| [Health Care Financing Administration(now known as Centers for Medicare and Medicaid Services(CMS))] | [Table of Contents] | [National Institutes of Health] |
Purpose Of The Database And Study Design: The ADAP Monthly Report allows the HAB to routinely monitor the fiscal status of ADAPs across the US, trends in enrollment in those programs, and other developments that may have an impact on the ability of HIV positive low-income individuals to access life sustaining and enhancing therapeutics.
Nature Of The Data Collected: Cross-sectional administrative data
Unit Of Analysis: Individual State ADAPs
Data Collection Methods: Reports are submitted electronically or on hardcopy. HAB contractors enter data into an administrative database.
General Attributes: ADAP Monthly Reports were initiated in February 1998 and are submitted by all 50 States, the District of Columbia, Puerto Rico, and US territories. As of April 1999, State submission of ADAP monthly reports is a condition of grant award.
Major Data Constructs And Key Data Elements: Data reported include: funds received by the ADAP by source of funding; monthly enrollment data; methods used to directly measure or estimate enrollment; expenditures by type of drug; unit prices paid by type of drug; changes in key aspects of the program (e.g., financial eligibility, drug formularies, and clinical guidelines issued in the State); and other related data.
Strengths And Weaknesses Of The Study Design And Database: Timeliness of report submissions varies among grantees due to inherent variation in State systems. ADAPs may impute some data (e.g., enrollment) using a variety of methods. Such imputation may result in variation in reliability of the data among ADAPs.
Gaps In The Data Collected And Factors Leading To The Gaps: Additional detailed antiretroviral data are needed. HAB staff is considering adding these elements to the report.
Feasibility Of Linking With Other Databases: ADAP monthly reports may be linked to other State-specific databases. The reports are considered confidential, however, due to confidential funding information provided in the reports.
Process To Access The Database And Contact Person: This is not a database accessible to the public. For more information contact: Paul Mahanna, Public Health Analyst, HRSA, HAB, Division of Service Systems at (301) 443-4063.
Selected Citations: Additional information also may be obtained from the HAB web site: http://www.hrsa.gov/hab
Purpose Of The Database And Study Design: The AAR provides standardized data regarding providers and clients participating in Titles I or II of the Ryan White CARE Act for administrative and fiscal monitoring purposes. The Resource Allocation Report provides data on the amount of funds allocated for various types of health and support services. Title I of the CARE Act provides formula and supplemental grants to Eligible Metropolitan Areas (EMAs) that are disproportionately impacted by the HIV epidemic. Grants are awarded to the chief elected official of the city or county that administers the health agency providing services to the greatest number of HIV positive individuals in the EMA. Title II of the Ryan White CARE Act provides formula grants to States, the District of Columbia, Puerto Rico, and eligible US territories to fund health care and support services for HIV positive individuals. The goal of the AAR is to provide uniformly collected data that shows what populations are being reached and what types and amounts of services are being provided. The AAR is designed to provide information on the number and characteristics of clients who are served by agencies funded by Titles I or II, the types and amount of services they receive, and the agencies from which they receive those services. The Resource Allocation Report supplements the AAR by identifying funds allocated to different types of services, aggregated at the grantee level.
Nature Of The Data Collected: Cross-sectional administrative data
Unit Of Analysis: Providers or programs receiving Titles I or II funds
Data Collection Methods: Providers are required to submit AAR reports annually using standardized reporting forms. The Standard AAR is completed by most providers and includes service counts for contracting agencies and their subcontractors. Providers either submit hardcopy aggregate reports or electronically stored data obtained from their automated files. Title II grantees must report summary fiscal and client data for the ADAPs using the AIDS Pharmaceutical Assistance Program AAR. Local providers that implement pharmaceutical assistance programs must also complete these data. Providers are responsible for developing a data collection system that reports all required data, including unduplicated client counts. Providers are responsible for obtaining and reporting AAR data from subcontractors, completing their aggregate reports, and submitting them to the grantee. Health Insurance Continuation Programs (HICP) must complete a HICP AAR. Titles I or II grantees are responsible for collecting AARs from their providers and subcontractors on a calendar year basis. They must also prepare the AIDS Pharmaceutical Assistance and HICP AARs. The grantees are responsible for ensuring compliance with AAR reporting requirements and providing training and technical assistance to contract providers. Grantees must edit the AARs for completeness and accuracy and forward them to HAB in March of each year. HAB disseminates aggregate data to each grantee and produces national tabular data that summarizes the submissions of grantees. Grantees are required to submit Resource Allocation Reports twice annually by fiscal year, using an Office of Management and Budget (OMB) approved form to report on anticipated allocations 90 days after grant award and then final allocations with their final grant progress report.
General Attributes: AAR data have been submitted by grantees for the period between 1994 and 1999. Summary AAR reports have been completed through 1998, with 1999 data to be available by Fall 2000. A total of 51 Title I grantees and 54 Title II grantees currently submit AAR forms. Resource Allocation Reports were instituted in FY 1996 as a requirement of OMB and approved as a revised AAR. Summary reports and trend analyses have been completed for FY 1996 to 1999. A total of 51 Title I grantees and 54 Title II grantees currently submit Resource Allocation Reports as a condition of grant award and as part of their final progress report.
Major Data Constructs And Key Data Elements: AAR data provided by grantees include provider information (for agencies receiving funds to deliver direct services), the type and units of service provided, and summary client demographic data. The AAR collects data on all clients who receive at least one service in a calendar year that is eligible for Title I or II funding. Resource allocation data can be used to provide amounts, percentages, and trends in increases/decreases of the use of Title I and II funds for various service categories.
Strengths And Weaknesses Of The Study Design And Database: Data are aggregated at the grantee level. Clients often use more than one provider and patient level files with a unique client ID are not submitted to the grantee. Most providers report all services and clients eligible for Titles I or II funding, not just services and clients funded by the Ryan White CARE Act. Although this strategy provides a more complete assessment of the HIV-related services delivered by Ryan White CARE Act providers, the data report over estimates the number of individuals served by Titles I or II. Resource allocation data provide an aggregate description of the use of funds, but they do not represent the actual expenditure of funds by providers.
Gaps In The Data Collected And Factors Leading To The Gaps: In addition to duplicate counts of patients by multiple providers, longitudinal person-based clinical data are not collected. Clinical outcomes cannot be linked to interventions due to lack of longitudinal databases. Provider performance and quality data are inadequately recorded.
Feasibility Of Linking With Other Databases: The provider data reported in the AAR might be linked to other databases. Client data are reported in the aggregate and cannot be linked due to the lack of unique identifiers. A cross-Title AAR prototype is in development.
Process To Access The Database And Contact Person: This is not a database accessible to the public. For more information on the AAR contact: John Milberg, Deputy Branch Chief, HRSA HAB Office of Science and Epidemiology at (310) 443-6560. For the information on the Resource Allocation Report contact: Richard Conviser, PhD, Chief, Evaluation Branch, HRSA HAB Office of Science and Epidemiology at (310) 443-6560
Selected Citations:
HIV/AIDS Bureau, Trends in Ryan White CARE Act Title I and II Allocations for HIV Services: FY 1996-1999. Rockville: HRSA, 2000.
HIV/AIDS Bureau. 1997 Annual Administrative Report: Ryan White CARE Act Title I and Title II National Data Tables. Rockville: HRSA, 1999.
HIV/AIDS Bureau. 1996 Annual Administrative Report: Ryan White CARE Act Title I and Title II National Data Tables. Rockville: HRSA, 1998.
McKinney MM, Wieland MK, Bowen GS, et al. States’ responses to Title II of the Ryan White CARE Act. Public Health Report. 108(1): 4-11, 1993.
Bowen GS, Marconi K, Kohn S, Bailey DM, et al. First year of AIDS services delivery under Title I of the Ryan White CARE Act. Public Health Reports. 107(5): 491-499, 1992.
Purpose Of The Database And Study Design: In 1994, HRSA initiated the URS to demonstrate the feasibility of collecting client demographic and service data on HIV/AIDS infected/affected clients across a network of service providers and the usefulness of these data for planning and evaluation purposes at both the local and national levels. Through this system, HRSA sought to overcome the limitations of the AAR, the national reporting system for the Ryan White CARE Act. The AAR collects data aggregated at the grantee level and has duplicated counts of clients.
Nature Of The Data Collected: Demographic information, service use, and health indicators are collected.
Unit Of Analysis: Clients of providers funded by Title I or Title II of the Ryan White CARE Act
Data Collection Methods: Demographic information, service utilization, and health indicators of all clients receiving services at providers funded by the Ryan White CARE Act are collected by service providers every six months and sent to their Title I or Title II grantee. The grantees process the data from all of their providers and send these data to HRSA. Also, they continually monitor the quality of the data they receive from their providers and immediately address any problems that arise with the submission of data from their providers. Continuing clients may be followed longitudinally through the use of a unique identifier.
General Attributes: TheURS is a voluntary program, established in 1994 to collect information from several Title I and Title II grantees and their subcontracted service providers about their individual clients. In 1997, through a competitive process, HRSA awarded seven contracts including five Title I sites and two Title II sites, one of which was a new grantee. HRSA supports, both financially and technically, the implementation and collection of the URS data at these seven sites. Although it was originally designed to include clients who received services from Title I and Title II providers, a number of the participating providers also receive funding from Titles III and IV of the Ryan White CARE Act. Therefore, the URS provides a relatively complete picture of all Ryan White CARE Act clients at these seven sites.
Major Data Constructs And Key Data Elements: Client demographics, service utilization, and health status indicators are collected.
Strengths And Weaknesses Of The Study Design And Database: One strength of the database is that an unique identifier is used to protect the anonymity of the clients, and as a further safeguard, this unique identifier is encrypted before it is sent to HRSA. Another strength is that grantees provide technical assistance to all their providers regarding the appropriate and accurate collection and entry of relevant data.
Gaps In The Data Collected And Factors Leading To The Gaps: Althoughclient-level clinical data are not currently collected, HAB is in the process of changing the database to include several outcome measures relating to medical outcomes and whether standards of care are being followed at Ryan White CARE Act providers.
Feasibility Of Linking With Other Databases: Linkages might be achieved through encoding of unique identifiers of other databases using the same algorithm as the systems used for the URS.
Process To Access The Database And Contact Person: Gaining access to the database will be determined on a case by case basis. For more information, please contact Jill M. Jacobsen, PhD, Statistician, HRSA, HAB, Office of Science and Epidemiology at (301) 443-6560.
Selected Citations:
Marconi K, Durbin RC, Niemcryk SJ, Baitty RL. Retention in primary health care of clients diagnosed with HIV by Ryan White CARE Act health care providers over a 30-month period. International Conference on AIDS. 12: 854 (Abstract No. 42402), 1998.
Purpose Of The Database And Study Design: Applications for funding systematically gather data annually that are used for administrative and fiscal monitoring and to confirm conformance with statutory provisions set forth in the Ryan White CARE Act. Special studies have also been conducted.
Nature Of The Data Collected: Cross-sectional administrative, clinical, and psychosocial service data
Unit Of Analysis: Title I and Title II grantees.
Data Collection Methods: Data are aggregated from administrative records, automated data systems, or hardcopy records. Grantees submit data using a standardized tabular format.
General Attributes: Automated data for selected tables is available for 1998 and 1999 application submissions for 49 Title I grantees and 54 Title II grantees.
Major Data Constructs And Key Data Elements: For Title I grantees data include: local HIV epidemiologic data by demographic group, HIV exposure, and other categories; Planning Council membership; Planning Council areas of interest/expertise; summary of the previous year’s expenditures by service area; progress in implementing previous year’s goals; qualitative assessment of populations with special needs; other sources of funding; HIV-related collaboration and coordination activities; and implementation plans. For Title II grantees data include: the previous year’s allocations by service area (i.e., Home and Community-Based Care, Health Insurance Continuation Program, ADAP, HIV Care Consortia, and Administration/Planning/Evaluation), the previous year’s disbursement and expenditures by program category; other sources of HIV-related funding; proposed implementation plans; detailed consortium information by program category; and the demographic characteristics of clients served within consortium region by program category.
Strengths And Weaknesses Of The Study Design And Database: The applications provide useful summary information regarding the processes undertaken to plan, allocate, and deliver HIV services. The quality and completeness of the data provided, however, vary among grantees.
Gaps In The Data Collected And Factors Leading To The Gaps: Unique client service utilization data are not available.
Feasibility Of Linking With Other Databases: Grantee identifiers (e.g., name of the jurisdiction) may be linked to other databases.
Process To Access The Database And Contact Person: This is not a database accessible to the public. For more information contact Richard Conviser, PhD, Chief, Evaluation Branch, HRSA HAB Office of Science and Epidemiology at (310) 443-6560.
Selected Citations:
Hines R, Rosenberg L, Nelson J, Marconi K. Changes in the composition of Ryan White CARE Act Title I Comprehensive Health Services Planning Councils from 1993 to 1996. Meeting of the Association of Health Services Research. 14: 279, 1997.
Purpose Of The Database And Study Design: Title III of the Ryan White CARE Act funds outpatient HIV early intervention services for low-income, medically underserved individuals in established primary care systems. Data from Title III Program Data Reports are used for administrative and programmatic monitoring and to confirm conformance with statutory provisions set forth in Title III of the Ryan White CARE Act.
Nature Of The Data Collected: Cross-sectional unduplicated administrative, demographic, clinical, and psychosocial service data
Unit Of Analysis: Agency receiving Title III funding
Data Collection Methods: Grantees submit aggregate data on an annual, calendar year basis using standardized reporting forms. Submissions are commonly mailed in on a fax-to-data form or submitted electronically using the Internet.
General Attributes: A total of 165 grantees submit data on an annual basis. Reporting was initiated on a voluntary basis for FY 1992 and 1993 (with about 50% of grantees submitting data). Mandatory reporting was initiated inFY 1994. 174 projects will be reporting on CY 1999 activities and approximately 23 more will be added in FY 2000.
Major Data Constructs And Key Data Elements: Reports from grantees include: summary grantee data; counseling and testing services provided to clients; primary health care services provided to clients; referrals; case management and/or eligibility assistance services provided; outreach services provided; demographic characteristics and health status of clients; fiscal data related to the Title III award; and summary service utilization among grantee clients. The scope of data reported by the Title III grantee spans all patients, clients, or other individuals served by the agency, as well as services provided by the agency, regardless of the source of funding.
Strengths And Weaknesses Of The Study Design And Database: The quality of the data varies substantially among grantees. Title III grantees are asked to report data that spans all services provided and clients served by the agency, regardless of the funding source. Discretion is given to the grantee to define their Title III program. The actual number of clients served may be under-estimated and that estimation may vary among grantees because data reported may not include services provided through subcontractors.
Gaps In The Data Collected And Factors Leading To The Gaps: Insufficient data systems used by grantees; Title III program data report does not collect direct service utilization data.
Feasibility Of Linking With Other Databases: There are no identifiedlinks to other databases. A cross-Title AAR prototype is in development.
Process To Access The Database And Contact Person: This is not a database accessible to the public. For more information contact:Betty Gramley, Project Officer, HRSA HAB Title III Program, Division of Community Based Programs at (301) 443-0735.
Selected Citations:
HIV/AIDS Bureau, 1996 Program Data Report: Title III Early Intervention Services Ryan White CARE Act. Rockville: HRSA, 1998.
Purpose Of The Database And Study Design: Title IV of the Ryan White CARE Act funds the development and operation of primary care and social services for children, youth, and women living with HIV, as well as their families. The Title IV program supports comprehensive, community-based, coordinated services that integrate both health and social services. Title IV programs must also develop strategies to effectively link with HIV research studies funded by the National Institutes of Health (NIH) and other entities. The Title IV program actively collaborates with the NIH in the Reaching for Excellence in Adolescent Care and Health (REACH) project. Data from the Title IV Data Reporting System are used for administrative and fiscal monitoring and to confirm conformance with statutory provisions set forth in Title IV of the Ryan White CARE Act. Additionally, the Title IV Data Reporting System is designed to assist HAB to describe to Congress and other policymakers the unique characteristics of service delivery to HIV positive children and their families, as well as prevention of HIV transmission to women and children at-risk.
Nature Of The Data Collected: Cross-sectional administrative, clinical, and support service data
Unit Of Analysis: Program grantees and their subcontractors
Data Collection Methods: Tabular reports must be completed annually by Title IV grantees and their subcontractors. Grantees are responsible for the quality of data reported by sub-contractors and for ensuring that the data reported represent unique, unduplicated client counts. Detailed criteria are provided to the grantees regarding the definition of enrolled clients, family members, and other sub-populations that may be served by the Title IV program.
General Attributes: A total of 53 grantees currently submit annual reports to HAB; five additional adolescent specific grantees will initiate data reporting in FY 2000
Major Data Constructs And Key Data Elements: Data collected include: organizational structure of the grantee and their subcontractors; demographic characteristics and clinical status of clients who are enrolled in the Title IV program; housing/living arrangements; primary caregiver; source of reimbursement for basic medical services; rates of utilization of services by service type; and prevention, outreach, and education activities conducted by the program, including the characteristics of the individuals reached by these services and the frequency with which the services were provided.
Strengths And Weaknesses Of The Study Design And Database: Title IV programs may not have centralized automated information systems that support the data reporting. Client counts may be duplicated due to lack of a centralized information system. Frequency of service use within a Title IV program may be under-counted due to inadequate service tracking systems. Title IV programs vary significantly in design and the array of services provided; those differences may not be accurately reflected in the organization data submitted to the Reporting System. The validity and reliability of the data reported may also be highly variable.
Gaps In The Data Collected And Factors Leading To The Gaps: Minimal clinical data are recorded in the Reporting System.
Feasibility Of Linking With Other Databases: Linkage with other databases is feasible at the local programmatic level. No client identifiers are transmitted to HAB. A cross-Title AAR prototype is in development.
Process To Access The Database And Contact Person: This is not a database accessible to the public. For more information contact: Ivana Williams, HRSA HAB, Deputy Branch Chief, Title IV Programs, Division of Community Based Programs at (301) 443-9051.
Selected Citations:
HIV/AIDS Bureau. Ryan White CARE Act Title IV: Summary Presentation and Comparisons of Selected 1995 and 1996 Data Elements Reported by Grantees. Rockville: HRSA, 1998.
Teitelbaum M, Toland G, Saulsbury K. Ryan White CARE Act Title IV Grant Program: Summary Presentation and Comparisons of Selected 1995 and 1996 Data Elements Reported By Grantees. Cambridge: Abt Associates, Inc., 1994.
Teitelbaum M, Saulsbury K. Ryan White Title IV Grant Program: Summary Presentation and Comparison of 1994 and 1995 Data Elements. Cambridge: Abt Associates, Inc., 1994.
Palinecek J, Hidalgo J, Hutton N, Weiss B. Impact of on-site social work services on the documentation of client and family-centered information: The experience of Ryan White CARE Act (Title IV) pediatric programs in Maryland. Pediatric AIDS and HIV Infection: Fetus to Adolescent. 7(5): 337-345, 1996.
Purpose Of The Database And Study Design: The SPNS Program is supported by Part F of the Ryan White CARE Act to develop innovative models of HIV/AIDS care. These models are designed to address special care needs of HIV positive individuals in minority and hard-to-reach populations. The SPNS projects are designed to be replicable in other parts of the US and to have strong evaluation components. SPNS projects focus on a variety of topics including: managed care, infrastructure development among care providers, access to care through reduction of barriers for specific populations, housing (in collaboration with the Department of Housing and Urban Development), legal advocacy, comprehensive primary care, integration of mental health and primary care, and services for inmates.
Nature Of The Data Collected: Varies by SPNS project
Unit Of Analysis: Varies by SPNS project
Data Collection Methods: Reflecting the unique nature of each SPNS project, data collection methods vary substantially. The data collected is dependent upon the project’s design and the services provided. Several groups of SPNS projects use standardized data collection instruments developed to uniformly capture programmatic, fiscal, client demographic characteristics and health status, and service delivery data.
General Attributes: In Federal Fiscal Year 1999, 87 SPNS grantees were funded.
Major Data Constructs And Key Data Elements: Data elements vary among grantees and are based on the service model used and the scope of the project.
Strengths And Weaknesses Of The Study Design And Database: Given the unique nature of many of the SPNS projects, the study designs and data collection methods vary substantially. The timeliness of reporting and the content of reporting also vary widely among projects.
Gaps In The Data Collected And Factors Leading To The Gaps: Gaps vary among grantees.
Feasibility Of Linking With Other Databases: The feasibility of linkage with other databases varies, based on the data collection strategies used by the project. Some projects rely on clinical, administrative, and insurance claims files that might be linked to other databases at the program level. Unique identifiers are not provided to HAB so linkage at the federal level is not feasible.
Process To Access The Database And Contact Person: These are not databases generally accessible to the public. For more information contact: Barbara Aranda-Naranjo, PhD, Chief, Demonstration Project Development and Evaluation Branch, HRSA HAB, Office of Science and Epidemiology, Special Projects of National Significance Program at (301) 443-9976.
Selected Citations:
Huba GJ, Melchior LA, De Veauuse NF, Hillary K, et al. A national program of innovative AIDS care projects and their evaluation. Home Health Care and Services Quarterly. 17(1): 3-30, 1998.
Gamliel S, Singer B, Marconi K. HIV healthcare delivery and managed care: applications and implications from the Special Projects of National Significance Program. Home Health Care and Services Quarterly. 17(1): 101-109, 1998.
Brady RE, Singer B, Marconi KM. Special Projects of National Significance Program: ten models of adolescent HIV care. Journal of Adolescent Health. 23 (2 Suppl): 1-4, 1998.
Melchior L, Feudo R, Greenberg B, Hodgins A. et al. Outreach to adolescent women with or at high risk for HIV: a report from ten innovative service models. National Conference on Women and HIV. 179 (Abstract No. P2.25), 1997.
Huba G, Hodgins A, Woods E, Kipke M, et al. A profile of adolescent women with or at high risk for HIV: personal and service needs. National Conference on Women and HIV. 178 (Abstract No. P2.24), 1997.
Huba G, Larson T, Marconi K, Melchoir L, et al. Cooperative information sharing, evaluation, and management model for 27 HIV service projects: first year results. International Conference on AIDS. 11(2): 407 (Abstract No. ThD. 50008), 1996.
Purpose Of The Database And Study Design: The AETC program is funded by Part F of the Ryan White CARE Act. The AETC program is a national network of centers that undertake targeted, multi-disciplinary education and training programs for health care workers in designated geographic areas. A goal of the AETC program is to expand the number of health care workers who are trained and motivated to counsel, diagnose, treat, and manage the care of HIV positive individuals, as well as help reduce high-risk behaviors that may lead to HIV infection. AETCs collaborate with providers funded by the Ryan White CARE Act, educational institutions, hospital and community-based providers, and professional associations to coordinate and conduct training. AETC projects and their subcontractors maintain several databases. The Individual Program Data Record is completed by participating grantees twice annually. Pertinent information forms are distributed at AETC training sessions to capture data regarding participants.
Nature Of The Data Collected: Cross-sectional administrative and training data
Unit Of Analysis: AETC grantees and subcontractors and providers participating in AETC training sessions
Data Collection Methods: Pertinent information forms are distributed at each training session supported by the AETC program. Attendees complete the forms and return them to the grantees for batching and submission to a centralized site for editing, automation, data analysis, and report development. The Individual Program Data Record reflects aggregate data collected on the submitted information forms, as well as additional programmatic data collected by the grantee and their performance sites.
General Attributes: Currently 15 centers and 75 local subcontractors participate in the program.
Major Data Constructs And Key Data Elements: Information forms include demographic, discipline, and training characteristics of the attendees at the training sessions. Additionally, information is collected regarding the attendees’ site of practice, the patient characteristics, the nature of HIV care they provide, and their training needs. The Individual Program Data Record summarizes the training sessions conducted by the grantee and their performance sites, collaborating organizations, number of sessions offered by level of the training sessions, summary characteristics of the attendees of their training sessions, and summary characteristics of patients seen by the attendees.
Strengths And Weaknesses Of The Study Design And Database: HAB is revising their data collection instruments. Revised forms will be introduced in 2000.
Gaps In The Data Collected And Factors Leading To The Gaps: HAB staff members have identified gaps in the data being collected and items that require updating to reflect new treatment and service modalities.
Feasibility Of Linking With Other Databases: Linkage might be feasible at the grantee or sub-contractor level. Unique identifiers of training session attendees are not recorded so linkage with other databases is not feasible.
Process To Access The Database And Contact Person: This is not a database accessible to the public. For more information contact: Juanita Koziol, Deputy Branch Chief, HRSA, HAB, AIDS Education and Training Center Program, Division of Training and Technical Assistance at (301) 443-6364.
Selected Citations: Additional information also may be obtained from the HAB web site: www.hrsa.gov/hab.
Purpose Of The Database And Study Design: The HIV/AIDS Dental Reimbursement Program assists accredited dental schools and post-doctoral dental programs with uncompensated costs resulting from provision of oral health care to HIV positive patients. The Commission on Dental Accreditation must accredit these institutions. Eligible institutions must document uncompensated costs of oral health care for HIV positive persons. Reimbursement levels reflect the number of patients served by each applicant institution and their unreimbursed oral health care costs, compared to the total number of patients served and total costs incurred across all eligible applicants. In Federal Fiscal Year 1997, 103 institutions received funding through this program.
Nature Of The Data Collected: Cross-sectional administrative and clinical data
Unit Of Analysis: Individual institutions applying for reimbursement
Data Collection Methods: Applicants received a standardized data collection form in March 1999 for reporting of aggregate patient and billing data for the period between July 1997 and June 1998.
General Attributes: Data are collected annually from each institution applying for reimbursement. Methods used to obtain the data submitted in the Dental Reimbursement Program Application vary among applicants.
Major Data Constructs And Key Data Elements: Data collected by the 1999 Program Application include: number of HIV positive patients treated by the applicant institution, method used to estimate the number of patients treated, demographic characteristics of the patients, reimbursement sources, amount of Ryan White CARE Act funds received, numbers of patients who received types of treatment services, estimated unreimbursed costs, methods used to estimate those costs, activities to be funded with the reimbursed costs, and narrative describing the institutions’ collaboration with Ryan White CARE Act planning councils, consortia, and other CARE Act-funded programs, as well as participation in outreach to persons with HIV and to other providers of HIV services.
Strengths And Weaknesses Of The Study Design And Database: The Program Application form was recently revised to gather more complete and accurate data. Detailed instructions for completing the Program Application form are included.
Gaps In The Data Collected And Factors Leading To The Gaps: None identified
Feasibility Of Linking With Other Databases: Individual institutions are identified in the Program Application. Linkage with other institution-specific data is feasible.
Process To Access The Database And Contact Person: This is not a database accessible to the public; functionally, the database is a contact database used by HRSA’s contractor to enter and verify submitted data. It is not currently formatted in a way that would allow easy access, or that allows searches/finds/sorts etc. as a typical database would. For further information contact: Barry H. Waterman, DMD, HRSA, HAB, Dental Reimbursement Program, Division of Community Based Services at (301) 443-1434.
Selected Citations:
There are two documents being prepared for publication in 2000. One is a Report of Aggregate Program Data for the 1998 reporting year; the other is an evaluation of the Dental Reimbursement Program conducted by a consultant/contractor.
Schneider DA, Hardwick KS, Marconi KM, Niemcryk SJ, et al. Delivery of oral health care through the Ryan White CARE Act to people infected with HIV. Journal of Public Health Dentistry. 53(4): 258-264, 1993.
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