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Reports & Studies:

2003 Ryan White CARE Act Title I Data Book

   
Printer-friendly:  Download the pdf versionPrinter-friendly slides (pdf 60KB)
 

Title I provides emergency assistance to eligible metropolitan areas (EMAs) that are most severely affected by the HIV/AIDS epidemic. These funds may be used to provide a range of community-based services for persons living with HIV (PLWH).

In 2003, 51 Ryan White CARE Act Title I EMAs (otherwise referred to as grantees) contracted with 1,520 agencies / organizations (otherwise referred to as providers) to provide CARE Act eligible services to HIV-positive individuals. They served a total of 840,421 clients of which 662,662 were HIV-positive duplicated clients and 177,759 were affected [1] duplicated clients.

Table of Contents:

  1. Types of Title I Provider Organizations / Agencies Serving Clients
  2. Ownership Status of Title I Organizations/Agencies Serving Clients
  3. Number of Duplicated Clients Served by Title I Providers
  4. HIV/AIDS Status of Duplicated Clients Served by Title I Providers
  5. Gender of Duplicated Clients Served by Title I Providers
  6. Age of Duplicated Clients Served by Title I Providers
  7. Ethnicity of Duplicated Clients Served by Title I Providers
  8. Race of Duplicated Clients Served by Title I Providers
  9. Health Insurance Status of Duplicated Clients Served by Title I Providers
  10. Number of Visits for Health Care and Case Management Services to Title I Providers
  11. Number of Visits per Client to Title I Service Providers
  12. Number of Duplicated Clients Receiving Support Services from Title I Providers
  13. Percentage Distribution of HIV Positive Clients by Gender Receiving Medical Care from Title I Providers
  14. Percentage Distribution of HIV Exposure among Duplicated HIV Positive Clients from Title I Providers
  15. Data Considerations

 

Types of Title I Provider Organizations / Agencies Serving Clients

N=1,520 providers

Pie Chart containing the following data...
Hospital or University, 210
Publicly funded community health center, 108
Publicly funded community mental health center, 23
Other community-based service organization, 813
Health department, 125
Substance abuse treatment center, 50
Other*, 36
Other facility, 155

  • Source: 2003 CARE Act Data Report, Section 1, Item 7
  • Percentages may not sum to 100 percent due to rounding error
  • Other* includes solo/group private medical practice, agency reporting for multiple fee-for-service providers, PLWHA coalition, and VA facility

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Ownership Status of Title I Organizations / Agencies Serving Clients

N=1,520 providers

Pie chart containing the following data...
Public/local, 163
Public/state, 84
Public/federal, 13
Private, nonprofit (not faith-based), 1,096
Private, for-profit, 68
Unincorporated, 3
Faith-based organization, 67
Other, 26

  • Source: 2003 CARE Act Data Report, Section 1, Item 9
  • Percentages may not sum to 100 percent due to rounding error

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Number of Duplicated Clients Served by Title I Providers

Bar Chart containing the following data...
2002 HIV Positive New Clients, 194,937	
2002 Affected New Clients, 87,039
2003 HIV Positive New Clients, 183,922
2003 Affected New Clients, 132,294	
2002 HIV Positive Total Clients, 621,684
2002 Affected Total Clients, 156,773	
2003 HIV Positive Total Clients, 662,662	
2003 Affected Total Clients, 177,759

  • Source: 2003 CARE Act Data Report, Section 2, Items 24 & 25

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HIV/AIDS Status of Duplicated Clients Served by Title I Providers

N=840,421 duplicated clients

Pie Chart containing the following data...
HIV Positive not AIDS, 264,600
HIV Positive, unknown AIDS, 170,051
AIDS, 228,011
HIV negative, 64,694
Unknown, 113,065

  • Source: 2003 CARE Act Data Report, Section 2, Items 33
  • Percentages may not sum to 100 percent due to rounding error

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Gender of Duplicated Clients Served by Title I Providers

N=840,421 duplicated clients


Pie Chart containing the following data...
Male, 539,360
Female, 259,548
Transgender, 4,541
Unknown, 36,972

  • Source: 2003 CARE Act Data Report, Section 2, Item 26
  • Percentages may not sum to 100 percent due to rounding error

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Age of Duplicated Clients Served by Title I Providers

N=840,421 duplicated clients

Pie Chart containing the following data...
Less than 2 years, 5,713
2-12 years, 16,920
13-24 years, 53,293
25-44 years, 455,825
45-64 years, 242,482
65 years or older, 11,149
Unknown, 55,039

  • Source: 2003 CARE Act Data Report, Section 2, Item 27

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Ethnicity of Duplicated Clients Served by Title I Providers

N=840,421 duplicated clients

Pie Chart containing the following data...
Hispanic or Latino/a, 199,628
Non-Hispanic or Latino/a, 561,109
Unknown, 79,684

  • Source: 2003 CARE Act Data Report, Section 2, Items 28

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Race of Duplicated Clients Served by Title I Providers

N=840,421 duplicated clients

Pie Chart containing the following data...
White, 278,402
Black, 375,403
Other race, 13,377
More than one race, 32,243
Unknown, 140,996

  • Source: 2003 CARE Act Data Report, Section 2, Items 29
  • Percentages may not sum to 100 percent due to rounding error
  • “Other race” category includes Asian, Native American or Other Pacific Islander, and American Indian or Alaska Native.

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Health Insurance Status of Duplicated Clients Served by Title I Providers

N=840,421 duplicated clients

Pie Chart containing the following data...
Private, 50,227
Medicare, 52,288
Medicaid, 208,481
Other Public, 46,866
No insurance, 199,731
Other, 13,299
Unknown, 269,529

  • Source: 2003 CARE Act Data Report, Section 2, Items 32
  • Providers report the medical insurance that provides the most reimbursement if a client has more than one source of medical insurance.
  • Examples of Other Public medical insurance include State-funded insurance plans, military health care (CHAMPUS), State Children’s Health Insurance Program (SCHIP), Indian Health Services, and Veterans Health Administration.
  • Percentages may not sum to 100 percent due to rounding error

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Number of Visits for Health Care and Case Management Services to Title I Providers

Bar Chart containing the following data...
Rehabilitation services: 22,990(2003), 12,436(2002)
Substance abuse services–residential: 99,300(2003), 150,355(2002)
Oral health care: 185,001(2003), 174,782(2002)
Home health*: 505,793(2003), 555,347(2002)
Mental health services: 455,223(2003), 509,236(2002)
Substance abuse services–outpatient: 510,711(2003), 597,101(2002)
Ambulatory/outpatient medical care: 1,885,249(2003), 1,580,882(2002)
Case management services (among HIV positive clients): 2,724,827(2003), 2,377,751(2002)

  • Source: 2003 CARE Act Data Report, Section 3, Items 35
  • Home health* includes para-professional care, professional care, and specialized care

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Number of Visits per Client to Title I Service Providers

Service Number of Service Provider Percent of service providers (N=1,520) Average number of visits per client per provider * Median number of visits per client * Range number of visits per client *
Ambulatory/outpt. medical care
482
32%
7.90
5.78
1-134.00
Mental health services
537
35%
9.31
6.14
1-282.75
Oral health care
227 15% 23.78 8.05 1-336.21
Substance abuse services–outpatient
337
22%
65.30
28.35
1-365.00
Substance abuse services–residential
70
5%
31.39
7.63
1-365.00
Rehabilitation services
31 2% 9.27 4.41 1-43.57
Home health: para-professional care
74 2% 2.92 2.83 1-12.45
Home health: professional care
64 4% 32.99 20.50 1-111.25
Home health: specialized care 26 2% 13.42 4.25 1-119.23
Case management services
(among HIV + clients)
776 51% 15.22 9.77 1-240.00
  • Source: 2003 CARE Act Data Report, Section 3, Items 35
  • (*) Data reported in this table are based on valid reports only. Valid data are defined as providers reporting complete data for both the number of clients served and number of visits.
  • For each service type, the actual number of providers serving clients is higher. However, the average number of visits per client was calculated only for those providers with valid data for number of clients served and number of client visits. Providers may offer multiple services; thus, a provider may be included in more than one service category.
  • A client may only have one visit for each service per day. For residential substance abuse treatment, each day in a residence facility equals one visit.

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Number of Duplicated Clients Receiving Support Services from Title I Providers

Bar Chart containing the following data...
HIV + Outreach services, 26,624
HIV + Health education / risk reduction, 67,808
HIV + Food bank / home-delivered meals, 82,391
HIV + Transportation services, 80,501
HIV + Psychosocial support services, 66,631
HIV + Client advocacy, 69,337
HIV + Referral for health care / supportive services, 57,221
Affected Outreach services, 92,935
Affected Health education / risk reduction, 25,945
Affected Food bank / home-delivered meals, 4,209
Affected Transportation services, 3,774
Affected Psychosocial support services, 8,194
Affected Client advocacy, 	4,938
Affected Referral for health care / supportive services, 8,455

Bar Chart containing the following data...
HIV + Treatment adherence counseling, 63,644
HIV + Other services, 46,686
HIV + Nutritional counseling, 54,693
HIV + Emergency financial assistance, 42,810	
HIV + Housing services, 29,131	
HIV + Legal services, 19,095	
HIV + EIS* for Titles I and II, 10,265	
Affected Treatment adherence counseling, 1,333
Affected Other services, 10,277
Affected Nutritional counseling, 2,175
Affected Emergency financial assistance, 2,819
Affected Housing services, 2,140
Affected Legal services, 974
Affected EIS* for Titles I and II, 3,677

Bar Chart containing the following data...
HIV + Referrals to clinical research, 11,125	
HIV + Buddy / companion service, 6,230	
HIV + Day or respite care for adults, 5,272	
HIV + Child care services, 3,081
HIV + Permanency planning, 3,137	
HIV + Developmental assessment / EIS*, 2,480
HIV + Residential or in-home hospice care, 1,081	
HIV + Child welfare services, 855	
Affected Referrals to clinical research, 338
Affected Buddy / companion service, 1,142
Affected Day or respite care for adults, 163
Affected Child care services, 2,224
Affected Permanency planning, ,063
Affected Developmental assessment / EIS*, 432
Affected Residential or in-home hospice care, 119
Affected Child welfare services, 257

  • Source: 2003 CARE Act Data Report, Section 3, Items 35
  • Clients served include all individuals who had at least one visit for any eligible service during the reporting period.
  • (*) Early Intervention Services

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Percentage Distribution of HIV Positive Clients by Gender Receiving Medical Care from Title I Providers

N=253,542 duplicated clients

Pie Chart containing the following data...
Male medical clients, 71,313
Female medical clients, 79,955
Transgender medical clients, 1,313
Unknown/ unreported medical clients, 961

  • Source: 2003 CARE Act Data Report, Section 5, Items 45
  • These data are limited to medical service providers as reported in section 3, item 1a under ambulatory/outpatient medical care provider. Clients reported in section 5 may have received care other than medical and therefore the number of clients reported in section 5 may not agree with the number of clients reported in section 3 under ambulatory/outpatient medical care.
  • Percentages may not sum to 100 percent due to rounding error

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Percentage Distribution of HIV Exposure among Duplicated HIV Positive Clients from Title I Providers

N=239,904 duplicated clients

Pie Chart containing the following data...
MSM, 71,158
IDU, 32,003
MSM and IDU, 6,834
Hemophilia/ coagulation disorder/ blood or tissue, 2,740
Heterosexual contact, 82,640
Perinatal transmission, 6,034
Other, 5,980
No identifiable risk factor, 32,515

  • Source: 2003 CARE Act Data Report, Section 5, Items 46
  • These data are limited to medical service providers as reported in section 3, item 1a under ambulatory/outpatient medical care provider. Clients reported in section 5 may have received care other than medical and therefore the number of clients reported in section 5 may not agree with the number of clients reported in section 3 under ambulatory/outpatient medical care.
  • HIV exposure information was not reported for 13,638 HIV positive duplicated medical clients
  • Percentages may not sum to 100 percent due to rounding error

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Data Considerations

Data in this presentation were submitted by Title I providers, many of whom also receive funds from other sources, including other CARE Act Titles (i.e., Title II, Title III, Title IV, and/or Title IV-Youth). Since many providers do receive funds from multiple CARE Act Titles, it is often impossible for them to distinguish which funds paid for various services they provide. Therefore, the data in these slides do not necessarily reflect services rendered or clients served exclusively with Title I funds. Rather, it is a presentation of provider, client, and service characteristics for providers who received Title I funds.

These data can not be compared with Title I, II, III, IV, or Title IV-Youth data collected prior to 2002. In previous years, HRSA/HAB used separate, Title-specific data systems to collect client and service information from CARE Act grantees and providers. Providers were required to complete separate data reporting forms for each Title-funding they received. Under the new CADR reporting system implemented in 2002, all providers, even those who are multiply-funded, complete one CADR, and report on all clients served regardless of funding source.

Ryan White CARE Act providers have the option of reporting on eligible or funded services[2]. When they report on eligible services, providers are reporting on any service permitted under any Title of the CARE Act, regardless of whether or not the providers use a specific Title to pay for these services. Conversely, if providers report on funded services, the data they report only includes those services that were actually paid for using CARE Act funds. Reporting eligible services provides a comprehensive picture of the services being delivered to HIV-positive clients.

Title I grantees have numerous providers under subcontract and each of these providers completes the same CADR. While data are unduplicated at the provider level, any summary of the total number of clients served and their demographic characteristics at the grantee or national level may result in duplicated client counts.

Since these data are aggregated at the national or grantee level, clients that may have been new to one provider could be continuing services to another service provider.

Clients served include all individuals who had at least one visit for any eligible service provided by a Title I provider during the reporting period, regardless of additional funding source.

An affected client is a family member or partner of an infected client who received case management or other supportive services during the calendar year. Affected clients include those who are HIV negative as well as those with unknown HIV status. Affected clients include those receiving Title I and II Early Intervention Services. Affected family members of HIV positive patients are served under Title IV.

“New” clients include clients whose first receipt of services from the provider agency occurred during the reporting period.

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[1] An affected client is a family member or partner of an infected client who received case management or other supportive services during the calendar year.

[2] All grantees and providers must report on eligible services unless they have prior permission from their HRSA project officer to report only funded services.


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