Annual Performance Report—Component 3: Form Instructions
Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments
Component 3: Special Projects—Prevention, Diagnosis, and Treatment Related to the Infectious Disease Consequences of Drug Use
The Annual Performance Report (APR) is required.
Recipients must submit the APR via www.Grantsolutions.gov no later than 120 days prior to the end of the budget period. Please visit the Notice of Funding Opportunity (CDC-RFA-PS21-2103) starting on page 68 for additional information.
Evaluation and Performance Measures are listed in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) starting on page 29. Please review this section, along with Strategies and Activities starting on page 11, before completing your APR.
Complete this form with information from the Reporting Period selected.
Note: Timelines are provided for each measure, however in general:
Short-term outcomes should be reached by the end of year 3. Measures associated with these outcomes should be reported each year. Recipient can define year 1 goal, and year 2 goal should be determined based on interim activities.
Intermediate outcomes should be reached by the end of year 5. Measures associated with these outcomes should be reported each year.
Outcomes for measures that are “contingent on funding” are not required to be reached unless funded during the course of the award. Reporting of these measures is recommended but not required.
3.1—Improve access to services for people who inject drugs (PWID)
in settings disproportionately affected by drug use
Measure 3.1.1.a
Number of PWID served, by setting serving PWID (syringe services programs, substance use disorder treatment programs, correctional facilities, emergency departments, hospital-based programs, sexually transmitted disease clinics, homeless services, health centers, other), during this reporting period
Clients served — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report the unduplicated count of clients seen at least once in each collaborating setting during the reporting period. Report data for all collaborating settings.
PWID served — This is a short-term outcome (years 1–3).
PWID is defined as persons reporting current (typically within 12 months) use of non-prescription drugs by injection.
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report the unduplicated count of PWID seen at least once in each collaborating setting during the reporting period. Report data for all collaborating settings.
Include total number of settings and total for each column across all settings in last row of table.
See pages 22–26 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.1.b
Number of syringes distributed, by setting serving PWID, during this reporting period
Syringes distributed — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Sterile injection equipment should be supplied as a complete set of all equipment needed to complete a single injection—needle, syringe, cooker, alcohol swab, etc. Sets of sterile injection equipment to inject drugs should be supplied in sufficient quantity so that all injections are performed with sterile equipment. For this measure, report the total number of syringes distributed to persons who inject drugs, stratified by setting serving PWID. Total number of syringes distributed is intended as a proxy for the number of complete sets of sterile injection equipment distributed.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.2.a
Number of PWID linked to substance use disorder treatment, by setting serving PWID, during this reporting period
PWID linked to substance use disorder treatment — This is a short-term outcome (years 1–3).
PWID is defined as a person who currently (typically within 12 months) uses non-prescription drugs by injection.
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the total number of PWID (from 3.1.1.a) who were linked to substance use disorder treatment. See definitions below.
Linkage is defined as attendance at the first provider visit for substance use disorder treatment. “Referral” could have a variety of meanings and does not count as “linkage.” Successful linkage can be documented by review of records or direct report by a peer navigator or other reliable means.
Treatment is defined as any treatment, behavioral or medical or a combination, for substance use disorder under the care of a licensed provider.
Substance use disorder is defined as a pathologic pattern of behaviors in which patients continue to use a substance despite experiencing significant problems related to its use. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM 5) gives 11 criteria divided into 4 categories.
Impaired control over use
The person takes the substance in larger amounts or for a longer time than originally planned
The person desires to stop or cut down use of the substance
The person spends substantial time obtaining, using, or recovering from the effects of the substance
The person has an intense desire (craving) to use the substance
Social impairment
The person fails to fulfill major role obligations at work, school, or home
The person continues to use the substance even though it causes (or worsens) social or interpersonal problems
The person gives up or reduces important social, occupational, or recreational activity because of substance use
Risky use
The person uses the substance in physically hazardous situations (eg, when driving or in dangerous social circumstances)
The person continues to use the substance despite knowing it is worsening a medical or psychologic problem
Pharmacologic symptoms*
Tolerance: The person needs to progressively increase the drug dose to produce intoxication or the desired effect, or the effect of a given dose decreases over time
Withdrawal: Untoward physical effects occur when the drug is stopped or when it is counteracted by a specific antagonist
* Note that some drugs, particularly opioids, sedative/hypnotics, and stimulants, can result in tolerance and/or withdrawal symptoms even when taken as prescribed for legitimate medical reasons. Withdrawal symptoms that develop following appropriate medical use do not count as criteria for diagnosis of a substance use disorder.
People with two or more of the 11 criteria within a 12-month period are considered to have a substance use disorder. Mild substance use disorder is defined as meeting 2 to 3 criteria. Moderate substance use disorder is defined as meeting 4 to 5 criteria. Severe substance use disorder is defined as ≥ 6 criteria
Because PWID with substance use disorder may often have more than one type of substance use disorder, and treatment for all diagnosed substance use disorders is usually addressed simultaneously, any initial visit for any substance use disorder is counted in this measure.
Include total number of settings and total for each column across all settings in last row of table.
See page 23 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.2.b
Number of PWID assessed for opioid use disorder, by setting serving PWID, during this reporting period
PWID assessed for opioid use disorder — This is a short-term outcome (years 1–3).
PWID is defined as a person who currently (typically within 12 months) uses non-prescription drugs by injection.
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the total number of PWID (from 3.1.1.a) who were assessed for opioid use disorder. See definitions below.
Complete a clinical interview to determine if the client meets DSM-5 criteria for opioid use disorder. The interview may be conducted by a licensed provider or a standardized interview may be conducted by appropriately trained and supervised staff, consistent with state and local regulations.
Opioid Use Disorder — According to the “Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5),” opioid use disorder is present if the pattern of opioid use causes clinically significant impairment or distress as manifested by the presence of ≥ 2 of the following over a 12-month period:
Taking opioids in larger amounts or for a longer time than intended
Persistently desiring or unsuccessfully attempting to decrease opioid use
Spending a great deal of time obtaining, using, or recovering from opioids
Craving opioids
Failing repeatedly to meet obligations at work, home, or school because of opioids
Continuing to use opioids despite having recurrent social or interpersonal problems because of opioids
Giving up important social, work, or recreational activities because of opioids
Using opioids in physically hazardous situations
Continuing to use opioids despite having a physical or mental disorder caused or worsened by opioids
Having tolerance to opioids (not a criterion when use is medically appropriate)
Having opioid withdrawal symptoms or taking opioids because of withdrawal”
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.2.c
Number of PWID with opioid use disorder, by setting serving PWID, during this reporting period
PWID with opioid use disorder — This is a short-term outcome (years 1–3).
PWID is defined as a person who currently (typically within 12 months) uses non-prescription drugs by injection.
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the total number of PWID (from 3.1.1.a) with opioid use disorder. Of PWID assessed for opioid use disorder (3.1.2.b), report the number of persons with opioid use disorder. Include only persons diagnosed with opioid use disorder as a result of screening for opioid use disorder during the project period. See definitions in 3.1.2.b.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.2.d
Number of PWID with opioid use disorder who are linked to medication for opioid use disorder, by setting serving PWID, during this reporting period
PWID with opioid use disorder who were linked to medication for opioid use disorder — This is a short-term outcome (years 1–3).
PWID is defined as a person who currently (typically within 12 months) uses non-prescription drugs by injection.
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the total number of PWID (from 3.1.1.a) with opioid use disorder who were linked to medication for opioid use disorder. Of PWID with opioid use disorder identified in 3.1.2.c, report the number who were linked to medication for opioid use disorder. See definitions below.
Linkage is defined as attendance at an initial visit to evaluate for medical treatment for opioid use disorder. “Referral” could have a variety of meanings and does not count as “linkage.” Successful linkage can be documented by review of records or direct report by a peer navigator or other reliable means.
Medication for opioid use disorder includes any of three FDA-approved medical treatments for opioid use disorder: methadone, buprenorphine and naltrexone.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.3.a
Number of clients tested for anti-HCV, by setting serving PWID, during this reporting period
Clients tested for anti-HCV — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the total number of clients (from 3.1.1.a) who were tested for anti-HCV antibody. Anti-HCV tests may include rapid point-of-care tests.
Testing includes laboratory testing by any FDA-approved or validated laboratory-developed test.
Include total number of settings and total for each column across all settings in last row of table.
See pages 23–24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.4.a
Number of clients testing positive for anti-HCV, by setting serving PWID, during this reporting period
Clients testing positive for anti-HCV — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who tested for anti-HCV antibody (from 3.1.3.a), report the number of clients who tested positive for anti-HCV antibody.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.4.b
Number of clients positive for anti-HCV that were tested for HCV RNA, by setting serving PWID, during this reporting period
Clients positive for anti-HCV tested for HCV RNA — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who tested positive for anti-HCV antibody (from 3.1.4.a), report the number of clients who were tested for HCV RNA.
Testing includes laboratory testing by any FDA-approved or validated laboratory-developed test.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.4.c
Number of clients testing positive for HCV RNA, by setting serving PWID, during this reporting period
Clients testing positive for HCV RNA — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who were tested for HCV RNA (from 3.1.4.b), report the number of clients who had a positive result for HCV RNA. This includes test results that are detectable but not quantifiable.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.4.d
Number of HCV RNA (+) clients linked to hepatitis C treatment, by setting serving PWID, during this reporting period
HCV RNA (+) clients linked to hepatitis C treatment — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who had a positive HCV RNA result (Measure 3.1.4.c), report the number who were linked to hepatitis C treatment. See definitions below.
Linkage is defined as provision of medical care at the facility or attendance at the initial visit to evaluate for medical treatment of hepatitis C. “Referral” could have a variety of meanings and does not count as “linkage.” Successful linkage can be documented by review of records or direct report by a peer navigator or other reliable means.
Include total number of settings and total for each column across all settings in last row of table.
See page 24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.3.b
Number of clients screened for HBV (anti-HBc, HBsAg, anti-HBs), by setting serving PWID, during this reporting period
Clients screened for HBV (total anti-HBc, HBsAg, anti-HBs) — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the number of clients (from 3.1.1.a) who were screened for hepatitis B, defined as receipt of testing for all of the following:
Total anti-hepatitis B core antibody (total anti-HBc)
Hepatitis B surface antigen (HBsAg); and
Hepatitis B surface antibody (anti-HBs).
Include total number of settings and total for each column across all settings in last row of table.
See pages 23–24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.4.e
Number of clients testing positive for HBsAg, by setting serving PWID, during this reporting period
Clients testing positive for HBsAg — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who were screened for hepatitis B (from 3.1.3.b), report the number who had a positive test result for hepatitis B surface antigen (HBsAg).
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.4.f
Number of HBV (+) clients linked to hepatitis B care, by setting serving PWID, during this reporting period
HBV (+) clients linked to hepatitis B care — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who had a positive test result for hepatitis B surface antigen (HBsAg) (from 3.1.4.e), report the number who were linked to hepatitis B care. See definitions below.
Linkage is defined as provision of medical care at the facility or attendance at the initial visit to evaluate for medical treatment for hepatitis B. “Referral” could have a variety of meanings and does not count as “linkage.” Successful linkage can be documented by review of records or direct report by a peer navigator or other reliable means.
Include total number of settings and total for each column across all settings in last row of table.
See page 24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.3.c
Number of clients screened for HIV, by setting serving PWID, during this reporting period
Clients screened for HIV — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the number of clients (from 3.1.1.a) who were screened for HIV. Any licensed screening or confirmatory test for HIV may be counted in this measure.
Include total number of settings and total for each column across all settings in last row of table.
See pages 23–24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.4.g
Number of clients testing positive for HIV, by setting serving PWID, during this reporting period
Clients testing positive for HIV — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who were screened for HIV (from 3.1.3.c), report the number who had a positive test result for HIV. Count only confirmed positive HIV results for this measure.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.4.h
Number of HIV (+) clients linked to HIV treatment, by setting serving PWID, during this reporting period
HIV (+) clients linked to HIV treatment — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Of clients who had a positive test result for HIV (from 3.1.4.g), report the number who were linked to HIV treatment. See definitions below.
Linkage is defined as provision of medical care at the facility or attendance at the initial visit to evaluate for medical treatment for HIV. “Referral” could have a variety of meanings and does not count as “linkage.” Successful linkage can be documented by review of records or direct report by a peer navigator or other reliable means.
Include total number of settings and total for each column across all settings in last row of table.
See page 24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.4.i
Number of clients referred for treatment for bacterial or fungal infections, by setting serving PWID, during this reporting period
Clients treated or referred for treatment of bacterial or fungal infections — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report number of clients (from 3.1.1.a) who were referred to treatment for bacterial or fungal infections. Referral can be to a primary care provider, emergency department or other appropriate provider. On-site treatment or attendance at a clinical visit for medical management of the infection can also be counted for this measure.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.5.a
Number of hepatitis A vaccination doses administered, by setting serving PWID, during this reporting period
Hepatitis A vaccination doses administered — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report total doses of any hepatitis A vaccine (single antigen or combination) administered.
Include total number of settings and total for each column across all settings in last row of table.
See page 24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.5.b
Number of clients who completed hepatitis A vaccination series, by setting serving PWID, during this reporting period
Clients who completed hepatitis A vaccination series — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the number of clients (from 3.1.1.a) who received the final dose of a complete hepatitis A vaccine series.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.5.c
Number of hepatitis B vaccination doses administered to clients, by setting serving PWID, during this reporting period
Hepatitis B vaccination doses administered — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report total doses of any hepatitis B vaccine (single antigen or combination) administered.
Include total number of settings and total for each column across all settings in last row of table.
See page 24 in the Notice of Funding Opportunity (CDC-RFA-PS21-2103) for more information.
Measure 3.1.5.d
Number of clients who completed hepatitis B vaccination series, by setting serving PWID, during this reporting period
Clients who completed hepatitis B vaccination series — This is a short-term outcome (years 1–3).
Stratify by setting serving PWID (one row per setting). Choose the appropriate setting from the drop-down list. Report data for all collaborating settings.
Report the number of clients (from 3.1.1.a) who received the final dose of a complete hepatitis B vaccine series.
Include total number of settings and total for each column across all settings in last row of table.
Measure 3.1.6.a
How many new confirmed acute hepatitis B cases were reported among people reporting a history of injection drug use in your jurisdiction during this reporting period?
New confirmed acute hepatitis B cases reported among people reporting a history of injection drug use — This is an intermediate outcome (years 4–5).
Using jurisdictional surveillance data for this reporting period, report the number of cases of acute hepatitis B with reported injection drug use during the incubation period.
Measure 3.1.6.b
How many new confirmed acute hepatitis C cases were reported among people reporting a history of injection drug use in your jurisdiction during this reporting period?
New confirmed acute hepatitis C cases reported among people reporting a history of injection drug use — This is an intermediate outcome (years 4–5).
Using jurisdictional surveillance data for this reporting period, report the number of cases of acute hepatitis C with reported injection drug use during the incubation period.
Measure 3.1.6.c
How many new confirmed HIV cases were reported among people reporting a history of injection drug use in your jurisdiction during this reporting period?
New confirmed HIV cases reported among people reporting a history of injection drug use — This is an intermediate outcome (years 4–5).
Using jurisdictional surveillance data for this reporting period, report the number of cases of confirmed HIV infection with reported injection drug use as a risk factor.
Measure 3.1.7.a
Do you report hepatitis C viral clearance cascade data for reported cases among people reporting a history of injection drug use in your jurisdiction?
Do you report hepatitis C viral clearance cascade data for reported cases among people reporting a history of injection drug use in your jurisdiction? This is an intermediate outcome (years 4–5).
Respond “yes” if your jurisdiction publishes a clearance cascade for persons reporting injection drug use as a risk factor for acute or chronic hepatitis C. Otherwise, respond “no.” Care cascade data are counted as “reported” if published (e.g., on a website) or if shared with partners.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Cooley, Laura A. (CDC/DDID/NCHHSTP/DVH) |
| File Modified | 0000-00-00 |
| File Created | 2023-08-27 |