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Secretary Sebelius Approves Indicators for Monitoring HHS-Funded HIV Services

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Secretary of Health and Human Services Kathleen Sebelius recently approved the use of seven common core indicators for monitoring HHS-funded HIV prevention, treatment, and care services. What are these indicators and what are the next steps in this effort?

Last month, we reported that the Secretary had directed leaders of HIV/AIDS services programs within the Department of Health and Human Services to develop and implement common, core indicators for monitoring HIV programs and services; streamline related data collection; and reduce undue reporting burden on HIV services grantees. We’re pleased to announce that Phase I of this multi-phase effort is now complete.

On July 24, 2012, Secretary Sebelius approved a package of seven common core indicators that were generated following multiple consultations with a group of federal and non-federal stakeholders and that are consistent both with the Institute of Medicine’s recommendations for monitoring HIV services and indicators deployed by the National Quality Forum Exit Disclaimer (NQF) and the National Committee for Quality Assurance Exit Disclaimer (NCQA).

These new HHS common HIV indicators, which were informed by relevant treatment guidelines and empirical evidence, include the following:

Measure Numerator Denominator
HIV Positivity Number of HIV positive tests in the 12-month measurement period Number of HIV tests conducted in the 12-month measurement period
Late HIV Diagnosis Number of persons with a diagnosis of Stage 3 HIV infection (AIDS) within 3 months of diagnosis of HIV infection in the 12-month measurement period Number of persons with an HIV diagnosis in the 12-month measurement period
Linkage to HIV Medical Care Number of persons who attended a routine HIV medical care visit within 3 months of HIV diagnosis Number of persons with an HIV diagnosis in 12-month measurement period
Retention in HIV Medical Care Number of persons with an HIV diagnosis who had at least one HIV medical care visit in each 6 month period of the 24 month measurement period, with a minimum of 60 days between the first medical visit in the prior 6 month period and the last medical visit in the subsequent 6 month period Number of persons with an HIV diagnosis with at least one HIV medical care visit in the first 6 months of the 24‐month measurement period
Antiretroviral Therapy (ART) Among Persons in HIV Medical Care Number of persons with an HIV diagnosis who are prescribed ART in the 12-month measurement period Number of persons with an HIV diagnosis and who had at least one HIV medical care visit in the 12-month measurement period
Viral Load Suppression Among Persons in HIV Medical Care Number of persons with an HIV diagnosis with a viral load <200 copies/mL at last test in the 12–month measurement period Number of persons with an HIV diagnosis and who had at least one HIV medical care visit in the 12-month measurement period
Housing Status Number of persons with an HIV diagnosis who were homeless or unstably housed in the 12-month measurement period Number of persons with an HIV diagnosis receiving HIV services in the last 12 months

 

It is noteworthy that several of the proposed indicators have been submitted for National Quality Forum endorsement and may be adjusted slightly during this process in order to achieve consistency across HHS and key consensus development groups.

“The approval of these seven common core indicators by the Secretary is an important milestone in our efforts to respond to the National HIV/AIDS Strategy’s call to standardize data collection and grantee reporting requirements for federal HIV programs,” commented Dr. Ronald Valdiserri, Deputy Assistant Secretary for Health, Infectious Diseases. “These common core HIV program indicators will facilitate our efforts to monitor and report on progress toward achieving the Strategy’s goals and we are grateful to the strong support of leaders across HHS agencies for coming together to make this happen.”

Many will recall that developing common core indicators represents only Phase 1 of an ambitious, cross-agency effort to streamline data collection and simplify administration of HHS HIV services grants. Phase II, which officially launched in mid-July, will entail the development of operational plans by HHS agencies that support HIV services to implement these core indicators across their funding programs, as well as the identification of strategies to streamline data collection from grantees and reduce undue grantee reporting burden by at least 20–25%. This will require ongoing engagement of federal and non-federal stakeholders and will culminate in the completion of these planning documents by mid-October 2012. After this time, key HHS agencies will transition to Phase III, when they’ll address the implementation challenges anticipated and pave the way for achieving the goals of reducing red tape while improving the delivery of HIV services in the U.S. Full deployment of all these streamlining activities is anticipated by the start of Fiscal Year 2014.

As always, we welcome your comments and ideas as this work progresses.

Comments

  1. Martin says:

    Possibly a random question: do you use Quality-of-life indicators/tests to compliment these? If not, why not? Thanks for a great blog!!

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