Ryan White CARE Act Data Report Training

1
Ryan White CARE Act Data Report Training

• Scottsdale, AZ
• December 5, 2005

2
Welcome and Overview

• Jill J. Ashman, Ph.D.
• Health Statistician
• Division of Science and Policy
• HRSA HIV/AIDS Bureau

3
Presenters

• Harry R. Day, Ph.D., Project Director
• Helene Quick, Associate Project Director
• Seima Ito, Research/Technical Assistant

4
Who We Are

• WRMA/CSR CARE Act Data Support
• Walter R. McDonald Associates, Inc., Prime
  Contractor
• CSR, Incorporated, Subcontractor

5
Training Ground Rules

• Please silence all cell phones and pagers until
  the end of the presentation
• Please hold your questions until a designated Q
  A time
• Return promptly from breaks

6
Agenda Day 1

• 830 a.m. Welcome/Introduction
• 900 a.m. Overview of Training and CADR
• 930 a.m. CADR Responsibilities - Section 2
• 1045 a.m. Section 3 - Section 7
• Noon Lunch
• 100 p.m. Data Relationships
• 145 p.m. Phase 1 Group Activities
• 245 p.m. Phase 2 Group Activities
• 330 p.m. Q A
• 400 p.m. Tips for Training Providers
• 445 p.m. Wrap-up and Evaluation

7
Terms CARE Act and CADR

• CARE Act
• Ryan White
• Comprehensive
• AIDS
• Resources
• Emergency Act
• CADR
• CARE Act Data Report

8
Purpose of the CADR

• Collect data for reports to Congress regarding
  the need for and the performance of each Ryan
  White Title
• Document grantee services
• Collect data on a single cross-Title form for
  each grantee and service provider
• Collect data to improve client services

9
CARE Act Data Support Goals

• Help Ryan White grantees submit complete and
  accurate 2005 CADRs on time
• Help Ryan White grantees resolve data issues
  through data verification and revision
• Provide technical assistance (TA) that achieves
  the first two goals

10
CADR Training Goals

• Provide a complete understanding of the new CADR
  form and accompanying materials
• Provide a clear understanding of the grantees
  responsibilities throughout the CADR reporting
  process
• Make clear where grantees and providers can go
  for help
• Help grantees anticipate potential challenges
  under each Title and provide useful tips for
  resolving problems
• Provide materials for grantees to train providers

11
Whats in your CADR binders

• CADR Timeline
• CADR Form and Instructions
• Presentation Slides
• CADR Data Checks
• Provider Toolkit
• CADR FAQs
• Helpful Resources

• Participant List
• Evaluation Form
• CD for Training Providers

12
CARE Act Titles

• Sources of Ryan White CARE Act funding
• Title I Eligible Metropolitan Areas (EMAs)
• Title II States and U.S. Territories
• Title III Early Intervention Services (EIS)
• Title IV Services for Women, Infants, Children,
  Youth and Their Families
• Title IV Adolescent Initiative Services for
  Adolescents

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
13
Terms Reporting Scope

• Reporting scope
• a term used to identify which services and
  clients are included in a CADR
• Scope 01
• all clients receiving an eligible service for
  CARE Act funding
• all clients served even if services were not paid
  by CARE Act funds
• Scope 02
• only clients receiving a funded service
• track clients and cost by Title

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
14
Terms Client Categories

• Infected client
• an individual who is HIV-positive who receives at
  least one Ryan White CARE Act-eligible service
  during the reporting period
• Indeterminate client
• a child under the age of 2 whose HIV status is
  not yet determined, but was born to an
  HIV-infected mother
• Affected client
• a family member or partner of an infected client
  who receives at least one Ryan White CARE Act
  supportive or case management service during the
  reporting period
• must be linked to a client infected with HIV/AIDS
  who was served by the agency

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
15
Organizational Terms

• Agencies - an inclusive, general term for
  organizations. Refers to both grantees and
  providers
• Grantees
• receive funding directly from HRSA
• Providers
• receive money through a contract with another
  agency (usually the grantee)
• Multiply funded
• an agency that receives funding under more than
  one CARE Act Title

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
16
Agency Funding Relationships
ider
HIV/AIDS Bureau
Title I Grantee
Title II Grantee
Title IV Grantee
Title III Grantee
Title IV Adolescent Initiative Grantee
Grantee Provider
Provider A
Provider
Provider
Provider B
Provider
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
17
Important Points

• Grantees
• must review and sign off on their providers
  CADRs
• Providers
• must complete a single CADR with all Title data
  combined
• must send their CADR to their grantee(s)
• Grantees who are also a provider
• must complete a single CADR with all Title data
  combined
• must submit their CADR directly as the grantee
• must send an identical copy of their CADR to the
  grantee(s) under which they are a provider

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
18
Examples CADR Responsibilities
HIV/AIDS Bureau
Title I Grantee
Title II Grantee
Title IV Grantee
Title IV Adolescent Initiative Grantee
Title II Title IV data
Title IV Adol. Init. data
Provider A
Title II, IV, IV Adol. Init. Provider
Provider B
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
19
Examples CADR Responsibilities
HIV/AIDS Bureau
Title II Grantee
Title IV Grantee
Title III IV Provider
Title III Grantee Title II Provider
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
20
(No Transcript)
21
EHB Status Categories
Web System
Not Started
In Progress
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
22
CADR Timeline
c
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
23
CADR Timeline (Continued)
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
24
2005 CADR Cover Page

• Cover Page no longer required as part of
  submission package
• Replaced by mandatory EHB submission and approval
  process

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
25
2005 CADR Form Training Legend

• Modified or added item
• Data relationship
• New item to the 2005 CADR
• Challenging area
• on highlighted version of the CADR

CAUTION!
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
26
2005 CADR Form

• Should be completed by all CARE Act-funded
  agencies
• One CADR per agency
• multiply funded Title IV Adolescent Initiative
  agencies are an exception to this rule
• Submit by CADR Web system, mail or fax

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
27
2005 CADR Form

• Overview of Sections
• Section 1 Service Provider Information
• Section 2 Client Information
• Section 3 Service Information
• Section 4 Counseling and Testing
• Section 5 Medical Information
• Section 6.1 Demographic Tables (Title III)
• Section 6.2 Demographic Tables (Title IV)
• Section 7 Health Insurance Program Information

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
28
Who Completes Each Section?
2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
29
Section 1 Items 1-22

• Service Provider Information
• Provider and agency contact information
• Reporting and program information
• Ownership status
• Funding information
• Populations identified for services

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
30
Section 1 Items 1-9

• Item 3 4
• provide full contact information
• Item 5
• calendar year must fall within 2005
• Item 6
• reporting scope
• Item 9
• Minority AIDS Initiative (MAI) funds

CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
31
Section 1 Items 10-16

• Item 10
• source of funding by Title
• Item 11a, 12a, 13a, 14a
• funding amount received as a grantee or provider
  under each Title
• Item 11b, 12b, 13b, 14b
• MAI funding amount
• Item 16
• administrative support services

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
32
Section 1 Items 17-22

• Item 17
• AIDS Drug Assistance Program (ADAP)
• AIDS Pharmaceutical Assistance (APA)
• Item 18
• Health Insurance Program (HIP)

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
33
Section 2 Items 23-32

• Client Information
• Number of unduplicated clients
• Number of new clients
• Gender, age, race/ethnicity
• Household income
• Housing/living arrangements
• Medical insurance
• HIV/AIDS status
• Vital/enrollment status

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
34
Section 2 Items 23-32

• Throughout Section 2
• report HIV-indeterminate clients
• minimize unknown/unreported
• Item 27
• combined race and ethnicity item
• White (Non-Hispanic)
• Black or African American (Non-Hispanic)
• Hispanic or Latino(a)
• Items 28-32
• report status of clients at the end of the
  reporting period

CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
35
Section 3 Item 33

• Service Information
• Services offered
• Total of unduplicated clients served
• Total of visits during reporting period

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
36
Section 3 Item 33

• Item 33
• report both of clients and visits
• affected client cells opened in rows a-i (Title
  IV only)
• report HIV-indeterminate clients
• clarification of the one visit per day rule
• cannot report more visits than clients in any one
  service category
• review program guidance to determine eligible
  services

CAUTION!
CAUTION!
CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
37
Section 4 Items 34-41

• HIV Counseling and Testing
• Pretest counseling
• Testing for HIV antibodies
• Posttest counseling
• Partner notification

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
38
Section 4 Items 34-41

• Throughout Section 4
• report confidential and anonymous individuals
• Item 35
• complete entire section if CARE Act funds
  supported this service
• Item 41
• report the total number of at-risk partners
  notified during this reporting period

CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
39
Section 5 Items 42-54

• Medical Information
• Ambulatory/outpatient medical care
• HIV exposure categories
• TB skin test
• Screening testing
• AIDS diagnoses
• Deceased HIV-positive clients
• Antiretroviral therapy
• Pregnant women
• Quality management

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
40
Section 5 Items 42-43

• Throughout section
• HIV-positive/indeterminate clients
• Item 42
• data relationships with Sections 2 (Client
  Information) Section 3 (Service Information)
• Item 43
• of ambulatory/outpatient medical
  care visits must equal the of visits reported
  in 33a

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
41
Section 5 Items 44-47

• Item 45
• of clients new to medical services
• Item 46
• new clients receiving CD4 count and viral
  load
• Item 47
• Tuberculosis (TB) skin test
• Status of PPD skin test
• Receiving treatment and follow-up

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
42
Section 5 Items 48-54

• Item 49
• of clients newly diagnosed with AIDS
• Item 50
• of HIV-positive clients who died
• Item 53
• pregnancy status of women entering care
• HIV status of infants delivered
• Item 54
• type of quality management program

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
43
Section 6.1 Items 55-65

• Title III Information
• Demographic information
• Cost and revenue
• Early Intervention Services offered

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
44
Section 6.1 Items 55-58

• Throughout Section 6.1
• report HIV-indeterminate
• data relationships with Sections 2 (Client
  Information) Section 3 (Service Information)
• Items 55-58
• how to proceed if the of clients equals the
  of clients reported in Section 2
• populated and disabled when Web-based check box
  is clicked

CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
45
Section 6.1 Items 59-65

• Item 58
• race and ethnicity now combined
• Items 59-61
• report receipt of primary health care services by
  race, gender, age, and exposure category in
  various combinations
• data relationships with Items 55-58

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
46
Section 6.1 Items 62-65

• Item 62
• total cost of services
• Title III grant funds expended
• Item 63b
• report of EIS sites if more than one
• Item 65
• number of HIV-positive clients who were referred
  outside the EIS program for a primary health care
  service

CAUTION!
CAUTION!
CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
47
Section 6.2 Items 66-73

• Title IV Information
• Demographic information

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
48
Section 6.2 Items 66-70

• Throughout Section 6.2
• report HIV-indeterminate
• data relationship with Section 2 (Client
  Information)
• Items 66-70
• how to proceed if the of clients equals the
  of clients reported in Section 2
• populated and disabled if Web-based check box is
  clicked

CAUTION!
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
49
Section 6.2 Items 70-73

• Item 70
• race and ethnicity now combined
• Items 71-73
• report receipt of primary health care services by
  race, gender, age, and exposure category in
  various combinations
• data relationship with Items 66-70 or Section
  2 (Client Information)
• Item 73
• only report HIV-positive/indeterminate clients

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
50
Section 7 Items 74-82
Health Insurance Program (HIP) Information
2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
51
Section 7 Items 74-82

• Throughout Section
• data relationship with Section 1 (Service
  Provider Information)
• Item 78
• race and ethnicity are now combined

2005 CADR Form
Section 2
Section 3
Section 4
Section 5
Section 6
Section 7
Section 1
52
Data Validation

• Types of validation checks
• required items
• appropriate data types
• range checks
• data relationships
• Nature of checks
• error vs. warning

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
53
CADR Web Validation

• Validate your data at any time
• Page-level validation vs. CADR-level validation
• All errors must be resolved to submit

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
54
Data Verification Process

• Resolves Web system warnings
• Conducted late April early May
• Requires cooperation with other agencies
• only one grantee is assigned the responsibility
  for correcting a multiply funded providers CADR.
• Requires submission of corrections by mail or fax

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
55
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56
Methods of CADR Submission

• Web (preferred) The CADR Web data entry system
  may be accessed at https//performance.hrsa.gov/ha
  b
• Paper available at http//hab.hrsa.gov/tools.htm
  
• Providers Send to grantee for approval
• Grantees Send copies to Data Support
• WRMA/CSR Ryan White Project
• Attn Ryan White CARE Act Data
• 2107 Wilson Blvd., Suite 1000
• Arlington, VA 22201

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
57
Methods of CADR Submission

• RW CAREWare version 4.1 may also be used to
  assist in the submission of CADRs. This software
  generates the CADR to be
• uploaded to the CADR Web-Interface for submission
  via the Web system, OR
• downloaded for paper submission via mail to Data
  Support, OR
• copied to a floppy disk or CD and mailed to Data
  Support (grantees only) by February 10, 2006.

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
58
Grantee Submission DOs

• complete a Provider Verification Form and
  submit to Data Support by December 16, 2005.
• review each providers CADR before submitting
  it to Data Support to ensure accuracy and
  completeness.
• impose early deadlines for your providers
  CADRs to ensure that there is enough time to
  review them.
• check the status of your providers CADRs
  regularly through the EHB.

59
Grantee Submission DOs

• submit your CADRs by March 15, 2006.
• Web-based submissions must be in Submitted
  status by midnight on March 15, 2006.
• Paper-based submissions must be postmarked no
  later than February 10, 2006.
• ALL CADRs must be approved by grantees through
  the EHB by March 15, 2006.

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
60
Grantee Submission DOs

• Send a completed and signed CADR cover page via
  mail or fax to Data Support if submitting by
  paper.
• Advise Data Support if your submission is
  incomplete when submitting via mail.
• Work with Data Support to resolve problems during
  the data verification period.

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
61
Grantee Submission DONTs

• use last years CADR to report your
  information it will not be accepted.
• send hard copies of your CADR to Data Support,
  if submitting via the Web system.
• split your data across multiple CADRs. Data
  across all Titles should be reported in a single
  CADR, except for Title IV Adolescent Initiative
  data.
• submit your data on a non-OMB approved form it
  will not be accepted.

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
62
Who to Contact for Assistance

• For content or submission-related questions
  contact
• Ryan White CARE Act Data Support at 888.640.9356
  ext. 7300 or email at rwcaredatasupport.wrma_at_csri
  ncorporated.com
• Available 9 a.m. to 530 p.m. ET, Monday through
  Friday
• For Web-related technical questions contact
• HRSA Call Center at 877.GO4.HRSA or email at
  CallCenter_at_HRSA.gov
• Available 9 a.m. to 530 p.m. ET, Monday through
  Friday
• For RW CAREWare questions contact
• RW CAREWare help line at 877.294.3571 or email at
  cwhelp_at_jprog.com
• Available 12 p.m. to 4 p.m. ET, Monday through
  Friday

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline
63
Training Your Providers

• Planning
• Communication
• Creativity
• Provider Toolkit

2005 CADR Cover Page
2005 CADR Form
Submission Process
Important Terms
Data Verification
Provider Training
Timeline