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Standards of Care & Performance
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DEFINITIONS AND ACRONYMS ACTG (AIDS Clinical Trials Group):
A network of medical centers around the country in which federally-funded
clinical trials are conducted to test the safety and efficiency of
experimental treatments for HIV; studies funded by the National Institute of Allergy and Infectious Diseases
(NIAID). Administrative Agent: Organization, agent or other entity (e.g., public
health department, community-based organization) which functions in political
jurisdictions within Part A EMAs to assist the grantee in carrying out
administrative activities (i.e., disbursing program funds, developing
reimbursement and accounting systems, developing Requests for Proposals
[RFPs], monitoring contracts, etc.). Not all grantees use a separate administrative
agent. AETC (AIDS
Education and Training Center): Regional centers providing
education and training for primary care professionals and other personnel;
authorized under Part F of the CARE
Act. AIDS (Acquired
Immunodeficiency Syndrome): HIV Stage 3 diagnosis. ASO (AIDS
Service Organization): An organization that provides medical or
support services primarily or exclusively to populations living with and
affected by HIV. CARE Act (Ryan White Comprehensive AIDS
Resources Emergency Act): The Federal legislation created to
address the health care and service needs of people living with HIV disease and their families in
the United States; enacted in 1990 and reauthorized
in 1996 and 2000. In 2006, Congress passed
the Ryan White HIV/AIDS Treatment Modernization Act, extending the Ryan White
Care Act for an additional three years.
In 2009, Congress passed the Ryan White HIV/AIDS Treatment Extension
Act, extending the Ryan White Care Act for four more years. CBO (Community-based
organization): An organization which provides
services to locally defined populations, which may or may not include
populations infected with or affected by HIV disease. CDC (Centers for
Disease Control and Prevention): The Federal agency within
the U.S. Department of Health and Human Services that administers HIV
prevention programs, including the HIV Prevention Community Planning process,
among other programs; responsible for monitoring and reporting of infectious
diseases; administers surveillance grants and publishes epidemiological
reports such as the HIV Surveillance Report. CEO (Chief
Elected Official): The official recipient of Part A CARE Act
funds within the EMA, usually the mayor or chair of the county board of
supervisors. The CEO is ultimately responsible for administering all aspects
of the CARE Act in the EMA and ensuring that all legal requirements are met. In EMAs with more than one political
jurisdiction, the recipient of Part A CARE Act funds is the CEO of the city
or urban county that administers the public health agency that provides
outpatient and ambulatory services to the greatest number of people living
with HIV in the EMA. Comprehensive Planning: The process of determining the organization and delivery
of HIV services; strategy used by a planning council to improve
decision-making about services and maintain a continuum of care for PLWHAs. Core Services:
Ryan White Parts A, B, and C grantees must spend at least 75% of funds
on "core medical services." These services include outpatient and
ambulatory health services; pharmaceutical assistance; substance abuse
outpatient services; oral health; medical nutritional therapy; health
insurance premium assistance; home health care; hospice services; mental
health services; early intervention services; and medical case management,
including treatment adherence services.
The remaining funds may be spent on Support Services. CPCDMS (Centralized Patient Care Data
Management System): A
real-time, de-identified client-level computer database application that
allows Part A-funded providers share client eligibility information
maintaining client confidentiality.
Information collected includes demographic, co-morbidity, biological
marker, mortality and service utilization data. Since its inception in June
of 2000, over 10,000 clients have been registered in
the CPCDMS. In addition, the CPCDMS
has been the foundation upon which evaluation and quality management
activities in the EMA were
built. DSHS: Texas
Department of State Health Services. EIIHA
(Early Identification of Individuals with HIV/AIDS): Identifying, counseling, testing,
informing, and referring of diagnosed and undiagnosed individuals to
appropriate services, as well as linking newly diagnosed HIV positive
individuals to care. ECHPP (Enhanced Comprehensive HIV
Prevention Planning): A
3-year demonstration project funded by CDC's Division of
HIV/AIDS Prevention (DHAP) for the 12 municipalities with the highest number
of people living with HIV in the US.
As part of the response to the National HIV/AIDS Strategy (NHAS), the ECHPP project
supports the 12 Cities Project which is
directed by the U.S.
Department of Health and Human Services (HHS). EMA (Eligible Metropolitan Area):
The geographic area eligible to receive Part
A funds. The boundaries of the metropolitan area are
defined by the Census Bureau. Eligibility is
determined by HIV cases reported to the Centers for Disease
Control and Prevention (CDC). Some EMAs include just one city,
other EMAs are composed of several cities and/or counties; and some EMAs
extend over more than one state. Epidemic: The spread of an infectious disease through a population
or geographic area. Formula Grant Application: The application used by EMAs and
States each year to request an amount of CARE Act funding which is determined by a formula based on the number of reported
HIV cases in their location and other factors. The application includes
guidance from DHS on program requirements and expectations. FY (Fiscal Year):
The fiscal year for Ryan White Part
A funds is March 1 through February 28; the fiscal year for Part B and State Services funds runs from
September 1 through August 31. Grantee: Another term for the recipient of Part A funds. As the official recipient
of those funds in the EMA, the CEO is the grantee. However, the CEO usually
delegates his or her authority to administer Part A funds to an organizational unit within the city
or county government (e.g., the county health department). Often, this entity is also referred to as the grantee. Use of the terms CEO
and grantee helps to distinguish between the person ultimately responsible
for the CARE Act grant (the CEO) and the
entity which actually carries out the day-to-day operations associated with
it (the grantee). HHD: Houston Health
Department. HIV: The entire spectrum of the natural history of the human
immunodeficiency virus. Homeless: individuals who lack a fixed, regular
and adequate nighttime residence, including those who live in locations not
meant for human habitation such as public parks and streets, those who live
in or are transitioning from temporary housing or shelters, and those who
have persistent housing instability. HOPWA (Housing Opportunities for Persons
With AIDS): A program administered by the U.S. Department of Housing and Urban Development which
provides funding to support housing for people living with HIV and their
families. Locally, HOPWA funds are
administered by the City
of Houston Department of Housing and Community Development HRSA (Health Resources and Services Administration): The
agency of the U.S. Department of Health and Human Services that is
responsible for administering the Ryan White Program. HTBMN (How to Best Meet
the Need): Annual
process of the Quality Improvement Committee.
Workgroups are convened to review all service
category definitions for Part A, Part B and State Services funding and
recommend changes, if necessary, to improve them. Injection
Drug Users (IDU): individuals who inject medications or
drugs, including illegal drugs, hormones, and cosmetics. IGA (Intergovernmental
Agreement): A written agreement between a Part A
grantee and another governmental agency in the EMA; these agreements usually
address the allocation of funds across agencies or jurisdictions. Incarcerated or
Recently Released (IRR): individuals who are currently
incarcerated in the jail or prison system or have been released from
jail or prison within the past 12 months. Incidence: The number of new cases of a disease that occur during a
specified time period. Incidence
Rate: The number of cases of a disease per
population per specified time period often expressed
per 100,000 population (HIV rates are often expressed this way). Linkage to Care: Post-referral verification that care/services were accessed by an individual living with HIV
being referred into care. MSA (Metropolitan
Statistical Area): The geographic area designated to receive
CDC prevention funds. The boundaries of
the metropolitan areas are defined by the Office of Management
and Budget (OMB). MSM: Men who have sex
with men. MCSM: Men of color who have sex with men. Needs Assessment: A systematic process to determine the
service needs of a defined population; a definition
of the extent of need, available services, and service gaps by population and
geographic area. OMB (Office of Management
and Budget): The office within the
executive branch of the Federal government which
prepares the President's annual budget, develops the Federal government's
fiscal program, oversees administration of the budget and reviews government
regulations. Out of Care: HRSA defines an individual as “out-of-care”
if they have not had a CD4 count or viral load test, been prescribed
antiretroviral therapy (ART) and have not had a primary care visit in the
previous 12 months. Part
A: The part of the CARE Act that provides
emergency assistance to localities (EMAs) disproportionately affected by the
HIV epidemic. Part
B: The part of the CARE Act that enables
States and territories to improve the quality, availability, and organization
of health care and support services to individuals living with HIV and their
families. Part
C: The part of the CARE Act that supports
primary medical care and early intervention services to people living with
HIV through grants to service organizations. Part
D: The part of the CARE Act that supports
research and services for children living with HIV and their families and the
HIV Dental Reimbursement Program.. Part
F: The part of the CARE Act that funds AETC, SPNS. PHS (Public Health Service):
An administrative entity of the U.S. Department of Health and Human
Services. As of October 1, 1995, HRSA is an operating division of the PHS. Planning
Council: A planning body appointed or
established by the Chief Elected Official of an EMA whose basic function is
to establish a plan for the delivery of HIV care services in the EMA and
establish priorities for the use of CARE Act funds. PLWH: Person/People
Living with HIV. Prevalence: The total number of persons living with a specific
disease or condition at a given time. Prevalence
Rate: The proportion of a population living
at a given time with a condition or disease (compared to the incidence
rate, which refers to new cases). Priority
Setting: The process used by a planning council
or consortium to prioritize service categories, to ensure consistency with
locally identified needs, and to address how best to meet each priority. Public
Health Surveillance:
An ongoing,
systematic process of collecting, analyzing and using data on specific health
conditions and diseases (e.g., Centers for Disease Control and Prevention
surveillance system for HIV cases). QA (Quality Assurance):
A broad spectrum of evaluation activities aimed at ensuring compliance
with minimum quality standards. Ql (Quality Improvement): Activities
aimed at improving performance. Resource
Allocation: The
legislatively mandated responsibility of planning councils to assign CARE Act
dollars or percentages across specific service categories, using key
information such as documented need, defined service priorities and other
resources as part of the process. RFP (Request for Proposal):
An open and competitive process for selecting providers of services
(sometimes called RFA or Request for Application). SAMHSA (Substance Abuse and
Mental Health Services Administration): The entity within the U.S.
Department of Health and Human Services that administers alcohol, substance
abuse and mental health programs. SCSN
(Statewide Coordinated Statement of Need): A written
statement of HIV-related service needs for the entire State; the SCSN is developed through a process that includes
representatives of all CARE Act Parts, providers, PLWHs and public health agencies. Seroprevalence: The number of persons in a population who test HlV-positive based on serology (blood serum) specimens; often
presented as a percent of the total specimens tested or as a rate per 100,000
persons tested. Seroprevalence
Report: A report that provides information
about the percent or rate of people in specific testing groups and
populations who have tested positive for HIV. SIRR (Serving
the Incarcerated and Recently Released Partnership): SIRR, a project
of The Houston Regional
HIV/AIDS Resource Group, started in December 2009, building upon the
local discharge planning pilot project between the Harris County Sheriff’s
Office, Houston Area
Community Services, Legacy Community Health and the Houston Ryan White Part A Grant Administration. The group meets monthly. SPNS
(Special Projects of National Significance): A health
services demonstration, research and evaluation program funded under Part F
of the CARE Act. SPNS projects are awarded
competitively. Support Services: Ryan White grantees must spend at
least 75% of funds on core medical
services. The remaining funds may be spent on support services, defined as services
needed to achieve outcomes that affect the HIV-related clinical status of a
person living with HIV. HRSA outlines support services as
outreach, medical transportation, language services, respite
care for persons caring for individuals living with HIV and referrals for
health care and other support services.
Surveillance
Report: A report providing information on the
number of reported cases of a disease such as HIV, nationally and for
specific sub-populations. Target
Population: A population to be reached through
some action or intervention; may refer to groups with specific demographic
(e.g. Latino, Women, Youth) or geographic characteristics (e.g. rural,
specific zip code). Transgender: individuals who cross or transcend culturally-defined categories of gender. Transmission Category: A grouping of disease exposure and infection routes; in
relation to HIV, exposure groupings include injecting drug use, men
who have sex with men, heterosexual contact, perinatal (mother to child)
transmission, etc. |
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