Performance Improvement 1999. HIV/AIDS Services


TITLE: A Review and Synthesis of HIV/AIDS-Related Client Level Evaluation Activities Among Ryan White CARE Act Grantees

ABSTRACT: The purpose of this study was to gather information about whether and how Ryan White Comprehensive AIDS Resources Emergency (CARE) Act grantees were evaluating client satisfaction, and how the grantees were improving delivery systems in response to client needs and concerns. The development of new, clinically effective therapies that present challenges in their use has intensified the need for the re-design of HIV services and the increased involvement of people living with HIV/AIDS in managing their own health. A mail survey about assessment of client satisfaction was mailed to 480 grantees in September, 1997. Subsequently, site visits were made to six grantees. An advisory board including representatives of a wide spectrum of HIV/AIDS organizations helped guide the design of the survey and developed criteria for selecting the sites for the six case studies. The study found that grantees assessed client satisfaction most commonly through self-administered surveys, but some conducted group sessions or focus groups. Grantees using the latter methods reported making changes in their delivery systems more frequently than those using surveys. Ninety-three grantees reported making a wide range of changes in response to clients, including involvement of clients in policy and information development, and provision of sensitivity training for clinical and non-clinical staff. The Health Resources and Services Administration (HRSA) is using the findings in its technical assistance concerning client satisfaction and access to care. The National Association of People with AIDS (NAPWA) is using the results in a privately funded project to demonstrate the benefits of consumer involvement in the design and implementation of services.


FEDERAL CONTACT: Moses B. Pounds, Ph.D.

PHONE NUMBER: 301-443-2894

PIC ID: 6362

PERFORMER ORGANIZATION: National Association of People with AIDS, Washington, D.C.

TITLE: Data Collection and Budget Forecasting Strategies: A Primer for State AIDS Drug Assistance Programs

ABSTRACT: State-administered AIDS Drug Assistance Programs (ADAPs), funded by the Health Resources and Services Administration (HRSA) under Title II of the Ryan White CARE Act, along with other State and private sector resources, have been thrust to the forefront of the public debate over the cost-efficient provision of public health care services to individuals in this country. Over the last two years, ADAPs in most States have experienced significant growth, both in the number of clients served and in monthly expenditures on pharmaceuticals. This rapid growth has strained the limited resources of these programs and has resulted in many ADAPs being forced to limit access to life-sustaining HIV/AIDS medications by capping overall program enrollment, capping or limiting access to expensive new drug therapies, or developing more restrictive financial and medical program eligibility criteria. The rapidly changing fiscal and treatment environments in which ADAPs now operate have raised many challenges for the State-level or State-contracted administrators of these programs. Good data and good data collection systems are necessary to develop accurate budget projections and to aid in program planning. The purposes of this study were to provide directors of ADAPs with information necessary to assess their current data collection program and to provide practical tools to assist in developing an appropriate budget forecasting model. This study developed a primer on basic data collection and forecasting strategies. The primer addresses the fundamental program need for data to estimate expected monthly expenditures and the cost impact of adding a specific new drug to the ADAP formulary. The products of this study will enable ADAPs to assume greater accountability by streamlining data management strategies and enhancing forecasting capacity.



PHONE NUMBER: 301-443-6745

PIC ID: 7159

PERFORMER ORGANIZATION: National Alliance of State and Territorial AIDS Directors, Washington, D.C.

TITLE: Evaluating HIV Case Management: Invited Research & Evaluation Papers

ABSTRACT: The purpose of this study is to report on the papers and recommendations of a conference on approaches for evaluating the effectiveness of HIV case management. Case management for HIV services is eligible for funding under the Ryan White Comprehensive AIDS Resources Emergency Act Amendments of 1996 (CARE Act). The expansion of case management has not been accompanied by consistent standards for service delivery, validation of its aims and purposes, comparative analysis of its multiple forms, or systematic investigation of its various service configurations and outcomes. There is evidence that HIV case management is a highly needed service that leads to problem resolution, and that clients who receive case management have high levels of satisfaction with their case manager. However, health services research data about the effectiveness of HIV case management are generally lacking. For this project, a group of health services researchers, case managers, and Federal representatives met to discuss the evaluation and study of the effectiveness of HIV case management. Ten papers were commissioned for presentation at the meeting that, together with a summary introduction, constitute this final report.


FEDERAL CONTACT: Gloria Weissman

PHONE NUMBER: 301-443-3478

PIC ID: 7158

PERFORMER ORGANIZATION: Sociomedical Resources Associates, Inc. Westport, CT