This man is a resident at a Los Angeles shelter. Homelessness is seen with alarming frequency among PLWHA and is one of many factors related to severity of need.
The AIDS rate (per 100,000 population) among Blacks (99.4) is more than twice that of Hispanics (37.9) and more than eight times the rate among Whites (12.3).1
Presidential Emergency Plan for AIDS Relief (PEPFAR) funds its first grantees.2
HRSA MOVES TO DEFINE SEVERE NEED
In the 2000 reauthorization of the Ryan White HIV/AIDS Program, Congress asked the Institute of Medicine (IOM) to report on
- how to better measure severity of need
- the use of HIV data (in addition to reported AIDS cases) in funding formulas, and
- recommendations on using quantitative measures for evaluating quality of care.
At the time the request was made, applicants for funding were using the best measures available to them, but these measures were not the same across all applicants. Thus, a discrepancy existed on how severe need was defined and described, making comparison of one application against another difficult.
In its report Measuring What Matters, Allocation, Planning and Quality Assessment for the Ryan White CARE Act, the IOM stated that a single index was needed to calculate severe need for all funding applicants. The response was HRSA’s HIV/AIDS Severity of Need Collaboration.
Since that time, HRSA has convened more than 47 panelists and examined over 56 variables for possible consideration. The result is that the agency will be rolling out a severity of need index in FY 2009.
Since enactment, the purpose of the Ryan White HIV/AIDS Program has been to serve those with nowhere else to turn—people who are un- or under-insured, people who are impoverished, and people who may have lost the capacity to provide for themselves because of their illness. The new severity of need index will help HRSA identify areas where access to resources is poorest. The agency will then be able to concentrate resources in areas where need is greatest.
