To help achieve a more coordinated response to HIV in the U.S., the National HIV/AIDS Strategy contains the following recommendation: “The Federal Government should take short and longer-term efforts to simplify grant administration activities, including work to standardize data collection and grantee reporting requirements for Federal HIV programs.”
Acting upon that recommendation, in April 2012, then-HHS Secretary Kathleen Sebelius sent an action memo to HHS agencies and offices directing them to finalize a set of common core HIV indicators and to develop an implementation plan to deploy the core indicators and streamline data collection and reduce reporting burden by at least 20-25%. (See related post.) In response to that memo and the NHAS, in July 2012 HHS agencies and offices agreed upon a set of 7 common indicators to monitor HHS-funded HIV services. Subsequently, 9 HHS operating divisions and staff offices developed and received Secretarial approval on plans to implement those indicators and to streamline data collection and reduce reporting requirements for HIV services grantees. Implementation of those plans began last fiscal year. Since that time, HHS agencies and offices have implemented a number of positive actions in response to those plans and other recommendations.
Many of our federal partners and health department stakeholders would agree that we can do even more in striking an optimal balance between maintaining program accountability and streamlining program reporting. Clearly, all of us would agree that some level of program-generated data is necessary to ensure the most effective use of federal HIV resources. But, at the same time, we do not want federal reporting processes to become so burdensome (i.e., because of redundancies and information that has no true impact on performance outcomes) that they detract from the primary program goals of preventing HIV infection and providing comprehensive care and treatment to those who are living with the virus.
This was precisely the topic under discussion at a recent meeting of the HIV/AIDS Indicators Implementation Group (HAIIG). Convened by the Office of HIV/AIDS and Infectious Disease Policy (OHAIDP) and chaired by Dr. Andrew Forsyth, OHAIDP’s Senior Science Advisor, the HAIIG has been working on these issues since 2012. The HAIIG includes representatives of HHS agencies and staff offices that support HIV prevention, treatment and care services, as well as representatives from the National Alliance of State and Territorial AIDS Directors (NASTAD), the Urban Coalition for HIV/AIDS Prevention Services (UCHAPS), the Presidential Advisory Council on HIV/AIDS (PACHA), and AIDS Directors from several state and local health departments. HAIIG members convened this month to discuss an analysis, released in December 2014 by NASTAD, which detailed health department reporting requirements associated with federally-funded HIV/AIDS, viral hepatitis, STD and TB programs. NASTAD leadership reported that they continue to field concerns from members regarding reporting burden, especially in terms of redundancies, lack of data harmonization across agencies, and lack of data sharing across funding streams and federal agencies.
During the HAIIG meeting, I – along with some of the non-federal participants – applauded our HHS colleagues for the progress they’ve made while at the same time urging them to identify additional opportunities to reduce grantee reporting requirements. Toward that end, CDC and HRSA have already initiated a process to integrate HIV prevention and care planning activities, which has great potential to streamline requirements and improve outcomes.
The HAIIG will continue to address this important operational issue through a number of follow-up actions, including a thorough review of the recommendations made by NASTAD in its December 2014 report as well as an active “cross-walk” of HIV prevention and care data requirements to identify potential areas for further streamlining.