2017 RSR Manual Final

2017 RSR Manual Final.pdf

Ryan White HIV/AIDS Program Client-Level Data Reporting System

2017 RSR Manual Final

OMB: 0906-0039

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2017 ANNUAL
RYAN WHITE
HIV/AIDS PROGRAM
SERVICES REPORT (RSR)
INSTRUCTION MANUAL

Public Burden Statement: An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it displays a
currently valid OMB control number. The OMB control number for this project is
0915-0323, and the expiration date is 7/31/2020. Public reporting burden for
this collection of information is estimated to average 91 hours per respondent
annually, including the time for reviewing instructions, searching existing data
sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding this burden
estimate or any other aspect of this collection of information, including
suggestions for reducing this burden, to HRSA Reports Clearance Officer, 5600
Fishers Lane, Room 14N-39, Rockville, MD 20857.
HIV/AIDS Bureau
Division of Policy and Data
Health Resources and Services Administration
U.S. Department of Health and Human Services
5600 Fishers Lane, Room 9N164A
Rockville, MD 20857

2017 RSR Instruction Manual

WHAT’S NEW FOR 2017
(Last Updated: August 28, 2017)

New in 2017 are changes to several variable names and response options. These changes are listed below:

1. Service Category definition changes will align with the Policy Clarification Notice (PCN) 16-02 (Ryan White
HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds), which provides both a
description of covered service categories and program guidance for RWHAP Part recipient implementation.
2. Incorporate the transgender variable response options into the “Self-reported gender” variable:
a. Transgender Male to Female
b. Transgender Female to Male
c. Transgender Other

3. Remove the “transgender” variable, since this information is now captured in “Self-reported gender”
4. Modify the Core Medical Services response option “Early Intervention Services”

5. Expand the Support Services Service ID response options to include Other Professional Services, and
remove the response options for Legal Services and Permanency Planning

6. Changing variable names:
a. Date First HIV Outpatient/Ambulatory Care Visit TO Date of First HIV Outpatient/Ambulatory
Health Services Visit
b. Dates of all Outpatient Ambulatory Care Visits TO Dates of All Outpatient/Ambulatory Health
Services Visits
c. OAMC Link Date TO OAHS Link Date

2017 RSR Instruction Manual

TABLE OF CONTENTS
What’s New for 2017 ..........................................................................................................................................................................................................i

Background............................................................................................................................................................................................................................ 1

Recipient/Subrecipient Reporting Requirements ............................................................................................................................................ 2

Recipient and Subrecipient Relationships ............................................................................................................................................................ 3

Recipient/Subrecipient Exemptions ........................................................................................................................................................................ 4

Ryan White HIV/AIDS Program Services............................................................................................................................................................... 6

Checking the Client-level Data XML File ................................................................................................................................................................. 7

RSR Recipient Report ....................................................................................................................................................................................................... 8
The Grantee Contract Management System (GCMS)................................................................................................................................... 8
Instructions for Completing the Recipient Report ....................................................................................................................................... 8

RSR Service Provider Report ..................................................................................................................................................................................... 16

Instructions for Completing the Provider Report ..................................................................................................................................... 16

RSR Client-level Data Report ..................................................................................................................................................................................... 24
Importing the Client-level Data XML File to the Provider Report..................................................................................................... 24

Client-Level Data Elements ................................................................................................................................................................................... 25

Appendix A. Required Client-level Data Elements for RWHAP Services ............................................................................................ 49
Glossary ................................................................................................................................................................................................................................ 51
Index....................................................................................................................................................................................................................................... 56

2017 RSR Instruction Manual

BACKGROUND
(Last Updated: August 28, 2017)

The Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87, October 30, 2009) gives
Federal HIV/AIDS programs in the Public Health Service (PHS) Act under Title XXVI the flexibility to
respond effectively to the changing epidemic. Its emphasis is on providing life-saving and life-extending
services for people living with HIV across the country and resources to targeted areas with the greatest
need.

All “Parts” of the Ryan White HIV/AIDS Program (RWHAP) legislation specify the Health Resources and
Services Administration’s (HRSA) responsibilities in the administration and allocation of grant funds,
evaluation of programs for the population served, and improvement in quality of care. Accurate records
of subrecipients receiving RWHAP funding, services provided, and clients served continue to be critical to
implementing the legislation and thus are necessary for HRSA to fulfill its responsibilities.
The HIV/AIDS Bureau (HAB) aims to have a client-level data reporting system that provides data on
the characteristics of the funded recipients, their subrecipients, and the clients served. The data you
submit will be used to do the following:
•
•
•
•
•

Monitor the outcomes achieved on behalf of HIV/AIDS clients and their affected families receiving
care and treatment through RWHAP recipients and/or subrecipients;
Address the disproportionate impact of HIV in communities of color by assessing organizational
capacity and service utilization in minority communities;
Monitor the use of RWHAP for appropriately addressing the HIV/AIDS epidemic in the United
States;

Address the needs and concerns of Congress and the Department of Health and Human Services
(HHS) concerning the HIV/AIDS epidemic and RWHAP; and
Monitor progress toward achieving the goals identified in the national goals for ending the HIV
epidemic.

HAB has taken every measure possible, including the implementation and use of an encrypted Unique
Client Identifier (eUCI), to limit data collection to only the information that is “reasonably necessary
to accomplish the purpose” of the RSR.

HAB also understands how important the data submitted can be to each RWHAP recipient as each
assesses its client service needs and establishes practical outcome measures for its programs.

2017 RSR Instruction Manual

RECIPIENT/SUBRECIPIENT REPORTING
REQUIREMENTS
(Last Updated: August 28, 2017)

Federal regulations explicitly state that grant recipients have a responsibility to monitor their funded
subrecipients to ensure they are using their Federal grant program funds in accordance with program
requirements. 1
Title 45 CFR 92.40, monitoring and reporting program performance; monitoring by grantees:

Recipients are responsible for managing the day-to-day operations of grant and
subgrant supported activities. Grantees must monitor grant and subgrant supported
activities to assure compliance with applicable Federal requirements and that
performance goals are being achieved. Grantee monitoring must cover each program,
function, or activity.

Title 45 CFR 74.51, monitoring and reporting program performance:

Recipients are responsible for managing and monitoring each project, program,
subaward, function or activity supported by the award. Recipients shall monitor
subawards to ensure that subrecipients have met the audit requirements as set forth
in §74.26.

The Federal regulations go on to affirm that grantees are required to maintain, as set forth in 45 CFR Sec.
74.47:
a system for contract administration . . . to ensure contractor conformance with the
terms, conditions and specifications of the contract and to ensure adequate and
timely follow-up of all purchases . . . [Recipients] shall evaluate contractor
performance and document, as appropriate, whether contractors have met the
terms, conditions, and specifications of the contract.

Likewise, HRSA, HHS, and Congress hold HAB responsible for monitoring and reporting the program
performance of its recipients and its subrecipients, the RWHAP service providers. HAB has established the
following reporting requirements for recipients of RWHAP funds accordingly.
Additional information on a covered entity’s use or disclosure of protected health information without the
written authorization of the individual to a public health authority can be found in 45 CFR 164.512 at:
http://www.gpo.gov/fdsys/pkg/CFR-2011-title45-vol1/pdf/CFR-2011-title45-vol1-sec164-512.pdf

The rules and requirements that govern the administration of HHS grants are set forth in the regulations found in Title 45, Code of
Federal Regulations (CFR), Part 74—Uniform Administrative Requirements for Awards and Subawards to Institutions of Higher
Education, Hospitals, Other Nonprofit Organizations, and Commercial Organizations; And Certain Grants And Agreements With
States, Local Governments And Indian Tribal Governments; And Part 92—Uniform Administrative Requirements For Grants And
Cooperative Agreements To State, Local, And Tribal Governments.

2017 RSR Instruction Manual

RECIPIENT AND SUBRECIPIENT
RELATIONSHIPS
(Last Updated: August 28, 2017)

Recipients and subrecipients work together to quickly and easily submit the RSR. Below are illustrations
and definitions of recipient and subrecipient relationships.
A recipient-provider, which is a
service provider that also is a
recipient, must complete a
Recipient Report and a Provider
Report. A recipient-provider of
core medical or support services
must also upload client-level data.

A service organization that has a
contract with a recipient is
considered a first-level subrecipient.
A first-level subrecipient must
complete a Provider Report and, if it
provides core medical or support
services, upload client-level data.

Occasionally,
recipients will
use an
administrative
agent to award
and/or monitor
the use of their
RWHAP funds.
In this
situation, the
administrative
agent (or fiscal
intermediary
service
provider) is the
recipient’s first-level subrecipient. When the
recipient’s first-level subrecipient
(administrative agent or fiscal intermediary
provider) enters into a contract with another
provider to use the recipient’s funds to deliver
services, that provider is considered a secondlevel subrecipient to the recipient. A secondlevel subrecipient must complete a Provider
Report and, if it provides core medical or
support services, upload client-level data.

If a service
organization is
a multilevel
provider (a
second-level
subrecipient to
one recipient
and a first-level
subrecipient to
another
recipient), it
must complete
a single
Provider Report
and, if it
provides core
medical or support services, upload client-level
data. The provider must include client data for
all of its RWHAP contracts.

2017 RSR Instruction Manual

RECIPIENT/SUBRECIPIENT
EXEMPTIONS
Service organizations may be exempt* from completing their own Provider Report and Client Report at the
recipient’s discretion if any of the following apply to them:
•
•
•
•
•
•
•
•
•

They submit only vouchers or invoices for payment (e.g., a taxicab company that only provides
transportation services);
They do not see clients on a regular and sustained basis (e.g., on an emergency basis only);
They offer services to clients on a “fee-for-service” basis;
They provide only laboratory services to clients;

They received less than $10,000 in RWHAP funding during the reporting period;
They see a small number (1–25 patients) of RWHAP clients;

They did not provide services during the reporting period (January 1–December 31);
They are no longer funded by the recipient; and/or
They are no longer in business.

*HAB recommends that an exempted subrecipient has the reason and approval for an exemption in writing from its
recipient.

Exempting a subrecipient from submitting a Provider Report or Client Report does not exempt the
recipient from collecting and submitting data for that subrecipient. If a recipient exempts a subrecipient,
the recipient must ensure that the subrecipient’s data are reported to HAB. See page 12 for instructions on
marking a subrecipient as exempt in the RSR system. If you choose to exempt a subrecipient you may:
•
•
•

Complete a Provider Report and upload client-level data in the exempted subrecipient’s name. In
this case, do not select the “Exempt” check box;
Report the exempted subrecipient’s data with your agency’s RSR data. In this case, all recipients
must select the “Exempt” box; or

Include the second-level subrecipient’s data in the Provider Report of the first-level subrecipient. In
this case, the recipient WILL select the “Exempt” checkbox for the second-level subrecipient.

Not all subrecipients are eligible to receive a reporting exemption:
•
•
•

Recipient-providers may not be given an exemption.

Multilevel subrecipients may not be given an exemption.

A multiply funded subrecipient may be given an exemption only if all its recipients agree to the
exemption.

2017 RSR Instruction Manual

FREQUENTLY ASKED QUESTIONS

about Recipient/Subrecipient Relationships and Reporting Requirements

I have several subrecipients that delivered services to RWHAP-eligible clients during the
reporting period. I have decided to give one of them an exemption from submitting an RSR
Provider Report and client-level data. How should I report the data for the exempt
subrecipient?
If you exempt a subrecipient from submitting an RSR Provider Report and client-level data, you are
required to submit the data to HAB on behalf of the subrecipient. There are three options for
accomplishing this:
1. You may complete the subrecipient’s RSR Provider Report and upload client-level data
into the subrecipient’s report.,
2. You may direct your first-level subrecipient to complete the report on a second-level
subrecipient’s behalf. If you or your first-level subrecipient will be completing the report,
DO NOT indicate that the subrecipient is exempted from reporting.
Note: First-level subrecipients cannot access a second-level subrecipient’s report if the
first-level subrecipient is not (1) a recipient AND (2) also funds the subrecipient.

3. You may report the exempted subrecipient’s data with your agency’s RSR data. In this
instance, you WILL select the exempt option in your Recipient Report. See page 4 for
instructions on marking a subrecipient as exempt in the RSR system.

What if a subrecipient receiving funding from multiple RWHAP Parts is given an exemption
from reporting by one recipient but not another?
Subrecipients must be exempted from reporting by all of their recipients. If your subrecipient has
other recipients, you will need to coordinate with the other recipient(s) to ensure that all recipients
have indicated that the subrecipient is exempted. If one or more of a subrecipient’s recipients does
not agree to exempt the subrecipient, the subrecipient will still need to complete the RSR Provider
Report.
I have a subrecipient that has been exempted by all recipients that fund the agency. Why is
there a report in “Not Started” status for the agency?
If a subrecipient has been exempted by all recipients that fund the agency, all recipients will still be
required to submit a “blank” report for the agency. See page 24 for instructions.

2017 RSR Instruction Manual

RYAN WHITE HIV/AIDS PROGRAM
SERVICES
(Last Updated: August 28, 2017)

For the purposes of reporting, RWHAP-funded services are divided into three groups:
1. Administrative and technical services;
2. Core medical services; and
3. Support services.

Descriptions for all RWHAP services can be found in the Policy Clarification Notice (PCN) 16-02, Ryan White
HIV/AIDS Program Services: Eligible Individuals & Allowable Uses of Funds.

2017 RSR Instruction Manual

CHECKING THE CLIENT-LEVEL DATA
XML FILE
(Last Updated: August 28, 2017)

The Check Your XML Feature allows subrecipients to confirm that the XML file complies with RSR clientlevel data schema and to review data quality prior to the submission of client-level data. Subrecipients are
also able to check their client-level data to identify any data validations that need to be addressed before
submission. The Check Your XML feature is available to users before the RSR Recipient Report opens.

For detailed instructions on how to access and use the Check Your XML feature, refer to the materials
available on the TARGET Center website at https://careacttarget.org/library/check-your-xml-feature-rsr.
Instructions on how to import client-level data can be found on page 24 of this manual.
Uploading client-level data in the Check Your XML feature DOES
NOT meet the requirement for data reporting. A client-level
data file must be uploaded using the “import client-level data”
link in the RSR Provider Report to meet the reporting requirement.

2017 RSR Instruction Manual

RSR RECIPIENT REPORT
(Last Updated: August 28, 2017)

Each recipient of record completes a separate Recipient Report for each RWHAP grant the recipient
receives from HRSA. For example:
•
•

An agency with only a RWHAP Part A grant will complete one Recipient Report.

An agency with RWHAP Part C and D grants will complete two Recipient Reports—one for its
RWHAP Part C grant and another for its RWHAP Part D grant.

The Gra nt ee C ont ra c t M a na gemen t Syste m ( G C M S)

All RWHAP contract information is stored in the Grantee Contract Management System (GCMS). The GCMS uses
information from your previous RSR submissions, the Consolidated List of Contracts (CLC) and/or Program
Terms Report (PTR) to populate your RSR Recipient Report with all the elements necessary to complete the
RSR, such as subrecipient relationships and funded services. You will not be required to synchronize any
changes to the RSR Recipient Report if the subrecipient and service information populated from the GCMS are
correct. However, if the data that populates in the Recipient Report are incorrect, edit the information in the
GCMS and integrate your changes into your RSR via the Synchronize step on the Program Information page of
the RSR Recipient Report.
Instructions on how to synchronize information
into your RSR Recipient Report can be found on
page 12 of the manual.

Instruc tions for Compl eting the R ec ipie nt R ep ort
Step One: Access the GCMS

(Recipients and Recipient-providers only): Log in to the HRSA electronic handbooks (EHBs) site at
https://grants.hrsa.gov/webexternal and navigate to your Performance Reports. There are several methods
of accessing the RSR Report in the EHBs interface. You can find a video as well as slides to assist you with
this on the Target Center website: https://careacttarget.org/library/overview-hrsa-electronic-handbooksgrantees. Start at slide 26.
•

•

Select the “Grants” tab, also on the top-left side of the screen. This will take you to a list of all of the
grants with which you are affiliated. Select the “grants folder” link for the grant with an RSR due
and find the “Performance Reports” link under the Submission heading. Find your 2017 RSR
Deliverable, and click “Start” or “Edit.” On the left side of the screen, under the navigation panel,
select “Search Contracts.”
Select the “Tasks” tab at the top-left side of the screen. This will take you to a list of your current
deliverables. If your RSR is due soon, you’ll find it on the list of deliverables. Find your 2017 RSR
Deliverable, and click “Start” or “Edit.” On the left side of the screen, under the navigation panel,
select “Search Contracts.”
If you need help navigating the EHBs to
find your annual RSR, call the HRSA
Contact Center at 1-877-464-4772.
8

2017 RSR Instruction Manual

Step Two: Verify your contracts in the GCMS
In the GCMS enter the date range for your submission as the search criteria. For example, for the 2017 RSR,
enter “1/1/2017” in the Range Start Date field and “12/31/2017” in the Range End Date Field.

Contracts listed in the GCMS should match the actual agreements you have in place with your subrecipients.
For the purpose of the RSR, contracts include formal contracts, memoranda of understanding, or other
agreements. Each subrecipient listed and the corresponding services they are funded to provide will be copied
into your RSR Recipient Report when it is created.

You will need the following information for each of your contracts:

Contract Information

1. Contract Start Date: Enter the start date by typing into the box or selecting the date from the calendar.

2. Contract End Date: Enter the end date by typing into the box or selecting the date from the calendar.

3. Enter the Contract Reference number (if applicable): This item is for your reference and is not
required for you to be able to enter the contract.
4. Contract Execution: Select “Yes” if the contract has been signed and executed.

5. Is this agency serving as a consortia, fiscal intermediary provider, administrative agent, or lead
agency for this contract? Select “Yes” or “No.” If you select “Yes,” specify consortia, fiscal intermediary
provider, administrative agent, or lead agency in question 5a that appears after you select “Yes.”

6. Is this agency a subcontractor or second-level provider? Select “Yes” or “No.” If you select “Yes,” select
the provider’s fiscal intermediary from the drop-down menu in question 6a.

Service Information

1. Does this agency provide direct client services? Select “Yes” or “No.”

2. If applicable, select the administrative and technical services that are funded for this contractor.
Select all that apply:
• Planning and evaluation

• Technical assistance

• Administrative or technical support

• Capacity development

• Fiscal intermediary support

• Quality management

• Other fiscal services

3. If applicable, indicate the core medical and essential support services that are funded for this contract
by selecting the “Update Services” button. A screen will pop up with the list of services. Enter the
award amount(s) for each service that the subrecipient was funded to deliver, regardless of whether
the subrecipient actually used the funding. To review the service definitions, refer to page 6.

• Once you have entered all the information into the contract, click the “Done Updating Services” link.

Then click “Save” at the bottom of the main page.

The GCMS does not capture funding
amounts allocated to administrative
and technical services.

• After you have verified that all contracts listed are correct, you are ready to complete the RSR

Recipient Report.

2017 RSR Instruction Manual

Editing Contracts in the GCMS
If you need to make modifications to your list of service provider contracts displayed, click the
“Edit/Remove” link at the right side of the table to open the desired contract. Make the edits, and click
“Save.”
The GCMS is used to populate multiple HAB deliverables. Only
delete a contract from the GCMS if you no longer have a
contract in place during the reporting period. If a specific
contract is exempt from RSR reporting, use the exempt feature in the
RSR Recipient Report. See page 4 for exemption instructions.

Adding Contracts in the CGMS
If a contract is missing for one of your subrecipients, you will need to add a new contract:
1. Click the “Add Contract” button below the search results table.

2. Search for the organization by registration code, name, or City/State.

3. Locate the subrecipient in the results table, and click “Add” under the action column.

4. Complete questions 1–9.

Ensure all contracts within the
submission period are accurate and
present in the GCMS before
proceeding to Step Three.

If you need help locating/adding a
subrecipient to the GCMS, call Data
Support at 1-888-640-9356 or e-mail
ryanwhitedatasupport@wrma.com.

Step Three: Open and complete your RSR Recipient Report
Once all contracts from the submission period are in the GCMS, under the inbox heading in the left
navigation menu, select the “Recipient Report” link. Create or open your Recipient Report by clicking the
envelope icon under the “Action” column. You will be redirected to the RSR Recipient Report General
Information Page.

2017 RSR Instruction Manual

General Information
Figure 1. RSR Recipient Report Online Form: Screenshot of the “General Information” Section

Items 1–3 show the information on the Recipient report prepopulated from your notice of award (NOA).
These fields are editable, and you should also update your agency’s information on your NOA:
1. Official Mailing Address
a. Street
b. City

c. State
d. ZIP Code

2. Organization Identification
a. EIN

b. DUNS

3. Contact information of person completing this form (fillable item). This will be the primary contact
person with regards to RSR matters.
a. Name
d. Fax
b. Title
e. Email
c. Phone
4. Select the status of your agency’s clinical quality management program for assessing HIV health
services (select only one):
• Clinical quality management program initiated this reporting period;
• Previously established clinical quality management program;

• Previously established program with new quality standards added this reporting period; or
• Not applicable.

2017 RSR Instruction Manual

Every RWHAP agency that provides core medical services is required to have a clinical quality
management program to assess how HIV health services provided to patients by medical providers
and/or medical case managers under the grant are consistent with the most recent Public Health
Service guidelines for the treatment of HIV. For further information on quality management, refer to
the resources available at http://hab.hrsa.gov/deliverhivaidscare/qualitycare.html.

5. (RWHAP Part C and D Recipients Only) Indicate whether your agency received Minority AIDS
Initiative (MAI) funding during the reporting period. If your agency did receive MAI funding, specify
the most recent percentage designation for the reporting period.
Click “Save” on the bottom right of the page.

Program Information

Figure 2. RSR Recipient Report Online Form: Screenshot of the “Program Information” Section

00002

Health Labs of America

On the left navigation panel, select “Program Information.” Review the list of your service providers that
were active during the reporting period.
•

•

Select the “Expand/Collapse” icon to view the services you funded for each subrecipient. The list
should display all of the services that were funded, regardless of whether the subrecipient actually
delivered the service.

If you need to exempt a subrecipient from reporting, check the box in the “Exempt” column on the
right of the Program Information page, and enter a brief explanation for the exemption. Please
Note: If a subrecipient has other recipients in addition to you, all of their recipients must use the
“Exempt” check box for the subrecipient to be considered exempt from reporting. If one or more
recipient(s) choose not to exempt the subrecipient, then the Provider Report must be completed
and should include data for all programs. Refer to page 4 for a list of exemption criteria.

If all of the information displayed is correct, click “Save” at the bottom of the page, and move on to
Step 4 (Validate and Certify your RSR Recipient Report).

Synchronizing Changes to Your RSR Recipient Report

If you edit contracts in the GCMS after you start your Recipient Report, you must synchronize the changes
so that your changes appear in your RSR report. To access the “Synchronize” feature, click “Program
Information” in the left navigation panel. You will see a Warning message that contains links for each
subrecipient with contract edits.

2017 RSR Instruction Manual

Figure 3. RSR Recipient Report Online Form: Screenshot of the “Program Information” Section
with Synchronization Warning

•

Click on either the link in the Warning message box or the icon in the Warning column to open the
synchronization screen. As a note: If you added a new subrecipient contract in the GCMS, you will
not see that subrecipient in your list, you must select the link with the subrecipient name in the
Warning at the top of the page.
Review the list of changes you made to the subrecipient contract(s). To accept the changes and
update the data in your Recipient Report, click “Synchronize” at the bottom of the page. This step
must be completed for each subrecipient triggering the synchronization warning.
You must synchronize your Recipient Report to incorporate any changes that you made in the
GCMS. Changes are not visible to subrecipients until they have been synchronized.

Step Four: Validate and certify your RSR Recipient Report.

Once your Recipient Report is complete and correct, validate your Recipient Report by selecting the
Validate link in the menu on the left. Allow the system to validate for a few minutes, and then refresh the
page by selecting Validate again. If your Recipient Report triggers a validation error, you must revise your
Recipient Report. You cannot certify your Recipient Report with errors.

Indicate that you have completed data entry for your RSR Recipient Report by clicking “Certify” in the
menu on the left. Enter a comment in the text box, and check the box under the comment box indicating
that you certify that the information is accurate. Recipients should make an effort to certify their RSR
Recipient Reports as soon as possible after the RSR Web System opens. Subrecipients cannot submit their
RSR Provider Report and client-level data until their recipient(s) certify their RSR Recipient Report(s).
You will need to request a decertification if you
need to make edits to your Recipient Report
Program Information after it has been certified.

2017 RSR Instruction Manual

Step Five: Accepting Provider’s Reports (after subrecipients have submitted
their report)
When your subrecipient(s) have submitted their RSR Provider Report and client-level data, it is your
responsibility to review the reports.
•

•

Navigate to each subrecipient’s RSR by using the Provider Report inbox or searching for the
subrecipient using the search feature in the left navigation menu. Open the Provider Report by
selecting the envelope icon in the “Action” column.
Review:
–

–

Provider Report,

Upload Confirmation Report validation

Completeness Report

Validation comments the subrecipient has made

Then use the links on the left to either “Submit/Accept” or “Return for Changes.”

(For Exempted Subrecipients Only): If all recipients have exempted a subrecipient, “Create” the Provider
Report, and use the “Submit/Accept” link to submit a blank provider report.
•
•

Your RSR Recipient Report will not advance to “Submitted” status until you have accepted ALL of
your providers’ reports.

If you have multiple grants, such as RWHAP Part C and D grants, you must accept the report from
both grant folders before the Provider Report will advance to “Submitted” status.
If you need help completing your Recipient
Report or reviewing your provider’s reports,
contact RWHAP Data Support at 1-888-640-9356
or ryanwhitedatasupport@wrma.com.

FREQUENTLY ASKED QUESTIONS
about the RSR Recipient Report

My subrecipient is multiply funded. Does it have to submit multiple RSR Provider Reports?
No. Subrecipients only submit one RSR Provider Report, even if they are multiply funded. Their RSR
Provider Report should include data for all of their RWHAP funds.

We are a RWHAP Part C and D recipient; we are also a RWHAP Part A subrecipient. We do not
have RWHAP Part C or D subrecipients. We use all of our funds to deliver HIV counseling and
testing, core medical, and support services. What components of the RSR do I have to
complete?
To complete your RSR, submit two RSR Recipient Reports, one for your RWHAP Part C grant and
another for your RWHAP Part D grant. Complete one RSR Provider Report that includes data on all
the services your agency is funded to deliver. Finally, submit client-level data that includes one
record for each client that received a service visit during the reporting period.

One of my subrecipients receives funds to provide ADAP services only. Will this subrecipient
submit an RSR?
No. This subrecipient is not required to submit an RSR. When a contract is created for a subrecipient,
at least one non-ADAP service must be specified. Recipients should exclude subrecipients (and/or
14

2017 RSR Instruction Manual

subrecipients’ contracts) that are exclusively funded to provide only ADAP services from their
Recipient Reports.

Our organization contributes RWHAP Part A EMA/TGA funds and/or RWHAP Part B Base
Funds for ADAP. Should I include a contract with the State (or its ADAP contractor) on my
contract list?
Yes, a contract should be entered into the GCMS for the respective contract period. The State (or its
ADAP contractor) may be exempted from reporting on the Program Information section of the RSR
Recipient Report.

I am a recipient and have a contract with a fiscal intermediary. Do I list second-level
subrecipient services in the fiscal intermediary contract?
No. You must create a contract for the fiscal intermediary in the GCMS. On question 4 of the contract,
you will indicate that the subrecipient is a fiscal intermediary. Then, create a separate contract for
the second-level subrecipient. Under question 5 in the GCMS, you will indicate “Yes,” and select the
fiscal intermediary that funds the organization.

The services listed for one of my subrecipients are not correct. Where can I edit the services?
You can make modifications to the contract in the GCMS. Select “Search Contracts” to enter the
GCMS, search and select the subrecipients, make updates as necessary, and synchronize your report.
As a reminder, verify contracts BEFORE starting the Recipient Report to avoid the need to
synchronize the data.

I have already certified my Recipient Report, and I am no longer able to make any changes.
What do I need to do?
You are not able to make changes to your Recipient Report while it is in “Certified” status. You will
need to “request decertification” using the link on the left navigation panel. Once your request is
approved, you will be able to make changes, re-validate, and re-certify your report. Please contact
Data Support at 1-888-640-9356 or ryanwhitedatasupport@wrma.com for assistance with
requesting a decertification.

2017 RSR Instruction Manual

RSR SERVICE PROVIDER REPORT
(Last Updated: August 28, 2017)

An organization that provides RWHAP services to people living with HIV (PLWH) could fill any and all of
the roles noted on page 6. At the same time, it might be:
•
•
•

A recipient-provider,

A subrecipient provider, or

A second-level subrecipient provider.

For the purposes of the Provider Report, all of these entities are referred to as “providers.” They all provide
client-level data about their services (unless exempted).
The Provider Report is a collection of basic information about both the provider and the services the
provider delivered under each of its RWHAP contracts.

All agencies that provide RWHAP-funded services must complete one Provider Report using the RSR Web
System. Multiply funded providers will include information from all RWHAP Parts under which the agency
is funded in one Provider Report.
Unless exempted, all provider agencies are expected to complete their own reports to confirm that their
data accurately reflect their program and the quality of care their agency provides. A full explanation of
exempting provider is in the section Recipient/Subrecipient Reporting Requirements on page 2.

Instruc tions for Compl eting the Provid er R ep ort
Step One: Open the Provider Report.

Recipient-providers: If you are a recipient-provider, you must access the RSR Web System via the EHBs.
To access the RSR system, log in to the EHBs at https://grants.hrsa.gov/webexternal and navigate to your
Performance Reports. There are several methods of accessing the RSR in the EHBs interface, including
through the following:
•

•

Select the “Tasks” tab at the top-left side of the screen. This will take you to a list of your current
deliverables. If your RSR is due soon, you’ll find it on the list of deliverables. Find your 2017 RSR
Deliverable, and click “Edit.” On the left side of the screen, under the Inbox heading, select “Provider
Report.” Use the envelope icon in the Action column to access your Provider Report.
If you need help navigating the EHBs
to find your annual RSR, call the HRSA
Contact Center at 1-877-464-4772.

Providers Only: To access the RSR system, go to
https://performance.hrsa.gov/hab/RegLoginApp/Admin/Login.aspx. Enter your username and password,
and click “Log In.” If you have submitted the report in the past, you do not need to reregister in the system.
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2017 RSR Instruction Manual

If you are a new RSR system user, then you will need your agency’s registration code to create a user name
and password. You will automatically be taken to the first page of your Provider Report.
To get your registration code, contact your
recipient or Data Support at 1-888-640-9356. If you
need help logging into or registering to use the
RSR system, call the HRSA Contact Center at 1-877-464-4772.

Step Two: Complete the Provider Report
On the left navigation panel, there is a section called Provider Report Navigation. There are five links in this
section: General Information, Program Information, Service Information, HC&T Information, and Import
Client-level Data. You will need to complete each of these sections before validating and submitting the report.

General Information

Confirm the following information. This information is populated from your organization’s profile. Use the
“Update” link highlighted in red below to modify as needed.
Figure 4. RSR Provider Report Online Form: Screenshot of “General Information”

Organization Details:
•
•
•
•

Organization Name (editable for service “Provider Only” organizations)
Tax ID/EIN
DUNS

Mailing Address

Provider Profile Information
Subrecipient Type (select only one): Select the provider type that best describes your agency.
•

•
•
•

Hospital or university-based clinic includes ambulatory/outpatient care departments or clinics,
emergency rooms, rehabilitation facilities (physical, occupational, speech), hospice programs,
substance abuse treatment programs, sexually transmitted diseases (STD) clinics, HIV/AIDS clinics,
and inpatient case management service programs.
Publicly funded community health center includes community health centers, migrant health
centers, rural health centers, and homeless health centers.

Publicly funded community mental health center is a community-based agency, funded by local,
State, or Federal funds, that provides mental health services to low-income people.
Other community-based service organization includes nonhospital-based organizations;
HIV/AIDS service and volunteer organizations; private, nonprofit social service and mental health
organizations; hospice programs (home and residential); home health care agencies; rehabilitation
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2017 RSR Instruction Manual

•
•
•
•
•
•
•

programs; substance abuse treatment programs, case management agencies; and mental health
care providers.
Health department includes State or local health departments.

Substance abuse treatment center is an agency that focuses on the delivery of substance abuse
treatment services.

Solo/group private medical practice includes all health and health-related private practitioners
and practice groups.

Agency reporting for multiple fee-for-service providers is an agency that reports data for more
than one fee-for-service provider (e.g., a State operating a reimbursement pool).

People Living with HIV/AIDS (PLWHA) coalition includes organizations that provide support
services to individuals and families affected by HIV and AIDS.
VA facility is a facility funded through the U.S. Department of Veterans Affairs.

Other provider type is an agency that does not fit the agency types listed above. If you select
“Other facility,” you must provide a description.

Section 330 funding received: funds community health centers, migrant health centers, and health
care for the homeless? Section 330 of the Public Health Service Act (PHSA) supports the development and
operation of community health centers that provide preventive and primary health care services,
supplemental health and support services, and environmental health services to medically underserved
areas/populations. Indicate if you received such funding during the reporting period.
•
•
•

Yes
No

Unknown

Ownership Type (select only one):
•

•

•
•
•
•
•

Public/local is an organization funded by a local government entity and operated by local
government employees. Local health departments are examples of local publicly owned
organizations.

Public/State is an organization funded by a State government entity and operated by State
government employees. A State health department is an example of a State publicly owned
organization.

Public/Federal is an organization funded by the Federal Government and operated by Federal
Government employees. A VA hospital is an example of a Federal publicly owned organization.

Private, nonprofit is an organization owned and operated by a private, not-for-profit entity, such
as a nonprofit health clinic.

Private, for-profit is an organization owned and operated by a private entity, even though it may
receive government funding. A privately-owned hospital is an example.
Unincorporated is an agency that is not incorporated.
Other is an agency other than those listed above.

Faith-Based Organization (Indicate whether your organization considers itself faith based):
•
•

Yes
No

2017 RSR Instruction Manual

Categories that best describes the agency’s racial/ethnic characteristics. Select all that apply:
•
•
•
•
•

Agency in which racial/ethnic minority group members make up more than 50% of the agency’s
board members.
Agency in which more than 50% of the professional staff members in direct HIV services are
racial/ethnic minority group members.
Solo or group private health care practice in which more than 50% of the clinicians are
racial/ethnic minority group members.

Other “traditional” provider that has historically served racial/ethnic minority clients but does not
meet any of the criteria above.
Other type of agency or facility.

Providers may report any or all of the first, second, and/or third response if they apply. If none of these
apply, choose either the fourth response OR the fifth response.

Service Delivery Sites: If the provider delivers client services, at least one service delivery site should be
listed, even when the service delivery address matches the provider mailing address. Review the
information in the table for accuracy. Use the “Edit” link to make changes to site information and modify
delivered services at each agency. Use the “Add a Site” button to add additional service delivery sites.
Figure 5. RSR Provider Report Online Form: Screenshot of the “Service Delivery Sites”

Health and Happiness Clinic

123 R. White Blvd.

Rockville

28000

(555) 222-3333

Follow the on-screen prompts to enter the information into the “Add/Edit a New Service Delivery Site”
screen. The Hours of Operation field is a text field, so you can enter anything, such as “By appointment
only,” to complete this item. Once you have entered all the required information, select “Save” at the bottom
of the screen.

Program Information

1) Contact Information of person responsible for this submission. Verify that the contact
information is correct, and make any necessary changes.

2) Report the number of paid staff, in full-time equivalents (FTEs), funded by RWHAP during
the given reporting period. You may enter up to two decimal places. Enter a zero if there are no
paid staff.

How to Calculate FTEs

Count each staff member who works full time (at least
35–40 hours per week) on RWHAP as one FTE. Full-time
employees who regularly work overtime should not be
counted as more than one FTE.
If a percentage of each staff member’s time is being funded (e.g., part-time employees or full-time
employees who spend only a portion of their time in HIV care), simply add the percentages to calculate the
total. For example: An agency uses program funds to support two physicians, one full time (1.0 FTE) and
another part time (0.50 FTE); a nurse practitioner full time (1.0 FTE); a dentist part time (0.20 FTE); and
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2017 RSR Instruction Manual

two case managers, one part-time (0.75 FTE) and another full-time (1.0 FTE). This agency would report
4.45 FTEs in Item 10 of its Service Provider Report.

3) Select the status of your agency’s clinical quality management program for assessing HIV
core medical services (select only one):
•
•
•
•

Clinical quality management program initiated this reporting period;
Previously established clinical quality management program;

Previously established program with new quality standards added this reporting period; or
Not applicable.

Further information on clinical quality management is available in PCN 15-02, available on the HAB website.
After reviewing and updating the information on this page of the Service Provider Report (if necessary),
save the data and advance to the “HIV Counseling and Testing” section of the Provider Report.

Funding Source Certification

4) This item lists all of your agency's sources of RWHAP funding. Verify that this list is accurate by
checking the box under the funding source table. If a funding source is missing or services listed
are inaccurate, contact your recipient and ask it to add your agency to its list of contractors. If a
recipient that did not fund your organization is listed, contact RWHAP Data Support for assistance.
Figure 6. RSR Provider Report Online Form: Screenshot of the “Funding Source Certification”

Part C

H76HA00000

Health and Happiness Clinic

At the bottom of the page is a check box where you certify that the funding sources are correct. If
they are correct, click the check box.

Service Information

5) Review the services funded by your recipient(s). This is populated from the services indicated as
funded by your recipient(s) in its Recipient Report(s). This list includes ALL RWHAP funding
sources that are covered by the RSR. Your agency should select any service category that was
delivered using RWHAP funds during the reporting period. If a service category is missing, contact
the appropriate recipient.

HC&T Information

If your agency used RWHAP funding to provide HC&T services during the given reporting period, you must
complete this section. Report ALL individuals who received the service at your agency during the reporting
period, regardless of funding source. You will still complete this section if RWHAP funds are only used for
staff salaries.
If you provide HC&T services as part of your EIIHA
activities or under the EIS for RWHAP Parts A, B,
and C, report your HC&T data in this section.

2017 RSR Instruction Manual

6) Did your organization use RWHAP funds to provide HIV Counseling and Testing services
during the reporting period? Indicate “Yes” or “No.”

7) Number of individuals tested for HIV: Indicate the number of people tested using an FDAapproved test during the reporting period.

8) Of those tested, number that tested NEGATIVE: The number that tested NEGATIVE for HIV
during the reporting period.

9) Number who tested NEGATIVE and received post-test counseling: Of the number indicated in
Item 8, the number who received HIV post-test counseling.

10) Of those tested, number that tested POSITIVE: Of the total number tested, indicate how many
tested positive for HIV during the reporting period.

11) The number who tested POSITIVE and received post-test counseling: Of the number specified
in Item 10 indicate how many received HIV-post-test counseling immediately following the test or
returned for counseling at a later date.

12) Of those who tested POSITIVE, number referred to HIV medical care: Of the total number who
tested positive for HIV, indicate how many were referred to HIV medical care.

Step Three: Complete the Client-Level Data Report: Import Client-level data
(if applicable).
If you provide core medical or support services, you must upload a client-level data file to complete your
Provider Report. The Client Report is a collection of RWHAP client records that must be submitted in a
properly formatted client-level data XML (eXtensible Markup Language) file. To learn how to upload the
client-level data XML file, see page 24.

Step Four: Validate your RSR Provider Report and client-level data.

Validate your Provider Report by clicking “Validate” on the left navigation panel in the Provider Report
Actions section.
If you have questions about a specific
data validation check, contact Data
Support at 1-888-640-9356.

Your Validation Results may return three types of report validation results: Errors, Warnings, or Alerts.
•

•

Errors must be corrected before you can submit your Provider Report. If the errors are triggered by
the Provider Report, you must correct the information entered. If the errors are triggered by the
client-level data, the data file must be corrected and re-uploaded to the system. Be sure to clear the old
file by using the “Clear Clients” feature in the left navigation menu before uploading the corrected data
file. When you have finished updating your data, validate your report again.

Warnings should be corrected if possible or a comment must be entered explaining the data. To submit
your Provider Report with warnings, write a comment for all the warnings that cannot or should not
be fixed by clicking the “Add Comments” link under the action column in your validation report. Do not
include personal health information (PHI) when entering warning comments.
Alerts are informative and intended to help you identify potential issues in your data collection and
reporting processes. You can submit your report with alerts.

Your data system contains protected health information (PHI) that includes, but is not limited to, client
names, addresses, DOB, SSN, dates of service, and URNs generated for your organization’s client-level data
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2017 RSR Instruction Manual

XML file. To ensure client confidentiality, you must be compliant with all relevant Federal regulations. You
must protect this information the same way you protect all client data. For additional information, visit the
HHS Office of Civil Rights Health Information Privacy Web page. Do not disclose sensitive information in
your reporting comments. Refer to http://www.hhs.gov/ocr/privacy for additional information about client
confidentiality and privacy.

Step Five: Submit your data.

When you are satisfied that your report is complete, submit the Provider Report and client-level data by
clicking on “Submit” in the left navigation menu and following the instructions on your screen.

Your RSR Provider Report will proceed to either “Review” or “Submitted” status. If your report advances to
“submitted” status, you are done. If your report advances to “Review” status, one or more RWHAP funders
must review and accept the report before it will advance to “Submitted” status. If you have questions about
the status of your RSR, contact Data Support at 1-888-640-9356.

FREQUENTLY ASKED QUESTIONS
about the RSR Provider Report

Do providers receiving funding from multiple RWHAP Parts complete multiple Provider
Reports?
No. Each subrecipient will submit only one Provider Report including data from all RWHAP Parts
under which the agency is funded.

Are providers with whom we do not have formal contracts required to submit data?
For the purpose of the RSR, “contracts” include formal contracts, memoranda of understanding, or
other agreements. Data must be reported for all providers that delivered RWHAP services.

Do providers need to submit a Provider Report and client-level data if they do not serve any
clients, submit only vouchers, only serve clients on a fee-for-service basis, or receive a small
amount of funding from my grant?
All providers listed on your contract lists will be required to complete an RSR Provider Report
unless all the providers’ RWHAP funders have marked it as exempted. Data are still required of all
providers that delivered RWHAP services. Please refer to page 4 to review how to report for an
exempted provider.

Do second-level providers have to submit Provider Reports?
Yes, both first- and second-level providers need to complete Provider Reports. Second-level
providers will see the name of their RWHAP funders and the name of their fiscal intermediary, the
agency through which it receives funding, in their contracts list.

I have a lot of providers and have set an early submission deadline so I have time to review
their submissions. But one of my providers is multiply funded, and the other recipient told
my provider that it does not need to submit its data until HAB’s recommended submission
deadline. I really need my provider to submit its data early. What do I do?
Contact your provider’s other RWHAP funder(s), preferably before the report submission period
begins, to coordinate your deadlines. Taking the time up front to agree on the submission deadlines
that all the provider’s RWHAP funders will enforce will help ensure a smooth submission process. If
your provider is also a recipient, be sure to negotiate an early submission deadline that is agreeable
to both of you. Project Officers can be helpful in these decisions and can suggest due dates for
Recipient Reports.
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2017 RSR Instruction Manual

How do I report a service that I delivered that does not appear in my Provider Report?
If you receive Ryan White funds to deliver a service that is not populated in your Provider Report,
you will need to contact your RWHAP funder to add the service(s) on its Recipient Report. If you did
not receive RWHAP funds to deliver the service, you should not mark it in your Provider Report.

2017 RSR Instruction Manual

RSR CLIENT-LEVEL DATA REPORT
(Last Updated: August 28, 2017)

Client-level data must be submitted for all providers who used RWHAP funds to provide core medical or
support services directly to clients during the reporting period. Unless exempted from reporting, all
provider agencies must complete their own reports to confirm that their data accurately reflect their
program and the quality of care their agency provides. A full explanation of exempting providers can be
found in the section Recipient/Subrecipient Reporting Requirements on page 2.

Importi ng the Cl ient- l e vel Da ta XM L F il e to th e
Provide r R e port

To generate an XML file, providers need to extract the client-level data from their systems into the proper
XML format before the data can be submitted to HAB. Several software applications for managing and
monitoring HIV clinical and supportive care are able to export the data in the required XML format. A list of
RSR-ready vendor systems that can generate the RSR client-level data XML file can be found on the TARGET
Center Web site at https://careacttarget.org/content/vendor-status-and-contact-information-0. If your
organization uses a custom-built data collection system, you have two options:
1. Write a program that extracts the data from it, and insert it into an XML file that conforms to the rules
of the RSR XML schema. The schema can be obtained from HAB at
https://careacttarget.org/library/xml-file-all-things-xml . This list is updated every year.

2. Use TRAX to create your client-level data XML file. TRAX was created to help recipients and providers
that do not use CAREWare, a Provider Data Import (PDI), or other RSR-ready vendor system to create
their client-level Data XML file.
If you need help generating or modifying
your XML file, contact the DART Team at
data.ta@caiglobal.org.

To upload a client-level data XML file, open your RSR Provider Report. From within the RSR Provider
Report, click the “Import Client-level Data” link in the Provider Report Navigation menu on the left. Then,
follow the on-screen instructions.

Each file uploaded into the RSR system goes through a schema validation check. This check is automatically
performed by the RSR system when a file is uploaded. If the file is noncompliant, the user’s file will be
rejected by the RSR system, and a complete list of error messages will be displayed. Users can download
the list as a text file and use it to fix the client-level data in their source system.

Providers should generate and review the Data Completeness Report and Upload Confirmation Report
from the left navigation menu before submitting the data.
Data files must be uploaded to the RSR Provider
Report. Uploading to the Check Your XML feature
does not meet the reporting requirements.

2017 RSR Instruction Manual

Cl ient- L evel Da ta El ements

The client report should contain one record for each client who was eligible and who received RWHAP core
medical services or support services during the reporting period. The data elements reported per client are
determined by the specific RWHAP services that your agency is funded to provide. See the chart in
Appendix A. Required Client-level Data Elements for RWHAP Services on page 49 to determine which clientlevel data elements to report for a client.
Up to 64 data elements may be reported for each client. The data elements include the following:
•
•
•
•

The client’s encrypted Unique Client Identifier (eUCI);
The client’s demographic information;

The core medical and support services the client received; and

The client’s clinical information if he or she received outpatient/ambulatory medical care services.

This section outlines the data fields that may be submitted in the client-level data XML file. Each description
includes the following:

Element ID: Each data element has been assigned a value for convenient referencing between this
document and the RSR Data Dictionary available at https://careacttarget.org/library/xml-file-all-things-xml .

RSR Client-Level Data Element: A brief description of the client-level data element being collected.

XML Variable Name: The data elements have been assigned a variable name in the RSR data dictionary. It
is the method by which the data are labeled in the RSR client-level data XML file. The variable name is
provided for convenient referencing between this document and the RSR data dictionary.
Required for clients with service visits in the following categories: The data elements that must be
reported for your clients are based on the type of services your agency is RWHAP funded to provide. You
are required to report the data element for all clients who meet your eligibility criteria for the RWHAPfunded service, regardless of payer.

Description: A detailed discussion, if required, of the variable and responses that may be reported for the
variable. This section defines the responses allowed for the data element.

Frequently asked questions about this data element: Where applicable, answers are provided to the
questions recipients and providers ask the most about the data element.

2017 RSR Instruction Manual

System Variables

RSR system’s unique provider registration code SV3

XML Variable Name:
RegistrationCode

Description:
The Unique Provider Registration Code is automatically generated when the provider is entered into
the RSR web system provider directory. It is the same code that providers use when they create an
account in the RSR web system.

Client’s encrypted Unique Client Identifier SV4

XML Variable Name:
ClientUci

Required for clients with service visits in the following categories:
All core medical and support services.

Description:
To protect client information, an encrypted UCI(eUCI) is used for reporting Ryan White client data.
Using eUCIs allows HAB to de-duplicate the clients and obtain a more accurate count of the clients
RWHAP services.

Note: Your data system contains protected health information (PHI) that includes, but is not limited
to, client names, addresses, DOB, SSN, dates of service, and URNs generated for your organization’s
client-level data XML file. To ensure client confidentiality, you must be compliant with all relevant
Federal regulations. You must protect this information the same way you protect all client data. For
additional information, visit the HHS Office of Civil Rights Health Information Privacy Web page. Do
not disclose sensitive information in your reporting comments. Refer to
http://www.hhs.gov/ocr/privacy for additional information about client confidentiality and privacy.
To learn more about the eUCI, including rules on how to
construct the UCI before encryption, view the resources
available on the TARGET Center website at
https://careacttarget.org/library/encrypted-unique-client-identifiereuci-application-and-user-guide.

Guidelines for Collecting and Recording Client Names
Recipients should develop business rules/operating procedures outlining the method by which client
names should be collected and recorded. For example:
•
•
•
•

Enter the client’s entire name as it normally appears on documentation such as a driver’s license,
birth certificate, passport, or Social Security card.
Follow the naming patterns, practices, and customs of the local community or region (e.g., for
Hispanic clients living in Puerto Rico, record both surnames in the appropriate order).
Avoid using nicknames (e.g., do not use Becca if the client’s first name is Rebecca).
Avoid using initials.

2017 RSR Instruction Manual

Recipients should instruct providers and staff how to enter their client’s names. This is especially true
when clients receive services from multiple providers in a network. To avoid false duplicates, client names
must be entered in the same way at each provider location so that the client has the same eUCI.

FREQUENTLY ASKED QUESTIONS
about this data element

What if I am missing data elements that compose the eUCI?
If you are missing data elements required for the eUCI, you should do everything possible to obtain
those data elements. They are required for each client. This effort will improve not only the quality
of data linking but also patient care and case management.

Demographic Data

Up to 16 demographic data elements may be reported for each client. You can determine which
demographic data elements are required for a particular client by looking at Appendix A. Required Clientlevel Data Elements for RWHAP Services on page 49.

Client’s vital enrollment status at the end of this reporting period 2

XML Variable Name:
EnrollmentStatusID

Required for clients with service visits in the following categories:
• Outpatient/ambulatory health services
• Medical case management
• Nonmedical case management

Description:
This is the client’s vital enrollment status at the end of the reporting period. These are the response
categories for this data element:
• Active— The client is enrolled as of the end of the reporting period.
• Referred or Discharged—The client is not enrolled as of the end of the reporting period due to
referral to another program for services or discharged from the program for any reason
except those listed below.
• Removed—The client is disenrolled from the program due to violation of rules.
• Incarcerated—The client is disenrolled from the program because he or she is serving a
criminal sentence in a Federal, State, or local penitentiary, prison, jail, reformatory, work
farm, or similar correctional institution (whether operated by the government or a
contractor).
• Relocated—The client is disenrolled from the program because he or she has moved out of the
agency’s service area.
• Deceased

FREQUENTLY ASKED QUESTIONS
about this data element

How do I report a client who is no longer receiving services?
Each agency must determine its own guidelines for classifying a client’s vital enrollment status. If a
client is no longer active at the end of the reporting period, choose one of the alternate response
options. HAB recommends that these policies be in writing and applied at all providers within a
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2017 RSR Instruction Manual

recipient agency. HAB understands that different grant recipients may have different policies in the
same geographic area.

What if a client falls into more than one category (e.g., active and incarcerated)?
If the client received services during the reporting period and you expect the client to continue to
receive services from your program, report the client as “Active.” If the client is not “Active” in your
agency’s program, choose the category that explains why the client is no longer active.

Client’s year of birth 4

XML Variable Name:
BirthYear

Required for clients with service visits in the following categories:
All core medical and support services.

Description:
This is the client’s birth year. Even though only the year of birth will be reported to HAB, providers
should collect the client’s full date of birth. The client’s birth year, month and day are used to
generate the UCI. The value must be on or before all service dates for the client. This is a variable
that is used for the eUCI. The RSR System will reject any XML file with client records that do not
include the client’s year of birth.

Reporting Client Race and Ethnicity

Office of Management and Budget (OMB) Revisions to the Standards for the Classification of Federal Data
on Race and Ethnicity provides a minimum standard for maintaining, collecting, and presenting data on
race and ethnicity for all Federal reporting purposes. The standards were developed to provide a common
language for uniformity and comparability in the collection and use of data on race and ethnicity by Federal
agencies.

The standards have five categories for data on race: American Indian or Alaska Native, Asian, Black or
African American, Native Hawaiian or Other Pacific Islander, and White. There are two categories for data
on ethnicity: Hispanic or Latino and Not Hispanic or Latino. In addition, identification of ethnic and racial
subgroups is required for the categories of Hispanic/Latino, Asian, and Native Hawaiian/Pacific Islander.
The racial category descriptions, defined in October 1997, are required for all Federal reporting, as
mandated by the OMB.

HAB is required to use the OMB reporting standard for race and ethnicity. However, service providers
should feel free to collect race and ethnicity data in greater detail. If the agency chooses to use a more
detailed collection system, the data collected must be organized so that any new categories can be
aggregated into the standard OMB breakdown.
RWHAP providers are expected to make every effort to obtain and report race
and ethnicity, based on each client’s self-report. Self-identification is the
preferred means of obtaining this information. Providers should not establish
criteria or qualifications to use to determine a particular individual’s racial or ethnic
classification, nor should they specify how someone should classify himself or herself.

2017 RSR Instruction Manual

Client’s self-reported ethnicity 5
XML Variable Name:
EthnicityID

Required for clients with service visits in the following categories:
All core medical and support services.
Description:
The client’s ethnicity based on his or her self-report.

These are the response category options:
• Hispanic/ Latino/ or Spanish origin—A person of Cuban, Mexican, Puerto Rican, South or
Central American, or other Spanish culture or origin, regardless of race. The term “Spanish
origin” can be synonymous with “Hispanic or Latino.” If a client identifies as
Hispanic/Latino/a or Spanish origin, choose all Hispanic subgroups that apply in ID 68.
• Non-Hispanic/Latino/a or Spanish origin—A person who does not identify his or her
ethnicity as “Hispanic or Latino.”

Client Report Hispanic Subgroup 68

XML Variable Name:
HispanicSubgroupID

Required for clients if EthnicityID is Hispanic/Latino(a) or Spanish origin with service visits
in the following categories:
All core medical and support services.

Description:
If the response to ID 5, client’s self-reported ethnicity, is “Hispanic/ Latino/a or Spanish origin,”
indicate the client’s Hispanic subgroup (choose all that apply).
These are the response category options:
• Mexican, Mexican American, Chicano/a
• Puerto Rican
• Cuban
• Another Hispanic, Latino/a or Spanish origin

Client’s self-reported race 6

XML Variable Name:
RaceID

Required for all clients with service visits in the following categories:
All core medical and support services.

Description:
This is the client’s race based on his or her self-report. NOTE: Multiracial clients should select all
categories that apply.
•

American Indian or Alaska Native—A person having origins in any of the original peoples of
North and South America (including Central America), and who maintains tribal affiliation or
community attachment.
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2017 RSR Instruction Manual

•

•
•

•

Asian—A person having origins in any of the original peoples of the Far East, Southeast Asia,
or the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea,
Malaysia, Pakistan, the Philippine Islands, Thailand, and Vietnam. If a client identifies as
Asian, choose all Asian subgroups that apply in ID 69.
Black or African American—A person having origins in any of the black racial groups of
Africa.
Native Hawaiian or Other Pacific Islander—A person having origins in any of the original
peoples of Hawaii, Guam, Samoa, or other Pacific Islands. If a client identifies as Native
Hawaiian/Pacific Islander, choose all Native Hawaiian/Pacific Islander subgroups that apply
in ID 70.
White—A person having origins in any of the original peoples of Europe, the Middle East, or
North Africa.

Client Report Asian Subgroup 69

XML Variable Name:
AsianSubgroupID

Required for clients if RaceID is Asian with service visits in the following categories:
All core medical and support services.

Description:
If the response to ID 6, client’s self-reported race, is “Asian,” indicate the client’s Asian subgroup
(choose all that apply).
These are the response category options:
• Asian Indian
• Chinese
• Filipino
• Japanese
• Korean
• Vietnamese
• Other Asian

Client Report Native Hawaiian/Pacific Islander (NHPI) Subgroup 70

XML Variable Name:
NHPISubgroupID

Required for clients if RaceID is Native Hawaiian/Pacific Islander with service visits in the
following categories:
All core medical and support services.
Description:
If the response to ID 6, client’s self-reported race, is “Native Hawaiian or Other Pacific Islander,”
indicate the client’s Native Hawaiian/Pacific Islander subgroup (choose all that apply).
• Native Hawaiian
• Guamanian or Chamorro
• Samoan
• Other Pacific Islander
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2017 RSR Instruction Manual

Client’s current self-reported gender 7
XML Variable Name:
GenderID

Required for clients with service visits in the following categories:
All core medical and support services.

Description:
Indicate the client’s gender (the socially and psychologically constructed, understood, and
interpreted set of characteristics that describe the current sexual identity of an individual) based on
his or her self-report. Gender cannot be missing; one of the options below must be reported for
current gender. This is a variable that is used for the eUCI.
• Male— An individual with strong and persistent identification with the male gender.
• Female— An individual with strong and persistent identification with the female gender.
• Transgender Male to Female—An individual whose sex assigned at birth was male, but who
identifies their gender as female, regardless of the status of social gender transition or
surgical and hormonal sex reassignment processes.
• Transgender Female to Male—An individual whose sex assigned at birth was female, but who
identifies their gender as male, regardless of the status of social gender transition or surgical
and hormonal sex reassignment processes.
• Transgender Other—An individual who identifies as transgender but does not identify with
the other transgender options and/or does not identify with the binary positions of
male/female. These individuals may or may not engage in social gender transition or surgical
and hormonal sex reassignment processes (e.g., gender non-conforming, genderqueer, nonbinary, gender fluid, bi-gender).
• Unknown—Indicates the client’s gender category is unknown or was not reported, or does
not fit within one of the available options.

Client’s self-reported transgender status 8

Deleted for 2017

Client Sex at Birth 71
XML Variable Name:
SexAtBirthID

Required for clients with service visits in the following categories:
All core medical and support services.
Description:

The biological sex assigned to the client at birth.
• Male
• Female
XML Variable Name:
PovertyLevelID

Client’s annual household income category 9

Required for clients with service visits in the following categories:
• Outpatient/ambulatory health services
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2017 RSR Instruction Manual

•
•

Medical case management
Nonmedical case management

Description:
This is the client’s income in terms of the percent of the Federal poverty level at the end of the
reporting period. The response categories for this data are:
• Below 100% of the Federal poverty level
• 100–138% of the Federal poverty level
• 139–200% of the Federal poverty level
• 201–250% of the Federal poverty level
• 251–400% of the Federal poverty level
• 401–500% of the Federal poverty level
• More than 500% of the Federal poverty level

If your organization collects this information early in the reporting period, it is not necessary to collect it
again at the end of the reporting period (although changes should be documented). Report the latest
information on file for each client.

There are two slightly different versions of the Federal poverty measure—the poverty thresholds
(updated annually by the U.S. Bureau of the Census) and the poverty guidelines (updated annually by
HHS). For more information on poverty measures and to see the most recent HHS Poverty Guidelines, go
to http://aspe.hhs.gov/poverty/index.shtml.
If your agency already uses the poverty thresholds to calculate this data
element, continue to use the poverty thresholds to report these data.
Otherwise, HAB recommends (and prefers) that you use the poverty
guidelines to collect and report these data.

Client’s housing status 10
XML Variable Name:
HousingStatusID

Required for clients with service visits in the following categories:
• Outpatient/ambulatory medical care services
• Medical case management
• Nonmedical case management
• Housing services

Description:
This data element is the client’s housing status at the end of the reporting period. There are three
response categories for this data element:
• Stable Permanent Housing
• Temporary Housing
• Unstable Housing
Stable Permanent Housing includes the following:
• Renting and living in an unsubsidized room, house, or apartment.
• Owning and living in an unsubsidized house or apartment.
• Unsubsidized permanent placement with families or other self-sufficient arrangements.
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2017 RSR Instruction Manual

•
•
•
•

Housing Opportunities for Persons with AIDS (HOPWA)-funded housing assistance,
including Tenant-Based Rental Assistance (TBRA) or Facility-Based Housing Assistance, but
not including the Short-Term Rent, Mortgage and Utility (STRMU) Assistance Program.
Subsidized, non-HOPWA, house or apartment, including Section 8, the HOME Investment
Partnerships Program, and Public Housing.
Permanent housing for formerly homeless persons, including Shelter Plus Care, the
Supportive Housing Program (SHP), and the Moderate Rehabilitation Program for SRO
Dwellings (SRO Mod Rehab).
Institutional setting with greater support and continued residence expected (psychiatric
hospital or other psychiatric facility, foster care home or foster care group home, or other
residence or long-term care facility).

Temporary Housing includes the following:
• Transitional housing for homeless people.
• Temporary arrangement to stay or live with family or friends.
• Other temporary arrangement such as a Ryan White Program housing subsidy.
• Temporary placement in an institution (e.g., hospital, psychiatric hospital or other
psychiatric facility, substance abuse treatment facility, or detoxification center).
• Hotel or motel paid for without emergency shelter voucher.

Unstable Housing Arrangements include the following:
• Emergency shelter, a public or private place not designed for, or ordinarily used as, a regular
sleeping accommodation for human beings, including a vehicle, an abandoned building, a
bus/train/subway station/airport, or anywhere outside.
• Jail, prison, or a juvenile detention facility.
• Hotel or motel paid for with emergency shelter voucher.
These definitions are based on:
• HOPWA Program, Annual Progress Report (APR), Measuring Performance Outcomes, form
HUD-40110-C
• McKinney-Vento Act, Title 42 US Code, Sec. 11302, General definition of homeless individual

Client’s HIV/AIDS status 12

XML Variable Name:
HivAidsStatusID

Required for clients with service visits in the following categories:
• Outpatient/ambulatory health services
• Medical case management
• Nonmedical case management

Description:
This data element is the client’s HIV status at the end of the reporting period. For HIV-affected
clients for whom HIV status is not known, leave this value blank. The response categories for this
element are:
• HIV-negative (affected)—Client has tested negative for HIV, is an affected partner or family
member of an individual who is HIV positive, and has received at least one support service
during the reporting period.

2017 RSR Instruction Manual

HIV-affected clients are clients who are HIV negative
or have an unknown HIV status. An affected client
must be linked to a client infected with HIV.
•
•
•
•

HIV-positive, not AIDS—Client has been diagnosed with HIV but has not been diagnosed with
AIDS.
HIV-positive, AIDS status unknown—Client has been diagnosed with HIV. It is not known
whether the client has been diagnosed with AIDS.
CDC-defined AIDS—Client is an HIV-infected individual who meets the CDC AIDS case
definition for an adult or child. NOTE: Once a client has been diagnosed with AIDS, he or she
always is counted in the CDC-defined AIDS category regardless of changes in CD4 counts.
HIV-indeterminate (infants <2 years only)—A child under the age of 2 whose HIV status is
not yet determined but was born to an HIV-infected mother.
Once an HIV-indeterminate (infants <2 years
only) client is confirmed HIV negative, he or she
must be reclassified as an HIV-affected client.

FREQUENTLY ASKED QUESTIONS
about this data element

What is the operational definition of AIDS?
HAB uses the current CDC surveillance case definition for Acquired Immunodeficiency Syndrome for
national reporting. For additional information, see:
• http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5710a1.htm
• http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6303a1.htm

HIV Diagnosis Year 72
XML Variable Name:
HIVDiagnosisYearID

Required for new clients if HivAidsStatusID is not HIV-negative or HIV-indeterminate (infants
<2 years only) with service visits in the following categories:
• Outpatient/ambulatory health services
• Medical case management
• Nonmedical case management
Description:
If the response to ID 12 is not “HIV-negative” or “HIV-indeterminate (infants <2 years only),”
indicate the client’s year of HIV diagnosis, if known.
HIV Diagnosis Year:
• yyyy (Must be less than or equal to the reporting period year.)

2017 RSR Instruction Manual

FREQUENTLY ASKED QUESTIONS
about this data element

How do we determine what a new client is?
Each agency must determine its own guidelines for determining whether clients are new.
RWHAP providers are expected to make every effort to obtain
and report HIV risk factor(s) based on each client’s self-report.
Self-identification is the preferred means of obtaining this
information. Providers should not establish criteria or qualifications to use
to determine a particular client’s racial or ethnic classification, nor should
they specify how a person should classify himself or herself.

Client’s risk factor for HIV infection 14
XML Variable Name:
HivRiskFactorID

Required for clients with service visits in the following categories:
• Outpatient/ambulatory health services
• Medical case management
• Nonmedical case management

Description:
This data element is the client’s initial risk factor for HIV infection. You may report all of the
response categories that apply. It is primarily based on self-report.
• Men who have sex with men (MSM) cases include men who report sexual contact with other
men (i.e., homosexual contact) and men who report sexual contact with both men and
women (i.e., bisexual contact).
• Injection drug user (IDU) cases include clients who report use of drugs intravenously or
through skin-popping.
• Hemophilia/coagulation disorder cases include clients with delayed clotting of the blood.
• Heterosexual contact cases include clients who report specific heterosexual contact with an
individual with, or at increased risk for, HIV infection (e.g., an injection drug user).
• Receipt of transfusion of blood, blood components, or tissue cases include transmission
through receipt of infected blood or tissue products given for medical care.
• Mother with/at risk for HIV infection (perinatal transmission) cases include transmission
from mother to child during pregnancy. This category is exclusively for infants and children
infected by mothers who are HIV positive or at risk.
• Risk factor not reported or not identified above. This category also refers to HIV-affected
clients.

FREQUENTLY ASKED QUESTIONS
about this data element

How do we report risk factors not listed above?
Risk factors that are not expressly stated above—occupational exposure, prison tattoos, etc.—
should be reported under risk factor not reported or not identified above.
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2017 RSR Instruction Manual

Client’s Medical insurance 15
XML Variable Name:
MedicalInsuranceID

Required for clients with service visits in the following categories:
• All core medical services.
• Nonmedical case management.

Description:
Report all sources of health care coverage the client had for any part of the reporting period (select
one or more).
•
•
•
•
•
•
•
•

Private—Employer.
Private—Individual.
Medicare is a health insurance program for people ages 65 and older, some disabled people
ages 64 and younger, and people with end-stage renal disease (permanent kidney failure
treated with dialysis or a transplant).
Medicaid, CHIP, or other public plan.
Veterans Health Administration (VA), military health care (TRICARE), and other military
health care.
Indian Health Service.
No insurance/uninsured means the client did not have health insurance at some time during
the reporting period. HAB classifies clients who have no way to pay for medical expenses
other than with RWHAP funds as uninsured.
Other plan means client has an insurance type other than those listed above. An example of
other plan would be a company that chooses to “self-insure” and pay the medical expenses of
its employees directly as they are incurred, rather than purchasing health insurance for its
employees to use.

FREQUENTLY ASKED QUESTIONS
about this data element

How should a provider report clients who have private insurance but use RWHAP funds to
pay their copay and/or deductible?
If the client has private insurance, select the corresponding response option. Select all responses
that apply.

How should a provider report a client who has insurance for part of the reporting period but
has no insurance at a different point in the same reporting period?
If the client has insurance for part of the reporting period, select the corresponding response option
AND select “No Insurance.” Select all responses that apply.

How should a provider report a client who is covered by COBRA?
Insurance reporting is based on who is paying the premium for the insurance. When a client is
covered by COBRA, the client is responsible for payment, and insurance status should be reported as
“Private–Individual.”

RWHAP-Eligible Service Data

For the next set of data elements, report a client’s service visits delivered when the client was eligible to
receive RWHAP-funded services. Report clients who did not actually receive RWHAP-funded services if
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2017 RSR Instruction Manual

they meet your agency’s eligibility requirements for RWHAP services. Do not report clients who received
services that your agency is not funded by RWHAP to deliver.
To determine whether to report a client, refer to the flow chart below:

For example, you have two clients, Aaron and Robert, who are eligible to receive RWHAP services. Your
agency is funded by RWHAP to provide OAHS and medical case management services. You also provide
housing services but do not receive RWHAP funds to deliver housing services.

Aaron receives OAHS, but his visits are paid for from a non-RWHAP funding source. As Aaron is eligible to
receive RWHAP funds to cover his care, he should be reported on the RSR.

Robert only receives housing services. Robert would not be reported on the RSR because your agency is not
funded by RWHAP to deliver housing services.

FREQUENTLY ASKED QUESTIONS
about eligible scope

How do I determine which clients are eligible for RWHAP?
Requirements for RWHAP are set at the RWHAP recipient level. Contact your RWHAP funder to
determine your site’s eligibility requirements.
How do I know if I should report a client?
You should report a client if:
1) The client is RWHAP eligible; and

2) The client received a service that your agency was funded by RWHAP to deliver in 2017.

How does eligible scope affect clients with high deductible insurance plans?
The RWHAP assists all eligible people living with HIV. Clients with high deductible plans are likely to
need the RWHAP for assistance with deductibles and later in the year. Eligible scope allows
providers to collect client data prior to these PLWH being enrolled in the program and provide a
complete picture of the client’s care. Please review PCN 16-02 for allowable uses of RWHAP funds to
assist clients.
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2017 RSR Instruction Manual

What do I report if a client has a gap in eligibility? For example, a client is eligible from
January to July and has service visits in January and December. Which visits do we count?
If the client moves in and out of eligibility, report services that were within the period of eligibility
(Items 16-45). If an OAHS client moves in and out of eligibility and the agency is RWHAP funded for
OAHS, report the services (ID 16) within the period of eligibility AND all the clinical data elements
(including OAHS visit dates ID 48) from the ENTIRE year.

Should I report client-level data from HOPWA clients?
Yes. HAB is working with HUD to demonstrate how coordinated data can improve clinical outcomes.
This SPNS initiative started in 2016 and will help inform data collection for future RSRs.

Core Medical Service Visits Delivered 16, 18–19, 21–27

XML Variable Name:
ClientReportServiceVisits
• Service Visit
• ServiceID (See table below.)
• Visits (Number of visits (1–365) the client received in the service category indicated.)
Required for clients with service visits in the following categories:
Recipients of at least one core medical service, per client, as listed in the table below.

Description:
Report the number of core medical service visits the client received while he or she was eligible for
RWHAP. Remember, for each day, only one service visit per category may be reported for the RSR—
even if the client receives more than one service in a particular category during the day.
Example #1: During her visit with the dentist on June 19, Jane Doe receives five services: a dental
exam, a cleaning, a filling, X-rays, and a fluoride treatment. In this situation, even though Jane
received 5 services, the provider will only report 1 oral health care service visit for that day.

Example #2: On December 7, John Doe has a medical visit with his physician, meets with his medical
case manager, and participates in an individual counseling session with his psychologist in the
morning. Later that day, he also participates in a group counseling session. Even though John
received 4 services, the provider will report only 3 service visits for that day: 1 mental health service
visit, 1 medical case management service visit, and 1 outpatient/ambulatory health service visit.
Core medical services (IDs 16-27) should be reported only for
HIV-positive and HIV-indeterminate (infants <2 years) clients.
HIV-negative clients who receive HIV counseling and testing
services as part of EIS for RWHAP Part A, B, and C should only be reported
in the HIV Counseling and Testing section of the Provider Report.

The definitions for the RWHAP Core Medical Services can be found in the PCN 16-02 on the HAB
website.

ELEMENT ID

Service Category

Outpatient ambulatory health services

Early intervention

18
21

ServiceID

Service ID 8

Oral health care

Service ID 10

Home health care

Service ID 13

Service ID 11

2017 RSR Instruction Manual
ELEMENT ID

Service Category

ServiceID

Home and community-based health

Service ID 14

Mental health

Service ID 16

23
25
26
27

Hospice

Service ID 15

Medical nutrition therapy

Medical case management (including treatment adherence)
Substance abuse outpatient

Service ID 17
Service ID 18
Service ID 19

Core Medical and Support Services Delivered 17, 20, 28–45

XML Variable Name:
ClientReportServiceDelivered
• Service Delivered
• ServiceID (See table below.)
• DeliveredID (2—Yes)

Description:
Report whether or not eligible clients received these core medical and support services during the
reporting period. The definitions for the RWHAP Support Services can be found in the PCN 16-02 on
the HAB website.

ELEMENT ID

Service Category

AIDS Pharmaceutical Assistance (LPAP, CPAP)

Child care

20
28
31
32
33
34
36
37
38
75
40
41
42
43
44

ServiceID

Service ID 9

Health Insurance Program (HIP)

Service ID 12

Emergency financial assistance

Service ID 23

Non-medical case management

Service ID 20
Service ID 21

Food bank/home-delivered meals

Service ID 24

Health education/risk reduction

Service ID 25

Housing

Service ID 26

Linguistic

Service ID 28

Medical transportation

Service ID 29

Outreach

Service ID 30

Other Professional Services

Service ID 42

Psychosocial support

Service ID 32

Referral for health care/supportive

Service ID 33

Rehabilitation

Service ID 34

Respite care

Service ID 35

Substance abuse–residential

Service ID 36

2017 RSR Instruction Manual

Clinical Information
The final group of data elements collected in the client-level data XML file are the clinical information data
elements. Clinical information is required to be reported by all providers who received RWHAP funding to
provide outpatient/ambulatory health services.
Clinical information is required for HIV-positive clients
who received an outpatient/ambulatory medical care
visit. Clinical information is not required to be reported
for HIV-indeterminate (infants <2 years only) clients.

Data provided in this section will help HAB assess to what extent the RWHAP is meeting patient care and
treatment standards according to HHS HIV treatment guidelines.

Client received HIV risk-reduction screening/counseling 46

XML Variable Name:
RiskScreeningProvidedID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory medical care services

Description:
Indicate (yes/no) if HIV risk-reduction screening and/or counseling was provided to the client
during this reporting period. HIV risk-reduction screening and counseling refers to a short
questionnaire administered by a clinician to identify patients at risk for HIV infection or reinfection,
followed by counseling of patients about ways to reduce their risk.

Date client’s first HIV outpatient/ambulatory health service visit 47

XML Variable Name:
FirstAmbulatoryCareDate

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Report the date of the client’s first HIV outpatient/ambulatory health service visit with this provider.
When responding to this ID, keep these points in mind:
•
•

•
•
•

The visit must meet the RWHAP definition of an outpatient/ambulatory health service visit.
You are not expected to resort to unreasonable measures to locate this information in your
files. If you are unable to identify the first date of service, please report the earliest date
available in your records.
This visit may have occurred before the start of the reporting period.
This visit may or may not be a RWHAP-funded visit.
The date of first HIV outpatient/ambulatory health service visit does not change in
subsequent reports.

2017 RSR Instruction Manual

Dates of the client’s outpatient/ambulatory health service visits 48
XML Variable Name:
ClientReportAmbulatory
• Service
• ServiceDate

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Report all dates (MM/DD/YYYY) of the client’s outpatient/ambulatory health service visits in this
provider’s HIV care setting with a clinical care provider during the reporting period, regardless of
the payer. A clinical care provider is a physician, physician assistant, clinical nurse specialist, nurse
practitioner, or other health care professional who is certified in his or her jurisdiction to prescribe
antiretroviral (ARV) therapy. The number of outpatient ambulatory care visit dates reported for this
ID should be equal to or greater than the number of visits reported in ID 16.
NOTE: The visits should meet the RWHAP definition of an outpatient/ambulatory health services
visit.

Client’s CD4 Test 49

XML Variable Name:
ClientReportCd4Test
• Count
• ServiceDate

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Report the value and test date for all CD4 count tests administered to the client during the reporting
period. The CD4 cell count measures the number of T-helper lymphocytes per cubic millimeter of
blood. It is a good predictor of immunity. As CD4 cell count declines, the risk of developing
opportunistic infections increases. The test date is the date the client’s blood sample is taken, not the
date the results are reported by the lab.

Client’s Viral Load Test 50

XML Variable Name:
ClientReportViralLoadTest
• Count
• ServiceDate

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Report the value and test date for all viral load tests administered to the client during the reporting
period. Viral load is the quantity of HIV RNA in the blood and is a predictor of disease progression.
Test results are expressed as the number of copies per milliliter of blood plasma. The test date is the
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2017 RSR Instruction Manual

date the client’s blood sample is taken, not the date the results are reported by the lab. If a viral load
count is undetectable, you should report the lower bound of the test limit. If the lower bound is not
available, report 0.

Client prescribed PCP prophylaxis 51

XML Variable Name:
PrescribedPcpProphylaxisID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services
Description:
PCP prophylaxis is drug treatment to prevent Pneumocystis jiroveci pneumonia.

Indicate if clients were prescribed a PCP prophylaxis at any time during the reporting period. NOTE:
Select “yes” if the client began or was continuing a prophylactic regimen during the reporting period.
• Yes
• No
• Not medically indicated
• No, client refused
For additional information about PCP prophylaxis, see:
• http://hab.hrsa.gov/deliverhivaidscare/habperformmeasures.html
• http://aidsinfo.nih.gov/guidelines

Client prescribed ART 52
XML Variable Name:
PrescribedArtID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
ART is antiretroviral therapy, the daily use of a combination of HIV medicines to treat HIV infection.
NOTE: Report “yes” if the client began or was continuing on ART during the reporting period.
• Yes. This includes clients who were not adherent to the prescribed therapy.
• No, not ready (as determined by clinician)
• No, client refused
• No, intolerance, side effect, toxicity
• No, ART payment assistance unavailable
• No, other reason
For additional information about ART, visit: http://aidsinfo.nih.gov/guidelines.

2017 RSR Instruction Manual

Client has been screened for TB since HIV diagnosis 54
XML Variable Name:
ScreenedTBSinceHivDiagnosisID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services
Description:
Indicate if the client has been screened for TB since his or her HIV diagnosis.
• No
• Yes
• Not medically indicated
• Unknown

Client was screened for syphilis during this reporting period 55

XML Variable Name:
ScreenedSyphilisID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Syphilis is a sexually transmitted disease (STD) that can be diagnosed by examining material from a
chancre (infectious sore) using a dark-field microscope or with a blood test. This element is not
required for clients ages 17 or younger who are not sexually active. Has the client been screened for
syphilis during this reporting period?
• Yes
• No
• Not medically indicated
Additional information may be obtained at http://aidsinfo.nih.gov/guidelines.

Client was screened for hepatitis B since HIV diagnosis 57

XML Variable Name:
ScreenedHepatitisBSinceHivDiagnosisID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services
Description:
Indicate if the client has been screened for hepatitis B since his or her HIV diagnosis.
• No
• Yes
• Not medically indicated
• Unknown

2017 RSR Instruction Manual

Client has completed the vaccine series for hepatitis B 58
XML Variable Name:
VaccinatedHepatitisBID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
The hepatitis B vaccine series is a sequence of shots that stimulate a person’s natural immune
system to protect against HBV. Has the client completed the vaccine series for hepatitis B?
• Yes
• Not medically indicated
• No

FREQUENTLY ASKED QUESTIONS
about this data element

How do we report a client whose hepatitis B vaccination is in progress during the reporting
period?
If the client is in the process of completing a hepatitis B vaccination series, report “no” for the
reporting period. You will indicate that the client has completed the series in subsequent reports.

Can we report that the client has been vaccinated for hepatitis B if the client has a hepatitis B
surface antibody test that is positive/reactive and hepatitis B antigen that is negative/nonreactive? Can an immunity tests be a substitute for getting all documented hepatitis B vaccine
test dates in the series to note that the patient received the series?
No. You may not use a negative hepatitis B surface antigen test (HBsAg) result and a positive
hepatitis B surface antigen antibody (anti-HBs) test result in lieu of documentation showing that the
client received the hepatitis B vaccine series to report a “yes” response to the
VaccinatedHepatitisBID data element. A negative hepatitis B surface antigen test (HBsAg) and a
positive hepatitis B surface antibody test (anti-HBs) only indicate that the client is immune; they do
not necessarily indicate immunity through the vaccination. A negative HBsAg result and a positive
anti-HBs test result means that a vaccine is not medically indicated. Remember, this data element is
about vaccination, not immunity.

Client screened for hepatitis C since HIV diagnosis 60

XML Variable Name:
ScreenedHepatitisCSinceHivDiagnosisID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services
Description:
Indicate if the client has been screened for hepatitis C since his or her HIV diagnosis.
• No
• Yes
• Not medically indicated
• Unknown
44

2017 RSR Instruction Manual

Client was screened for substance use 61
XML Variable Name:
ScreenedSubstanceAbuseID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Substance use screening is a quick, simple way to identify clients who may need further assessment
or treatment for substance use disorders. Screening may include biomarkers (e.g., positive drug
screen or liver disease) and client reports of consumption patterns. Substance use screening may be
administered by a substance abuse treatment professional or by a trained health care professional in
another medical/clinical discipline. Was the client screened for substance use (alcohol and drugs)
during the reporting period?
• No
• Yes
• Not medically indicated

Client received mental health screening 62

XML Variable Name:
ScreenedMentalHealthID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Mental health screenings include the use of brief structured instruments or commonly used
questions to assess potential mental health problems. Screenings are designed to determine whether
the client presents signs or symptoms of a mental health problem and if the client should be referred
to a mental health professional. Screens are not diagnostic tools and, although typically administered
by a mental health professional, may be administered by trained health care professionals in other
medical/clinical disciplines. Was a mental health screening conducted for the client during this
reporting period?
• No
• Yes
• Not medically indicated

Client received a Pap Smear 63

XML Variable Name:
ReceivedCervicalPapSmearID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Reported for HIV-positive women only, only report a value for a cervical smear. Do not report a
value for an anal test for male or female clients. A Pap smear or screening is a way to examine cells
taken from a woman’s cervix. It can detect cell changes that may be pre-cancerous as well as hidden,
45

2017 RSR Instruction Manual

small tumors that may lead to cervical cancer. Did the client receive a Pap smear during this
reporting period?
• No
• Yes
• Not medically indicated
• Not applicable

Client was pregnant 64

XML Variable Name:
PregnantID

Required for HIV-positive clients with service visits in the following categories:
Outpatient/ambulatory health services

Description:
Reported for HIV-positive women only, do not report a value for male clients, unless the client is
transgender. Was the client pregnant during the reporting period?
• No
• Yes
• Not applicable

Positive HIV Test Date 73

XML Variable Name:
HIVPosTestDateID

Required for all clients with a new diagnosis of HIV in the reporting period with service visits
in the following categories:
Outpatient/ambulatory health services
Description:
Date of the client’s first documented positive HIV test during the reporting period. It can be a
positive HIV test from another site, as long as it is documented and not a client self-report. May be
the client’s HIV confirmatory test date.
Positive HIV Test Date:
• mm/dd/yyyy (Must be within the reporting period year.)

Outpatient/Ambulatory Health Service Link Date 74

XML Variable Name:
OAHSLinkDateID

Required for all clients with a new diagnosis of HIV in the reporting period with service visits
in the following categories:
Outpatient/ambulatory health services

Description:
Date of client’s first OAHS medical care visit after positive HIV test. The OAHS visit date must be a
visit with a prescribing provider and cannot be a date before that reported in ID 73.
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2017 RSR Instruction Manual

HIV OAHS linkage date:
• mm/dd/yyyy (Must be within the reporting period and on the same day or later than
positive HIV test date.)

FREQUENTLY ASKED QUESTIONS
about the client-level data

How does HAB define a confirmatory test?
Each agency must determine its own guidelines for standard of care that is practiced by its OAHS
providers based on HRSA and CDC guidelines.

My RWHAP funding covers only salaries. Do I report client-level data?
Yes. HAB expects that staff whose salary is paid by RWHAP will see clients who meet RWHAP
eligibility requirements. Providers should report all RWHAP-eligible clients who received services
that the provider was funded for.

Do I need to report my client-level data by RWHAP Part?
No. HAB doesn’t require you to submit your client-level data by RWHAP Part. Although providers
should have an adequate mechanism for tracking clients and services by contract or funding source
(RWHAP and non-RWHAP), the intention of the RSR client-level data is to capture all services for all
clients served by a provider, regardless of RWHAP Part.

May I upload more than one client-level data file?
Yes. If you choose to upload more than one client-level data file to “build” the client report, take the
time to (1) make certain your data systems are generating client eUCIs consistently and (2) review
the rules that the RSR system follows when it combines information from two or more client-level
data files before you upload multiple client-level data XML files. To learn more about the RSR
system merge rules, see the article Rules for Merging at https://careacttarget.org/library/rsr-mergerules .

What client-level data do I need to report?
Collect the applicable client-level data elements for each client who received services during the
reporting period. The data elements reported depend on the service(s) each client receives. To
determine the client-level data elements that must be reported for each client, review the chart in
Appendix A. Required Client-level Data Elements for RWHAP-Eligible Services.

What if we collect our client information at the first visit in the reporting period, rather than
at the end?
It is not necessary to collect this information again at the end of the reporting period, ensure changes
are documented. Report the latest information on file for each client.

What do we report if a client does not provide all of the data and there is no option to report
the element as unknown?
HAB encourages you to submit the most complete data possible. If you are unable to collect the data,
drop the tag from your data file, and it will be considered a missing value. You may receive a
validation message and will need to add comments as necessary. Please refer to page 13 to review
data validation reporting requirements.

2017 RSR Instruction Manual

My agency provides services to HIV-indeterminate infants. We do not perform CD4 or viral
load tests on these clients. How do I report this?
Providers are not required to report clinical information (IDs 46–64 and 73–74) for HIVindeterminate infants (<2 years only).

What if we do not know whether a new client has been screened for TB, hepatitis B, or
hepatitis C since his or her HIV diagnosis date? Are we expected to get retrospective data on
every client in medical care?
HAB understands that it may place an unreasonable burden on providers to determine whether
certain clients were screened for TB, hepatitis B, or hepatitis C since their diagnosis and advises
providers to report whatever data may be reasonably obtained. HAB expects you to screen your
client if you do not know whether or not your client has been screened since his or her HIV
diagnosis.

2017 RSR Instruction Manual

APPENDIX A. REQUIRED CLIENT-LEVEL DATA
ELEMENTS FOR RWHAP SERVICES
(Last Updated: August 28, 2017)
RATIONALE CODES

1) Necessary for identifying new clients

2) 2009 Ryan White Legislation requirement

3) Necessary to assess RWHAP performance as required for HAB’s programmatic measures
4) Necessary to track enrollment or vital status over the course of the reporting period
5) Informs the denominator of other items

6) Used to identify important population subgroups

•
•
•
•
•
•
•
•
•

•

•
•
•
•
•
•
•
•
•

Substance abuse services –
residential

•
•
•
•
•
•
•
•
•

Respite care

•
•
•
•
•
•
•
•
•

Rehabilitation services

•
•
•
•
•
•
•
•
•

Psychosocial support services
Referral health care/support
services

Other Professional Services

•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Outreach services

•
•
•
•
•
•
•
•
•
•

Medical transportation services

•
•
•
•
•
•
•
•
•
•

Linguistics services

•
•
•
•
•
•
•
•
•
•

Housing services

•
•
•
•
•
•
•
•
•
•

Health education/risk reduction

•
•
•
•
•
•
•
•
•
•

Food bank/home-delivered meals

•
•
•
•
•
•
•
•
•
•

Emergency financial assistance

•
•
•
•
•
•
•
•
•
•

Child care services

•
•
•
•
•
•
•
•
•
•

Non-medical case management

Home health care
Home & community-based health
services
Hospice services

•
•
•
•
•
•
•
•
•
•

Health Insurance Premium and CostSharing

•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

•
•
•
•
•
•
•
•
•
•

AIDS Pharmaceutical Assistance

HIV risk reduce screen/counseling
First outpatient/ambulatory health service visit
Outpatient ambulatory care visits
CD4 counts and dates
Viral Load Counts and Dates
Prescribed PCP prophylaxis
Prescribed ART
Screened for TB since diagnosis
Screened for syphilis
Screened for Hep B since diagnosis
Completed Hep B vaccine series
Screened for Hep C since diagnosis
Screened for substance use
Screened for mental health
Pap smear
Pregnant
Date of first Positive HIV Test
Date of OAHS visit after first positive HIV test

Client Clinical Data

•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Substance abuse services –
outpatient

•
•
•
•
•
•
•
•
•
•
•
•
•
•
•
•

Medical nutrition therapy

Year of birth
Ethnicity
Hispanic Subgroup
Race
Asian Subgroup
NHPI Subgroup
Gender
Transgender subgroup
Sex at Birth
Health insurance
Housing status
Federal poverty level
HIV/AIDS status
Client risk factor
Vital enrollment status
HIV Diagnosis Year

Mental health services

Client Demographics

Early intervention services

Client-level Data Elements

Oral healthcare

• report the data element

Outpatient/ambulatory Health
Services
Medical case management

2017 RSR Instruction Manual

•
•
•
•
•
•
•
•
•

Rationale
2,7
2,4,7
2,4,7
4,7
4,7
4,7
2,3,4,7
2,3,4,7
2,3,4,7
2,7
2,7
2,7
2,4
7
5,6
2,4
2,3
2,3,4
3,4
3,4
3,4
3
3,4
3
3
3
3
3
2,3
2,3
3,6
2,3,4
1,3,4,5,6
1,3,4,5

2017 RSR Instruction Manual

GLOSSARY
Active client: A person who was a client when the reporting period ended and is expected to continue in
the program during the next reporting period.

Affected client: A family member or partner of an infected client who receives at least one RWHAP support
service during the reporting period.
AIDS: Acquired Immune Deficiency Syndrome. A disease caused by the human immunodeficiency virus.

ART: Antiretroviral therapy. An aggressive anti-HIV treatment including a combination of three or more
drugs with activity against HIV that is designed to reduce viral load to undetectable levels.

ARV: Antiretroviral. A drug that interferes with the ability of a retrovirus, such as HIV, to make more copies
of itself.

CDC: Centers for Disease Control and Prevention. The U.S. Department of Health and Human Services
agency that administers HIV prevention programs, including the HIV Prevention Community Planning
process, among others. The CDC is responsible for monitoring and reporting infectious diseases,
administers HIV surveillance grants, and publishes epidemiologic reports such as the HIV Surveillance
Report.
Client: See infected client, affected client, active client, or indeterminate client.

Clinical care provider: A physician, physician assistant, clinical nurse specialist, nurse practitioner, or
other health care professional who is certified in his or her jurisdiction to prescribe ARV therapy.

Combination therapy: Two or more drugs or treatments used together to achieve optimum results against
HIV/AIDS. For more information on treatment guidelines, visit http://www.aidsinfo.nih.gov/guidelines.

Confidential information: Information, such as name, gender, age, and HIV status, that is collected on the
client and the unauthorized disclosure of which could cause the client unwelcome exposure,
discrimination, and/or abuse.

Consortium/HIV care consortium: An association of one or more public, and one or more nonprofit
private, health care, and support providers, people with HIV, and community-based organizations
operating within areas determined by the State to be most affected by HIV disease. The consortium agrees
to use RWHAP Part B grant assistance to plan, develop, and deliver (directly or through agreement with
others) comprehensive outpatient health and support services for people with HIV disease. Agencies
constituting the consortium are required to have a record of service to populations and subpopulations
with HIV.

Continuum of care: An approach that helps communities plan for and provide a full range of emergency
and long-term service resources to address the various needs of people living with HIV.

Contract: An agreement between two or more parties, especially one that is written and enforceable by
law. 2 For the purposes of the Ryan White Services Report, contracts include formal contracts, memoranda
of understanding, or other agreements.
Core medical services: A set of essential, direct health care services provided to people with HIV and
specified in the Ryan White HIV/AIDS Treatment Extension Act.

Contract. (n.d.). The American Heritage® Dictionary of the English Language, Fourth Edition. Accessed December 12, 2008, at
Dictionary.com Web site: http://dictionary.reference.com/browse/contract.

2017 RSR Instruction Manual

Division of Policy and Data: The Division within HRSA’s HIV/AIDS Bureau that serves as the Bureau’s
principal source of program data collection and evaluation and the focal point for coordination of program
performance activities, policy analysis, and development of policy guidance. The Division coordinates all
technical assistance activities for the Bureau in collaboration with each HAB Division.

Eligible Scope: A method of data collection based on a client’s ability to receive federally funded RWHAP
services using established recipient criteria.

EMA/TGA: Eligible Metropolitan Area/Transitional Grant Area. The geographic area eligible to receive
Part A RWHAP funds. The boundaries of the EMA/TGA are defined by the Census Bureau. Eligibility is
determined by AIDS cases reported to the CDC. Some EMA/TGAs include just one city and others are
composed of several cities and/or counties. Some EMA/TGAs extend across more than one State.
Exposure category: See risk factor.

Family-centered: A model in which systems of care under RWHAP Part D are designed to address the
needs of PLWH and affected family members as a unit, by providing or arranging for a full range of services.
The family structures may range from the traditional, biological family unit to nontraditional family units
with partners, significant others, and unrelated caregivers.
Fee-for-service: The method of billing for health services whereby a physician or other health service
provider charges the payer (whether it be the patient or his or her health insurance plan) separately for
each patient encounter or service rendered.

GCMS: The Grantee Contract Management System. An electronic data system that RWHAP recipients use to
manage their subrecipient contracts.

Grant Recipient of Record (or grantee): See “Recipient of record (or recipient).”

HAB: HIV/AIDS Bureau. The Bureau within HRSA of the U.S. Department of Health and Human Services
(HHS) that is responsible for administering the RWHAP. Within HAB, the Division of Metropolitan
HIV/AIDS Programs (DMHAP) administers Part A; the Division of State HIV/AIDS Programs (DSHAP)
administers Part B and the AIDS Drug Assistance Program (ADAP); the Division of Community HIV/AIDS
Programs (DCHAP) administers RWHAP Part C, Part D, the HIV/AIDS Dental Reimbursement Program
(DRP), and the Community-Based Dental Partnership Program (CBDPP); and the Office of Training and
Capacity Development administers the AIDS Education and Training Centers (AETC) Program and the
Special Projects of National Significance (SPNS) Program. The Bureau’s Division of Policy and Data (DPD)
administers HIV/AIDS evaluation studies, the Ryan White HIV/AIDS Program Services Report (RSR), the
ADAP Data Report (ADR), and the Allocation and Expenditure (A&E), Report, HIV Quality Measures
(HIVQM) Module, and AIDS Education and Training Centers (AETC) Reports.

High-risk insurance pool: A State health insurance program that provides coverage for people who are
denied coverage due to a preexisting condition or who have health conditions that would normally prevent
them from purchasing coverage in the private market.
HIP: Health insurance premium and cost-sharing assistance for low-income individuals. A program that
provides financial assistance for eligible clients living with HIV to maintain continuity of health insurance
or to receive medical and pharmacy benefits under a health care coverage program. The service provision
consists of either or both of the following: paying health insurance premiums to provide comprehensive
HIV Outpatient/Ambulatory Health Services and pharmacy benefits that offer a full range of HIV
medications for eligible clients, and/or paying cost-sharing on behalf of the client.
HIV disease: Any signs, symptoms, or other adverse health effects due to the human immunodeficiency
virus.

2017 RSR Instruction Manual

HOPWA: Housing Opportunities for Persons with AIDS. A program administered by the U.S. Department of
Housing and Urban Development (HUD) that provides funding to support housing for PLWH and their
families.

HRSA: Health Resources and Services Administration. A Federal public health agency of the U.S.
Department of Health and Human Services that is responsible for directing national health programs that
improve the Nation’s health by assuring equitable access to comprehensive, quality health care for all.
HRSA works to improve and extend life for people living with HIV, provides primary health care to
medically underserved people, serves women and children through State programs, and trains a health
workforce that is both diverse and motivated to work in underserved communities. HRSA administers
RWHAP.

Indeterminate client: A child ages 2 or younger with an HIV status that is not yet determined but was
born to an HIV-infected mother.

Infected client: A person who is HIV positive and eligible to receive at least one RWHAP service during the
reporting period.
Inpatient setting: This includes hospitals, emergency rooms and departments, and residential facilities
where clients typically receive food and lodging as well as treatments.

Institution: This includes residential, health care, and correctional facilities. Residential facilities include
supervised group homes and extended treatment programs for alcohol and other drug abuse or for mental
illness. Health care facilities include hospitals, nursing homes, and hospices. Correctional facilities include
jails, prisons, and correctional halfway houses.
Laboratory Services: Services provided by a licensed clinical laboratory responsible for analyzing client
specimens to inform the diagnosis, treatment, and evaluation of health factors for PLWH.

MAI: Minority AIDS Initiative. A national initiative that provides special resources to reduce the spread of
HIV and improve health outcomes for people living with HIV within communities of color. This initiative
was enacted to address the disproportionate impact of the disease in such communities.
Not medically indicated: A determination made by a clinical care provider that a service, procedure, or
treatment is not medically necessary. Medically necessary health care services are procedures used by a
prudent medical care provider to diagnosis or treat an illness, injury, or disease or its symptoms in a manner
that is (1) in accordance with generally accepted standards of medical practice; or (2) clinically appropriate in
terms of type, frequency, extent, site, and duration, and considered effective for a patient’s illness, injury, or
disease; and (3) not primarily for the convenience of the patient or treating clinical care provider.

OI: Opportunistic infection. An infection or cancer that occurs in people with weak immune systems due to
HIV, cancer, or immunosuppressive drugs such as corticosteroids or chemotherapy. Kaposi’s sarcoma (KS),
Pneumocystis jiroveci pneumonia (PCP), toxoplasmosis, and cytomegalovirus are all examples of such
infections.

OMB: Office of Management and Budget. The office within the executive branch of the Federal Government
that prepares the President’s annual budget, develops the Federal Government’s fiscal program, oversees
administration of the budget, and reviews government regulations.

Outpatient setting: A hospital, clinic, medical office, pass-through organization, or other place where
clients receive health care services but do not stay overnight.

Part A: The Part of RWHAP that provides direct financial assistance to designated EMAs/TGAs who have
been the most severely affected by the HIV epidemic. The purpose of these funds is to deliver or enhance
HIV-related core medical and support services to people living with HIV.

Part B: The Part of RWHAP that authorizes the distribution of Federal funds to States and Territories to
improve the quality, availability, and delivery of core medical and support services for people living with
53

2017 RSR Instruction Manual

HIV. RWHAP emphasizes that such care and support is part of a coordinated continuum of care designed to
improve medical outcomes.

Part C: The Part of RWHAP that provides support for early intervention services, including preventive,
diagnostic, and therapeutic services for people living with HIV. This support includes a comprehensive
continuum of outpatient HIV primary care services including: HIV counseling, testing, and referral; medical
evaluation and clinical care; other primary care services; and referrals to other health services.
Part D: The Part of RWHAP that supports coordinated family-centered outpatient care for women, infants,
children, and youth with HIV.
PHSA: Public Health Service Act.
PLWH: People living with HIV.

PLWH coalition: Organizations of people living with HIV that provide support services to individuals and
families infected with and/or affected by HIV.

Primary health care service: Any preventive, diagnostic, or therapeutic health service received on an
outpatient basis by a client who is HIV positive. Examples include medical, subspecialty care, dental,
nutrition, mental health, or substance abuse treatment, medical case management, and pharmacy services;
radiology, laboratory, and other tests used for diagnosis and treatment planning; and counseling and
testing.
Provider (or service provider): The agency that provides direct services to clients (and their families) or
the recipient. A provider may receive funds as a recipient (such as under Parts C and D) or through a
contractual relationship with a recipient funded directly by HRSA’s RWHAP. Also see subrecipient.

Recipient of record (or recipient): An organization receiving financial assistance directly from an HHS
awarding agency to carry out a project or program. A recipient also may be a recipient-provider if it
provides direct services in addition to administering its grant. Recipient of record (or recipient) replaces
the term “Grantee of record.”

Recipient-provider: An organization that receives RWHAP funds directly from HRSA and provides direct
client services. Replaces the term “Grantee-provider.”

Reporting period: A 12-month period, January 1 through December 31, of the calendar year.

Risk factor or risk behavior/exposure category: See also Transmission Category. Behavior or other
factor that places a person at risk for disease. For HIV, this includes such factors as male-to-male sexual
contact and injection drug use.
RSR: Ryan White HIV/AIDS Program Services Report.

RWHAP-funded service: A service paid for with Ryan White HIV/AIDS Program funds.

Ryan White HIV/AIDS Treatment Extension Act of 2009: The Federal legislation created to address the
health care and service needs of people living with HIV and their families in the United States and its
Territories.
SPNS: Special Projects of National Significance. A health services demonstration, research, and evaluation
program funded under Part F of RWHAP. SPNS projects are awarded competitively.

Subrecipient: The legal entity that receives RWHAP funds from a recipient and is accountable to the
recipient for the use of the funds provided. Subrecipients may provide direct client services or
administrative services directly to a recipient. Subrecipient replaces the term “Provider (or service
provider).”

Support services: A set of services needed to achieve medical outcomes that affect the HIV-related clinical
status of a person living with HIV.
54

2017 RSR Instruction Manual

Transmission category: A grouping of disease exposure and infection routes. In relation to HIV disease,
exposure groupings include injection drug use, men who have sex with men, heterosexual contact,
perinatal transmission, and so forth.
UCI: Unique Client Identifier. A unique alphanumeric code that distinguishes one RWHAP client from all
others and is the same for the client across all provider settings.

XML: eXtensible Markup Language. A standard, simple, and widely adopted method of formatting text and
data so that it can be exchanged across all of the different computer platforms, languages, and applications.

2017 RSR Instruction Manual

INDEX
ADAP, 14

Hispanic Subgroup, 29

ART, 42

HIV Diagnosis Year, 34

Asian Subgroup, 30

HIV risk factor, 35

CD4 Test, 41

HIV/AIDS status, 33–34

Client Report, 23–47

Housing status, client, 32

Client-level Data Elements, 25, 27, 25–46, 25–46,
25–46, 25–46, 25–46, 25–46, 49
Clinical Information, 40–46, 40–46, 40–46, 40–46,
40–46, 40–46
Demographic Data, 27–36

Native Hawaiian/Pacific Islander (NHPI)
Subgroup, 30
OAMC Link Date, 46
PCP prophylaxis, 42

Data Validation, 13, 21
Errors, 21
Warnings, 21

Positive HIV Test Date, 46
Race, 28, 29–30

Reporting Period, 4

Ethnicity, 28, 29

Reporting Requirements, 3
ADAP, 14
Client-level data, 21, 25–49

eUCI, 26, 47

First Service Visit Date
Outpatient/ambulatory medical care, 40

Syphilis, 43

Grantee Report, 6–15
Contract Lists, 12

Tuberculosis, 43

Viral Load Test, 41

HAART, 42

XML, 54
Client-level data file submission, 47
Variable Name, explanation of, 25

Health Medical Insurance, reporting sources of,
36
Medical insurance, 35–36
Hepatitis B, 43, 44

File Type	application/pdf
Author	Michael J.E. Grier
File Modified	2017-08-28
File Created	2017-08-28