.g., food stamps, housing
subsidies) and capital gains (or losses).
3. Look up the FPG for the family size, year, and geographic location. The FPG are dollar amounts
that vary according to family size and are used to determine poverty status. HHS issues them
each year in the Federal Register. There are separate guidelines for the contiguous 48 States,
Alaska, and Hawaii.
4. Calculate the family income as a percent of the family FPG:
family income / guideline × 100 = % family FPG
5. Use the percent of the family FPG to report the client percent of the Federal poverty measure
for ID 9 of your RSR Client Report.
All family members have the same poverty status;
thus, all family members have the same income
percentage of the Federal poverty measure.
Client’s housing status 10
XML Variable Name:
HousingStatusID
Required for clients with service visits in the following categories:
• Outpatient/ambulatory medical care services
• Medical case management
• Nonmedical case management
• Housing services
Description:
This data element is the client’s housing status at the end of the reporting period. NOTE: Unstable
housing is associated with poorer viral load suppression everywhere in the country. It is important
for recipients/providers to be continually aware of clients’ housing status and make every attempt
to connect unstably and temporarily housed clients with all available resources. There are three
response categories for this data element:
• Stable Permanent Housing
• Temporary Housing
• Unstable Housing
Stable Permanent Housing includes the following:
• Renting and living in an unsubsidized room, house, or apartment.
• Owning and living in an unsubsidized house or apartment.
• Unsubsidized permanent placement with families or other self-sufficient arrangements.
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• 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.
• Subsidized, non-HOPWA, house or apartment, including Section 8, the HOME Investment
Partnerships Program, and Public Housing.
• 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).
• 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 long-term care facility).
Temporary Housing includes the following:
• Transitional housing for homeless people.
• Temporary arrangement to stay or live with family or friends.
• Other temporary arrangement such as a Ryan White Program housing subsidy.
• Temporary placement in an institution (e.g., hospital, psychiatric hospital or other psychiatric
facility, substance abuse treatment facility, or detoxification center).
• Hotel or motel paid for without emergency shelter voucher.
Unstable Housing Arrangements include the following:
• 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.
• Jail, prison, or a juvenile detention facility.
• Hotel or motel paid for with emergency shelter voucher.
These definitions are based on:
• HOPWA Program, Annual Progress Report (APR), Measuring Performance Outcomes, form
HUD-40110-C
• McKinney-Vento Act, Title 42 US Code, Sec. 11302, General definition of homeless individual
Client’s HIV/AIDS status 12
XML Variable Name:
HivAidsStatusID
Required for clients with service visits in the following categories:
• Outpatient/ambulatory medical care services
• Medical case management
• Nonmedical case management
Description:
This data element is the client’s HIV/AIDS status at the end of the reporting period. For HIV-affected
clients for whom HIV/AIDS status is not known, leave this value blank. The response categories for
this element are:
• HIV-negative (affected)—Client has tested negative for HIV, is an affected partner or family
member of an individual who is HIV positive, and has received at least one support service
during the reporting period.
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HIV-affected clients are clients who are HIV negative
or have an unknown HIV status. An affected client
must be linked to a client infected with HIV/AIDS.
• HIV-positive, not AIDS—Client has been diagnosed with HIV but has not been diagnosed with
AIDS.
• HIV-positive, AIDS status unknown—Client has been diagnosed with HIV. It is not known
whether the client has been diagnosed with 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.
• HIV-indeterminate (infants <2 years only)—A child under the age of 2 whose HIV status is not
yet determined but was born to an HIV-infected mother.
Once an HIV-indeterminate (infants <2 years
only) client is confirmed HIV negative, he or she
must be reclassified as an HIV-affected client.
FREQUENTLY ASKED QUESTIONS
about this data element
What is the operational definition of AIDS?
HAB uses the current CDC surveillance case definition for Acquired Immunodeficiency Syndrome for
national reporting. For additional information, see:
• http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5710a1.htm
• http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6303a1.htm
HIV Diagnosis Year 72
XML Variable Name:
HIVDiagnosisYearID
Required for new clients if HivAidsStatusID is not HIV-negative or HIV-indeterminate (infants
<2 years only) with service visits in the following categories:
• Outpatient/ambulatory medical care
• Medical case management
• Nonmedical case management
Description:
If the response to ID 12 is not “HIV-negative” or “HIV-indeterminate (infants <2 years only),”
indicate the client’s year of HIV diagnosis, if known.
HIV Diagnosis Year:
• yyyy (Must be less than or equal to the reporting period year.)
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FREQUENTLY ASKED QUESTIONS
about this data element
How do we determine what a new client is?
Each agency must determine its own guidelines for determining whether clients are new.
RWHAP providers are expected to make every effort to obtain
and report HIV risk factor(s) 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 client’s racial or ethnic classification, nor should
they specify how a person should classify himself or herself.
Client’s risk factor for HIV infection 14
XML Variable Name:
HivRiskFactorID
Required for clients with service visits in the following categories:
• Outpatient/ambulatory medical care services
• Medical case management
• Nonmedical case management
Description:
This data element is the client’s initial risk factor for HIV infection. You may report all of the
response categories that apply. It is primarily based on self report.
• 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.
• 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.
• Risk factor not reported or not identified above. This category also refers to HIV-affected
clients who do not have a risk factor.
FREQUENTLY ASKED QUESTIONS
about this data element
How do we report risk factors not listed above?
Risk factors that are not expressly stated above—occupational exposure, prison tattoos, etc.—
should be reported under unknown risk factor.
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Client’s Medical insurance 15
XML Variable Name:
MedicalInsuranceID
Required for clients with service visits in the following categories:
• All core medical services.
• Nonmedical case management.
Description:
Report all sources of health insurance the client had for any part of the reporting period (select one
or more).
• Private—Employer.
• Private—Individual.
• Medicare is a health insurance program for people ages 65 and older, some disabled people
ages 64 and younger, and people with end-stage renal disease (permanent kidney failure
treated with dialysis or a transplant).
• Medicaid, CHIP, or other public plan.
• Veterans Health Administration (VA), military health care (TRICARE), and other military
health care.
• Indian Health Service.
• No insurance/uninsured means the client did not have health insurance at some time during
the reporting period. HAB classifies clients who have no way to pay for medical expenses other
than with RWHAP funds as uninsured.
• Other plan means client has an insurance type other than those listed above. An example of
other plan would be a company that chooses to “self-insure” and pay the medical expenses of
its employees directly as they are incurred, rather than purchasing health insurance for its
employees to use.
FREQUENTLY ASKED QUESTIONS
about this data element
How should a provider report a client who has private insurance, but Ryan White funds are
used to pay their copay and/or deductible?
If the client has private insurance, select the corresponding response option AND select “No
Insurance.” Select all responses that apply.
How should a provider report a client who has insurance for part of the reporting period but
has no insurance at a different point in the same reporting period?
If the client has insurance for part of the reporting period, select the corresponding response option
AND select “No Insurance.” Select all responses that apply.
How should a provider report a client who is covered by COBRA?
Insurance reporting is based on who is paying the premium for the insurance. When a client is
covered by COBRA, the client is responsible for payment, and insurance status should be reported as
“Private–Individual.”
RWHAP-Eligible Service Data
For the next set of data elements, report a client’s service visits delivered when the client was eligible to
receive RWHAP-funded services. Report clients who did not actually receive RWHAP-funded services if
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they meet your agency’s eligibility requirements. Do not report clients who received services that your
agency is not funded by RWHAP to deliver.
To determine whether to report a client, refer to the flow chart below:
For example, you have two clients, Aaron and Robert, who are eligible to receive RWHAP services. Your
agency is funded by RWHAP to provide OAMC and medical case management services. You also receive
non-RWHAP funds for housing services but do not receive RWHAP funds to deliver housing services.
• Aaron receives OAMC services, but his visits are paid for from a non-RWHAP funding source. As Aaron
is eligible to receive RWHAP funds to cover his care, he should be reported on the RSR.
• Robert only receives housing services. Robert would not be reported on the RSR because your agency is
not funded by RWHAP to deliver housing services.
FREQUENTLY ASKED QUESTIONS
about eligible scope
How do I determine which clients are eligible for RWHAP?
Requirements for RWHAP are set at the recipient level. Contact your recipient to determine your
site’s eligibility requirements.
How do I know if I should report a client?
You should report a client if:
1) The client is RWHAP eligible; and
2) The client received a service that your agency was funded by RWHAP to deliver in 2015.
How does eligible scope affect clients with high deductible insurance plans?
RWHAP is here to assist all clients affected by HIV. Clients with high deductible plans are likely to
need RWHAP for assistance with deductibles and later in the year. Eligible scope allows these
providers to collect client data prior to being enrolled in the program and provide a complete picture
of the client’s care.
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What do I report if a client has a gap in eligibility? For example, a client is eligible from
January to July and has service visits in January and December. Which visits do we count?
If the client moves in and out of eligibility, report services that were within the period of eligibility
(Items 16-45). If an OAMC client moves in and out of eligibility and the agency is RWHAP funded for
OAMC services, report the services (ID 16) within the period of eligibility AND all the clinical data
elements (including OAMC visit dates ID 48) from the ENTIRE year.
Should I report client-level data from HOPWA clients?
Yes. HAB is working with HUD to demonstrate how coordinated data can improve clinical outcomes.
This SPNS initiative started in 2016 and will help inform data collection for future RSRs.
Core Medical Service Visits Delivered 16, 18–19, 21–27
XML Variable Name:
ClientReportServiceVisits
• Service Visit
• ServiceID (See table below.)
• Visits (Number of visits (1–365) the client received in the service category indicated.)
Required for clients with service visits in the following categories:
Recipients of at least one core medical service, per client, as listed in the table below.
Description:
Report the number of core medical service visits the client received while he or she was eligible for
RWHAP. Remember, for each day, only one service visit per category may be reported for the RSR—
even if the client receives more than one service in a particular category during the day.
Example #1: During her visit with the dentist on June 19, Jane Doe receives five services: a dental
exam, a cleaning, a filling, X-rays, and a fluoride treatment. In this situation, even though Jane
received 5 services, the provider will only report 1 oral health care service visit for that day.
Example #2: On December 7, John Doe has a medical visit with his physician, meets with his medical
case manager, and participates in an individual counseling session with his psychologist in the
morning. Later that day, he also participates in a group counseling session. Even though John
received 4 services, the provider will report only 3 service visits for that day: 1 mental health service
visit, 1 medical case management service visit, and 1 outpatient/ambulatory medical care visit.
Core medical services (IDs 16-27) should be reported only for
HIV-positive and HIV-indeterminate (infants <2 years) clients.
HIV-negative clients who receive HIV counseling and testing
services as part of EIS for Part A and B should only be reported in the HIV
Counseling and Testing section of the Provider Report.
The definitions for the RWHAP Core Medical Services can be found in the Ryan White HIV/AIDS
Program Services chapter on page 6.
ELEMENT ID
Service Category
16
Outpatient ambulatory medical care
19
Early intervention (Parts A and B)
18
21
ServiceID
Service ID 8
Oral health care
Service ID 10
Home health care
Service ID 13
Service ID 11
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ELEMENT ID
Service Category
ServiceID
22
Home and community-based health
Service ID 14
24
Mental health
Service ID 16
23
25
26
27
Hospice
Service ID 15
Medical nutrition therapy
Medical case management (including treatment adherence)
Substance abuse outpatient
Service ID 17
Service ID 18
Service ID 19
Core Medical and Support Services Delivered 17, 20, 28–45
XML Variable Name:
ClientReportServiceDelivered
• Service Delivered
• ServiceID (See table below.)
• DeliveredID (2—Yes)
Description:
Report whether or not eligible clients received these core medical and support services during the
reporting period. The definitions for the RWHAP Core Medical Services can be found in the Ryan
White HIV/AIDS Program Services chapter on page 7. The definitions for the RWHAP Support Services
can be found in the Ryan White HIV/AIDS Program Services chapter on page 10.
ELEMENT ID
Service Category
17
Local AIDS Pharmaceutical Assistance (Local APA)
29
Child care
20
28
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
ServiceID
Service ID 9
Health Insurance Program (HIP)
Service ID 12
Pediatric developmental assessment/early intervention
Service ID 22
Case management (non-medical)
Emergency financial assistance
Food bank/home-delivered meals
Health education/risk reduction
Service ID 21
Service ID 23
Service ID 24
Service ID 25
Housing
Service ID 26
Legal
Service ID 27
Linguistic
Service ID 28
Medical transportation
Service ID 29
Outreach
Service ID 30
Permanency planning
Service ID 31
Psychosocial support
Service ID 32
Referral for health care/supportive
Service ID 33
Rehabilitation
Service ID 34
Respite care
Service ID 35
Substance abuse–residential
Treatment adherence counseling
Service ID 20
Service ID 36
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Clinical Information
The final group of data elements collected in the client-level data XML file are the clinical information data
elements. Clinical information is required to be reported by all providers who received RWHAP funding to
provide outpatient/ambulatory health services.
Clinical information is required for HIV-positive clients
who received an outpatient/ambulatory medical care
visit. Clinical information is not required to be reported
for HIV-indeterminate (infants <2 years only) clients.
Data provided in this section will help HAB measure to what extent the program is meeting patient care
requirements nationally, as set forth in the 2009 RWHAP legislation and HAB’s HIV/AIDS Core Clinical
Performance Measures for Adults & Adolescents. The reporting period for RSR purposes is the period of
time for which data are submitted to HAB (e.g., January 1–December 31). This should not be confused with
clinical performance measurement periods. Though you are required to report the applicable data
elements with each report submission, you should perform a clinical activity more frequently than required
to meet the generally accepted standards of medical care for HIV-positive patients.
Client received HIV risk-reduction screening/counseling 46
XML Variable Name:
RiskScreeningProvidedID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Indicate (yes/no) if HIV risk-reduction screening and/or counseling was provided to the client
during this reporting period. HIV risk-reduction screening and counseling refers to a short
questionnaire administered by a clinician to identify patients at risk for HIV infection or reinfection,
followed by counseling of patients about ways to reduce their risk.
Date client’s first HIV outpatient/ambulatory care visit 47
XML Variable Name:
FirstAmbulatoryCareDate
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Report the date of the client’s first HIV outpatient/ambulatory care visit with this provider. When
responding to this ID, keep these points in mind:
• The visit must meet the RWHAP definition of an outpatient/ambulatory medical care visit.
• 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.
• This visit may have occurred before the start of the reporting period.
• This visit may or may not be a RWHAP-funded visit.
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• The date of first HIV outpatient/ambulatory medical care visit does not change in subsequent
reports.
Dates of the client’s outpatient ambulatory care visits 48
XML Variable Name:
ClientReportAmbulatory
• Service
• ServiceDate
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Report all dates (MM/DD/YYYY) of the client’s outpatient/ambulatory care visits in this provider’s
HIV care setting with a clinical care provider during the reporting period, regardless of the payer. A
clinical care provider is a physician, physician assistant, clinical nurse specialist, nurse practitioner,
or other health care professional who is certified in his or her jurisdiction to prescribe antiretroviral
(ARV) therapy. The number of outpatient ambulatory care visit dates reported for this ID should be
equal to or greater than the number of visits reported in ID 16.
NOTE: The visits should meet the RWHAP definition of an outpatient/ambulatory medical care visit.
Client’s CD4 Test 49
XML Variable Name:
ClientReportCd4Test
• Count
• ServiceDate
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
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, not the
date the results are reported by the lab.
Client’s Viral Load Test 50
XML Variable Name:
ClientReportViralLoadTest
• Count
• ServiceDate
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
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Description:
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, not the date the results are reported by the lab. If a viral load
count is undetectable, you should report the lower bound of the test limit. If the lower bound is not
available, report 0.
Client prescribed PCP prophylaxis 51
XML Variable Name:
PrescribedPcpProphylaxisID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
PCP prophylaxis is drug treatment to prevent Pneumocystis jiroveci pneumonia. It is a major cause of
mortality among people with HIV infection, yet it is almost entirely preventable and treatable.
People with CD4 T-cell counts under 200 cells/mm3 are at greatest risk of developing PCP.
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.
• Yes
• No
• Not medically indicated
• No, client refused
For additional information about PCP prophylaxis, see:
• http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html
• http://aidsinfo.nih.gov/guidelines
Client prescribed ART 52
XML Variable Name:
PrescribedArtID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
ART is 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 ART during the reporting period.
• Yes. This includes clients who were not adherent to the prescribed therapy.
• No, not ready (as determined by clinician)
• No, client refused
• No, intolerance, side effect, toxicity
• No, ART payment assistance unavailable
• No, other reason
For additional information about ART, visit: http://aidsinfo.nih.gov/guidelines.
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Client has been screened for TB since HIV diagnosis 54
XML Variable Name:
ScreenedTBSinceHivDiagnosisID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Indicate if the client has been screened for TB since his or her HIV diagnosis.
• No
• Yes
• Not medically indicated
• Unknown
Client was screened for syphilis during this reporting period 55
XML Variable Name:
ScreenedSyphilisID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
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. This element is not
required for clients ages 17 or younger who are not sexually active. Has the client been screened for
syphilis during this reporting period?
• Yes
• No
• Not medically indicated
Additional information may be obtained at http://aidsinfo.nih.gov/guidelines.
Client was screened for hepatitis B since HIV diagnosis 57
XML Variable Name:
ScreenedHepatitisBSinceHivDiagnosisID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Indicate if the client has been screened for hepatitis B since his or her HIV diagnosis.
• No
• Yes
• Not medically indicated
• Unknown
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Client has completed the vaccine series for hepatitis B 58
XML Variable Name:
VaccinatedHepatitisBID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
The hepatitis B vaccine series is a sequence of shots that stimulate a person’s natural immune
system to protect against HBV. Has the client completed the vaccine series for hepatitis B?
• Yes
• Not medically indicated
• No
FREQUENTLY ASKED QUESTIONS
about this data element
How do we report a client whose hepatitis B vaccination is in progress during the reporting
period?
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.
Can we report that the client has been vaccinated for hepatitis B if the client has a hepatitis B
surface antibody test that is positive/reactive and hepatitis B antigen that is negative/nonreactive? Can an immunity tests be a substitute for getting all documented hepatitis B vaccine
test dates in the series to note that the patient received the series?
No. You may not use a negative hepatitis B surface antigen test (HBsAg) result and a positive
hepatitis B surface antigen antibody (anti-HBs) test result in lieu of documentation showing that the
client received the hepatitis B vaccine series to report a “yes” response to the
VaccinatedHepatitisBID data element. A negative hepatitis B surface antigen test (HBsAg) and a
positive hepatitis B surface antibody test (anti-HBs) only indicate that the client is immune; they do
not necessarily indicate immunity through the vaccination. A negative HBsAg result and a positive
anti-HBs test result means that a vaccine is not medically indicated. Remember, this data element is
about vaccination, not immunity.
Client screened for hepatitis C since HIV diagnosis 60
XML Variable Name:
ScreenedHepatitisCSinceHivDiagnosisID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Indicate if the client has been screened for hepatitis C since his or her HIV diagnosis.
• No
• Yes
• Not medically indicated
• Unknown
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Client was screened for substance use 61
XML Variable Name:
ScreenedSubstanceAbuseID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Substance use screening is a quick, simple way to identify clients who may 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. Substance use screening may be
administered by a substance abuse treatment professional or by a trained health care professional in
another medical/clinical discipline. Was the client screened for substance use (alcohol and drugs)
during the reporting period?
• No
• Yes
• Not medically indicated
Client received mental health screening 62
XML Variable Name:
ScreenedMentalHealthID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Mental health screenings include the use of brief structured instruments or commonly used
questions 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. Was a mental health screening conducted for the client during this
reporting period?
• No
• Yes
• Not medically indicated
Client received a Pap Smear 63
XML Variable Name:
ReceivedCervicalPapSmearID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Reported for HIV-positive women only, only report a value for a cervical smear. Do not report a
value for an anal test for male or female clients. 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 pre-cancerous as well as hidden,
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2016 RSR Instruction Manual
small tumors that may lead to cervical cancer. Did the client receive a Pap smear during this
reporting period?
• No
• Yes
• Not medically indicated
• Not applicable
Client was pregnant 64
XML Variable Name:
PregnantID
Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services
Description:
Reported for HIV-positive women only, do not report a value for male clients, unless the client is
transgendered. Was the client pregnant during the reporting period?
• No
• Yes
• Not applicable
Positive HIV Test Date 73
XML Variable Name:
HIVPosTestDateID
Required for all clients with a new diagnosis of HIV in the reporting period with service visits
in the following categories:
Outpatient/ambulatory medical care services
Description:
Date of the client’s first documented positive HIV test during the reporting period. It can be a
positive HIV test from another site, as long as it is documented and not a client self-report. May be
the client’s HIV confirmatory test date.
Positive HIV Test Date:
• mm/dd/yyyy (Must be within the reporting period year.)
OAMC Link Date 74
XML Variable Name:
OAMCLinkDateID
Required for all clients with a new diagnosis of HIV in the reporting period with service visits
in the following categories:
Outpatient/ambulatory medical care services
Description:
Date of client’s first OAMC medical care visit after positive HIV test. The OAMC visit date must be a
visit with a prescribing provider and cannot be a date before that reported in ID 73.
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HIV OAMC linkage date:
• mm/dd/yyyy (Must be within the reporting period and on the same day or later than positive
HIV test date.)
FREQUENTLY ASKED QUESTIONS
about the client-level data
How does HAB define a confirmatory test?
Each agency must determine its own guidelines for standard of care that is practiced by its OAMC
provider based on CDC guidelines.
My RWHAP funding covers only salaries. Do I report client-level data?
Yes. HAB expects that staff whose salary is paid by RWHAP will see clients who meet RWHAP
eligibility requirements. Providers should report all RWHAP-eligible clients who received services
that the provider was funded for.
Do I need to report my client-level data by RWHAP Part?
No. HAB doesn’t require you to submit your client-level data by RWHAP Part. Although providers
should have an adequate mechanism for tracking clients and services by contract or funding source
(RWHAP and non-RWHAP), the intention of the RSR client-level data is to capture all services for all
clients served by a provider, regardless of RWHAP Part.
May I upload more than one client-level data file?
Yes. If you choose to upload more than one client-level data file to “build” the client report, take the
time to (1) make certain your data systems are generating client eUCIs consistently and (2) review
the rules that the RSR system follows when it combines information from two or more client-level
data files before you upload multiple client-level data XML files. To learn more about the RSR
system merge rules, see the article Rules for Merging at https://careacttarget.org/library/rsr-mergerules .
What client-level data do I need to report?
Collect the applicable client-level data elements for each client who received services during the
reporting period. The data elements reported depend on the service(s) each client receives. To
determine the client-level data elements that must be reported for each client, review the chart in
Appendix A. Required Client-level Data Elements for RWHAP-Eligible Services.
What if we collect our client information at the first visit in the reporting period, rather than
at the end?
It is not necessary to collect this information again at the end of the reporting period, ensure changes
are documented. Report the latest information on file for each client.
What do we report if a client does not provide all of the data and there is no option to report
the element as unknown?
HAB encourages you to submit the most complete data possible. If you are unable to collect the data,
drop the tag from your data file, and it will be considered a missing value. You may receive a
validation message and will need to add comments as necessary. Please refer to page 21 to review
data validation reporting requirements.
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My agency provides services to HIV-indeterminate infants. We do not perform CD4 or viral
load tests on these clients. How do I report this?
Providers are not required to report clinical information (IDs 46–64 and 73–74) for HIVindeterminate infants (<2 years only).
What if we do not know whether a new client has been screened for TB, Hepatitis B, or
Hepatitis C since his or her HIV diagnosis date? Are we expected to get retrospective data on
every client in medical care?
HAB understands that it may place an unreasonable burden on providers to determine whether
certain clients were screened for TB, Hep B, or Hep C since their diagnosis and advises providers to
report whatever data may be reasonably obtained. HAB expects you to screen your client if you do
not know whether or not your client has been screened since his or her HIV diagnosis.
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APPENDIX A. REQUIRED CLIENT-LEVEL DATA
ELEMENTS FOR RWHAP SERVICES
(Last Updated: September 8, 2016)
RATIONALE CODES
1) Necessary for identifying new clients
2) 2009 Ryan White Legislation requirement
3) Necessary to assess RWHAP performance as required for GPRA
4) Necessary to assess RWHAP performance as required for HAB’s
programmatic measures
5) Necessary to track enrollment or vital status over the
course of the reporting period
6) Informs the denominator of other items
7) Used to identify important population subgroups
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GLOSSARY
Active client: A person who was a client when the reporting period ended and is expected to continue in
the program during the next reporting period.
Affected client: A family member or partner of an infected client who receives at least one RWHAP support
service during the reporting period.
AIDS: Acquired immune deficiency syndrome. A disease caused by the human immunodeficiency virus.
ART: Antiretroviral therapy. An aggressive anti-HIV treatment including a combination of three or more
drugs with activity against HIV that is designed to reduce viral load to undetectable levels.
ARV: Antiretroviral. A drug that interferes with the ability of a retrovirus, such as HIV, to make more copies
of itself.
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 HIV 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 assistant, clinical nurse specialist, nurse practitioner, or
other health care professional who is certified in his or her jurisdiction to prescribe ARV therapy.
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 the unauthorized disclosure of which 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 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 people 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.
Contract: An agreement between two or more parties, especially one that is written and enforceable by
law.2 For the purposes of the Ryan White Services Report, contracts include formal contracts, memoranda
of understanding, or other agreements.
Core medical services: A set of essential, direct health care services provided to people with HIV/AIDS
and specified in the Ryan White HIV/AIDS Treatment Extension Act.
Division of Policy and Data: The Division within HRSA’s HIV/AIDS Bureau that serves as the Bureau’s
principal source of program data collection and evaluation and the focal point for coordination of program
Contract. (n.d.). The American Heritage® Dictionary of the English Language, Fourth Edition. Accessed December 12,
2008, at Dictionary.com Web site: http://dictionary.reference.com/browse/contract.
2
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performance activities, policy analysis, and development of policy guidance. The Division coordinates all
technical assistance activities for the Bureau in collaboration with each HAB Division.
Eligible Scope: A method of data collection based on a client’s ability to receive federally funded RWHAP
services using established recipient criteria.
EMA/TGA: Eligible Metropolitan Area/Transitional Grant Area. The geographic area eligible to receive
Part A RWHAP funds. The boundaries of the EMA/TGA are defined by the Census Bureau. Eligibility is
determined by AIDS cases reported to the CDC. Some EMA/TGAs include just one city and others are
composed of several cities and/or counties. Some EMA/TGAs extend across more than one State.
Exposure category: See risk factor.
Family-centered: A model in which systems of care under RWHAP 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 or her health insurance plan) separately for
each patient encounter or service rendered.
GCMS: The Grantee Contract Management System. An electronic data system that RWHAP recipients use to
manage their subrecipient contracts.
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 RWHAP services. http://www.whitehouse.gov/omb/mgmtgpra/index-gpra
Grant Recipient of Record (or grantee): See “Recipient of record (or recipient).”
HAB: HIV/AIDS Bureau. The Bureau within HRSA of the U.S. Department of Health and Human Services
(HHS) that is responsible for administering RWHAP. Within HAB, the Division of Metropolitan HIV/AIDS
Programs (DMHAP) administers Part A; the Division of State HIV/AIDS Programs (DSHAP) administers
Part B and the AIDS Drug Assistance Program (ADAP); the Division of Community HIV/AIDS Programs
(DCHAP) administers Part C, Part D, the HIV/AIDS Dental Reimbursement Program (DRP), and the
Community-Based Dental Partnership Program (CBDPP); and the Division of Training and Capacity
Development administers the AIDS Education and Training Centers (AETC) Program and the Special
Projects of National Significance (SPNS) Program. The Bureau’s Division of Policy and Data administers
HIV/AIDS evaluation studies, the Ryan White HIV/AIDS Program Services Report (RSR), the ADAP
Quarterly Report (AQR), the ADAP Data Report (ADR), and the Allocation and Expenditure (A&E) Report.
High-risk insurance pool: A State health insurance program that provides coverage for people 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 people 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 Persons 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.
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HRSA: Health Resources and Services Administration. A Federal public health agency of the U.S.
Department of Health and Human Services 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
RWHAP.
Indeterminate client: A child ages 2 or younger with an HIV status that is not yet determined but was
born to an HIV-infected mother.
Infected client: A person who is HIV positive and receives at least one RWHAP 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.
Laboratory Services: Services provided by a licensed clinical laboratory responsible for analyzing client
specimens to inform the diagnosis, treatment, and evaluation of health factors for PLWHA.
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.
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, or disease or its symptoms in a manner
that is (1) in accordance with generally accepted standards of medical practice; or (2) clinically appropriate in
terms of type, frequency, extent, site, and duration, and considered effective for a patient’s illness, injury, or
disease; and (3) not primarily for the convenience of the patient or treating clinical care provider.
OI: Opportunistic infection. An infection or cancer that occurs in people with weak immune systems due to
HIV, cancer, or immunosuppressive drugs such as corticosteroids or chemotherapy. Kaposi’s sarcoma (KS),
Pneumocystis carinii 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 RWHAP, 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/expectmore/part.html
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Part A: The part of RWHAP that provides direct financial assistance to designated EMAs who 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 RWHAP 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 people living with
HIV/AIDS and their affected partners and family members. RWHAP emphasizes that such care and support
is part of a coordinated continuum of care designed to improve medical outcomes.
Part C: The part of RWHAP 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 RWHAP that supports coordinated family-centered 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 HIV
positive and enrolling and retaining them in care.
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 (or service provider): The agency that provides direct services to clients (and their families) or
the grantee. A provider 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 RWHAP. Also see subrecipient.
Recipient of record (or recipient): An organization receiving financial assistance directly from an HHS
awarding agency to carry out a project or program. A recipient also may be a recipient-provider if it
provides direct services in addition to administering its grant. Recipient of record (or recipient) replaces
the term “Grantee of record.”
Recipient-provider: An organization that receives RWHAP funds directly from HRSA and provides direct
client services. Replaces the term “Grantee-provider.”
Reporting period: A 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 a person at risk for disease. For HIV/AIDS, this includes such factors as male-to-male
sexual contact and injection drug use.
RSR: Ryan White HIV/AIDS Program Services Report.
RWHAP-funded service: A service paid for with Ryan White HIV/AIDS Program funds.
Ryan White HIV/AIDS Treatment Extension Act of 2009: The Federal legislation created to address the
health care and service needs of people living with HIV/AIDS disease and their families in the United States
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and its territories. The law has changed how RWHAP 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 RWHAP. SPNS projects are awarded competitively.
Subrecipient: The legal entity that receives RWHAP funds from a recipient and is accountable to the
recipient for the use of the funds provided. Subrecipients may provide direct client services or
administrative services directly to a recipient. Subrecipient replaces the term “Provider (or service
provider).”
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.
UCI: Unique Client Identifier. A unique alphanumeric code that distinguishes one RWHAP client from all
others and is the same for the client across all provider settings.
XML: EXtensible Markup Language. 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.
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INDEX
ADAP, 8, 9, 22
Outpatient/ambulatory medical care, 7, 47
ART, 51
PCP prophylaxis, 51
Asian Subgroup, 38
Positive HIV Test Date, 55
CD4 Test, 50
Race, 36, 38–39
Client Report, 31–56
Reporting Period, 4
Client-level Data Elements, 33, 35, 33–55, 33–55,
33–55, 33–55, 33–55, 33–55, 58
Clinical Information, 49–55, 49–55, 49–55, 49–55,
49–55, 49–55
Demographic Data, 35–45
Ryan White HIV/AIDS Program Funded Service
Data, 45–48
Reporting Requirements, 3
ADAP, 8, 9, 22
Client-level data, 29, 33–58
Data Validation, 21, 29
Errors, 29
Warnings, 30
EIS. See Services, Early Intervention
Ethnicity, 36, 37
eUCI, 34, 56
First Service Visit Date
Outpatient/ambulatory medical care, 49
Grantee Report, 14–23
Contract Lists, 20
HAART, 51
Health Medical Insurance, reporting sources of,
45
Medical insurance, 44–45
Hepatitis B, 52, 53
Hispanic Subgroup, 37
HIV Diagnosis Year, 43
HIV risk factor, 44
HIV/AIDs status, 42–43
HIV/AIDS status, 42
Household income, calculation of, 40
Housing status, client, 41
Native Hawaiian/Pacific Islander (NHPI)
Subgroup, 39
OAMC Link Date, 55
65
Services, 6–14
Administrative or technical support, 6
AIDS Drug Assistance Program (ADAP), 8
Capacity development, 6
Child care, 11
Early Intervention (EIS), 8, 11
Emergency financial assistance, 11, 48
Fiscal intermediary, 6
Food bank/home-delivered meals, 11, 48
Health education/risk reduction, 12
Health insurance premium and cost-sharing
assistance, 9
Home and community-based health, 9
Home health care, 9
Hospice, 9
Housing, 12, 48
Legal, 12
Linguistic, 12
Local AIDS pharmaceutical assistance (APA), 8, 48
Medical case management, 10
Medical nutrition therapy, 10
Medical transportation, 12
Mental health, 9, 48
Non-medical case management, 11, 48
Oral health care, 8
Outpatient/ambulatory medical care, 7, 50
Outreach, 12
Pediatric developmental assessment and early
intervention, 10, 11
Permanency planning, 13
Planning or evaluation, 6
Psychosocial support, 13
Quality management, 6, 7
Referral for health care/supportive services, 12,
13
Rehabilitation, 13
Respite care, 13
2016 RSR Instruction Manual
Substance abuse (outpatient), 10
Substance abuse (residential), 13
Technical assistance, 6
Treatment adherence counseling, 13
Tuberculosis, 52
Viral Load Test, 51
XML, 64
Client-level data file submission, 56
Variable Name, explanation of, 33
Syphilis, 52
Transgender status, 39
66
| File Type | application/pdf |
| File Title | 2016 ANNUAL RYAN WHITE HIV/AIDS PROGRAM SERVICES REPORT (RSR) INSTRUCTION MANUAL |
| Subject | 2016 ANNUAL RYAN WHITE HIV/AIDS PROGRAM SERVICES REPORT (RSR) INSTRUCTION MANUAL, RYAN WHITE HIV/AIDS PROGRAM, RYAN WHITE HIV/AI |
| Author | HRSA |
| File Modified | 2016-09-09 |
| File Created | 2016-09-08 |