Data Variable Recommendations DSR 2019

Data Variable Recommendations DSR 2019.docx

Ryan White HIV/AIDS Program Part F Dental Services Report

Data Variable Recommendations DSR 2019

OMB: 0915-0151

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DSR OMB Package 2020 – Proposed Changes



SECTION 2. PATIENT DEMOGRAPHICS AND ORAL HEALTH SERVICES

#

Variable

Response Option

Recommendation

8

HIV/AIDS Status

  • HIV-positive, not AIDS

  • CDC-defined AIDS (HIV-positive with AIDS-defining illness)

  • HIV-positive, AIDS status unknown

  • HIV-positive, not AIDS

  • HIV-positive, AIDS status unknown

  • CDC-defined AIDS

  • HIV-indeterminate (infants <2 years old)

9a

Gender

  • Male

  • Female

  • Transgender

  • Unknown/unreported

  • Male

  • Female

  • Transgender Male to Female

  • Transgender Female to Male

  • Transgender Other

  • Unknown

9b

Sex at birth

  • Male

  • Female

No change

10

Pregnancy Status

  • Pregnant

  • Not pregnant

  • Unsure if pregnant

  • Unknown/unreported

  • Pregnant

  • Not pregnant

  • Unknown/unreported

11a

Ethnicity

  • Hispanic or Latino/a

  • Non-Hispanic or Latino/a

  • Hispanic, Latino/a

  • Non-Hispanic/Latino/a

11b

Hispanic subgroup

  • Mexican, Mexican American, Chicano/a

  • Puerto Rican

  • Cuban

  • Other Hispanic, Latino/a or Spanish origin

  • Mexican, Mexican American, Chicano/a

  • Puerto Rican

  • Cuban

  • Another Hispanic, Latino/a or Spanish origin

12a

Race

  • White

  • Black or African American

  • Asian

  • Native Hawaiian or other Pacific Islander

  • American Indian or Alaska Native

  • More than one race

Alphabetize list


No change to response options.

12b

Asian subgroup

  • Asian Indian

  • Chinese

  • Filipino

  • Japanese

  • Korean

  • Vietnamese

  • Other Asian

No change

12c

Native Hawaiian/Pacific Islander subgroup

  • Native Hawaiian

  • Guamanian or Chamorro

  • Samoan

  • Other Pacific Islander

No change

13

Age

  • 12 or younger

  • 13–24

  • 25–44

  • 45–64

  • 65 or older

  • Unknown/unreported


to match the RSR report:

<13

13-24

25-34

35-44

45-54

55-64

65>


14

Income

  • Equal to or below the Federal poverty line

  • 101–200% of Federal poverty line

  • 201–300% of Federal poverty line

  • > 300% of Federal poverty line

  • Unknown/unreported

No change



Section 5: Additional Dental Reimbursement Program Information

#

Variable

Response Option

Recommendation

23a

Amount of unreimbursed costs

Total unreimbursed costs of oral health care provided to patients with HIV (rounded to the nearest dollar)

Total unreimbursed costs of oral health care provided to patients with HIV during the reporting period (rounded to the nearest dollar)




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October 11, 2019, V1


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AuthorJordan, Anthony (HRSA)
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