Form 1 ADR variable changes Instrument

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
Client demographics
Reference
ID

Current
CY 2017 Variable

2.1

ClientUCI

1

Ethnicity

2

Race

3

Hispanic
Subgroup

4

Asian Subgroup

5

Nhpi Subgroup

Final, December 26, 2019

Current Coding
String
1=Hispanic
2=Non-Hispanic
1 = White
2 = Black or African
American
3 = Asian
4 = Native Hawaiian
or Other Pacific
Islander
5 = American Indian
or Alaska Native
1 = Mexican,
Mexican American,
or Chicano/a
2 = Puerto Rican
3 = Cuban
4 = Another Hispanic,
Latino/a, or Spanish
origin
1 = Asian Indian
2 = Chinese
3 = Filipino
4 = Japanese
5 = Korean
6 = Vietnamese
7 = Other Asian
1 = Native Hawaiian
2 = Guamanian or
Chamorro

Corresponding
NASTAD variable

Recommendation

N/A

Final decision on
variable and coding

Rationale / Where
and how used

No change

Same response
options

No change

OMB Mandated
coding
OMB mandated
coding. No
additional
subgroups added so
that race subgroups
align with OMB
reporting.

Same response
options

No change

N/A

No change

OMB Mandated
Coding

N/A

No change.

OMB Mandated
Coding

N/A

No change.

OMB Mandated
Coding

1

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting

6

Gender

8

Sex at Birth

9
10

Birth Year
HIV AIDS Status

11

Poverty Level

12

HighRiskInsurance

Final, December 26, 2019

3 = Samoan
4 = Other Pacific
Islander
1 = Male
2 = Female
4 = Unknown
6 = Transgender
Male to Female
7 = Transgender
Female to Male
8 = Transgender
Other
1= Male
2=Female
Yyyy
2 = HIV-Positive, not
AIDS
3 = HIV-Positive,
AIDS status unknown
4 = CDC-defined AIDS
13 = Below 100% of
the FPL
9 = 100-138% of the
FPL
10 = 139-200% of the
FPL
11 = 201-250% of the
FPL
12 = 251-400% of the
FPL
7 = 401-500% of the
FPL
8 = More than 500%
of the FPL
1 = No
2 = Yes
3 = Unknown

Male
Female
Transgender
Unknown

No change

Aligns with RSR

No change
Age Groups

No change
No change

<=100% FPL
101-138% FPL
139-200% FPL
201-300% FPL
301-400% FPL
401-500% FPL
>500% FPL
Unknown

Collect continuous,
rather than tiered,
field.

Change this to align
with RSR reporting.
This change will
allow flexibility in
analyzing FPL for
the future

Remove

These types of
insurance became
much less common

2

We cannot remove
this field since it is
used in the RSR-ADR
linkage

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting

13

Medical Insurance

10 = Private –
Employer
11 = Private –
Individual
8 = Medicare Part
A/B
9 = Medicare Part D
12 = Medicaid, CHIP,
or other public plan
13 = VA, Tricare, or
other military health
care
14 = IHS
15 = Other Plan
16 = No
Insurance/uninsured

-Enrolled as
Medicaid
Beneficiaries only
-Dually Eligible for
Medicaid and
Medicare
-Eligible for
Medicare Part D Full
Subsidy
-Eligible for
Medicare Part D
Partial Subsidy
-Eligible for
Medicare Part D
Standard Benefit
-Private insurance
-No form of
insurance
For Clients with
Private Insurance
Coverage:
-Enrolled in an
individual qualified
health plan (QHP) in
the ACA Marketplace
-Enrolled in an
individual qualified

Final, December 26, 2019

3

Change variable
name to: Health Care
Coverage
Change Response
options to:
10 = Private –
Employer
11 = Private –
Individual
8 = Medicare Part
A/B
9 = Medicare Part D
12 = Medicaid, CHIP,
or other public plan
13 = VA, Tricare, or
other military health
care
14 = IHS
15 = Other Plan
16 = No
Insurance/uninsured
XX=Medicare Part C
XX=High Risk
Insurance
XX=Association Plan

with the
implementation of
ACA. In addition, it
makes more sense
for this to be
included as an
option Under
Medical Insurance.
Align name with RSR
Reporting
Medicare Part C
should be added to
ensure all types of
Medicare coverage
are available
selections. Add
High risk health
insurance as an
option for this
variable rather than
a separate variable.
Add association
plans

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
health plan (QHP) off
the ACA Marketplace
-Enrolled in any
other private
insurance (e.g.,
employer-sponsored
coverage)

Housing Status

Do not add

Not feasible to add
this additional field
since it’s not
collected in the
ADAP application.

Client-Level Data – Enrollment and Certification
#
14

Current
CY 2017
Variable
New
Enrollment
Flag

Final, December 26, 2019

Current Coding
0= No
1= Yes

Corresponding
NASTAD variable
Total number of new
clients enrolled in
your ADAP at any
point during calendar
year 2017 (i.e., clients
who were enrolled in
calendar year 2017
and were not enrolled
in calendar year 2016)
(this number should
include clients
enrolled in both your
ADAP-funded full-pay
medication program
and your ADAP-

4

Recommen
dation

Final decision on
variable and coding

Rationale / Where and
how used

No change
Change variable name
to: New Enrollment

Removing “flag” will
make it consistent with
other variable naming
conventions. This is not
duplicative of the
application received
date, since an
application can be
received for someone
who was previously
enrolled in ADAP.

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
funded insurance
program)
15

Application
Received
Date

Mm,dd,yyyy

Change variable name
to: Date Completed
Application Received.
More information
needed – see comment

16

Application
Approval
Date
Recertificati
on Date

Mm,dd,yyyy

No change

Enrollment
Status

8 = Enrolled, receiving
services
9 = Enrolled, on waiting list
10 = Enrolled services not
requested
11 = Disenrolled

17

18

Final, December 26, 2019

Mm,dd,yyyy

Total number of
unduplicated clients
enrolled in your
ADAP at any point
during calendar year
2017 who were
successfully
recertified twice in a
12-month period12
of time by ADAP (this
should include clients
enrolled in both your
ADAP-funded full-pay
medication program
and your ADAPfunded insurance
program)?
Total Number of
unduplicated clients
enrolled in your
ADAP at any point
during the calendar
year (this should
include clients
enrolled in both your

5

This helps us to
understand the time
that it takes to approve
an application. We can
include this on a
recipient level
summary for PO’s

No Change

Removing this variable
may indicate to
recipients that we are
not interested in
understanding
recertification’s.

Change variable name
to: Enrollment status at
the end of the calendar
year”

This change will clarify
the intent of
enrollment status

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
ADAP-funded fully
pay medication
program and your
ADAP-funded
insurance program)
19

Disenrollme
nt Reason

9 = Program eligibility criteria
changed, client Ineligible
10 = Client’s eligibility
changed, Ineligible due to
client no longer meeting
eligibility criteria
4 = Did not recertify
5 = Did not fill prescription as
required by program
6 = Deceased
7 = Dropped out, no reason
given
11 = Other/Unknown

Client-Level Data – Insurance Services
#
20

Current
CY 2017
Variable
Insurance
Assistance
Received
Flag

Final, December 26, 2019

Current Coding
0= No
1= Yes

Corresponding
NASTAD variable
Unduplicated
clients served
through an ADAP
funded insurance
program only at
any point in the
calendar year

6

Recommendatio
n

Change response
options to:
9 = Program eligibility
criteria changed, client
no longer eligible
10 = Client’s eligibility
changed, client no
longer meets eligibility
criteria
4 = Did not recertify
5 = Did not fill
prescription as
required by program
6 = Deceased
7 = Dropped out, no
reason given
11 = Other/Unknown
XX= Other
XX= Unknown

We are changing
response options 9 and
10 to clarify the intent
and improve accuracy
of reporting. We are
removing “Dropped
out, no reason given”
as this is very similar to
“unknown”. We are
separating “other” and
“unknown”, since these
have different
meanings

Final decision on
variable and coding

Rationale / Where and
how used

No change

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
67

Insurance
Assistance
Type

1 = Full Premium
payment
2 = Partial Premium payment
3 = Co-pay/deductible
including Medicare Part D coInsurance, co-payment, or
donut hole coverage.

21

Insurance
Premium
Amount

0-100,000

22

Insurance
Premium
Month
Count
Insurance
Deductible
and Copay

0-12

23

Final, December 26, 2019

0-100,000

Unduplicated
total number of
clients served
through ADAPfunded insurance
program who
had:
-Premium
payment made
on their behalf
only
-Deductible/copay/co-insurance
payment made
on their behalf
only
-Premium AND
deductible/copay/co-insurance
payment made
on their behalf
Total ADAP only
expenditures for
Insurance
premiums
(private, state
high-risk pools,
PCIPs, Medicare
Part D, and/or
Medicaid)

Change response
options to:
1 = Full Premium
payment
2 = Partial Premium
payment
3 = Medication copay/deductible
including Medicare Part
D co-Insurance, copayment, or donut hole
coverage

Adding “Medication” to
response option 3
provides additional
clarity in response
options.

No change

Since we will continue
to receive medication
costs, it would make
sense to also receiving
insurance assistance
costs

Total ADAP only
expenditures for
Insurance co-

Change variable name:
Medication
Copay/Deductible

7

No change

Clarifies meaning of
variable

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
Amount

Final, December 26, 2019

payments, coinsurance, and
deductibles
(private, State
high-risk pools,
Medicare Part D,
and/or Medicaid)

8

Amount

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
Client-Level Data – Drug and Drug Expenditure Elements
#
25

26

Current
CY 2017
Variable
Medication
Dispensed
Flag

Medication
ID

Final, December 26, 2019

Current Coding
0= No
1= Yes

Valid Dcode

Corresponding
NASTAD variable

Unduplicated
clients served
with full-pay
medications only
at any point in
the calendar year

9

Recommendatio
n

Final decision on
variable and coding

Rationale / Where and
how used

No change

Valid National Drug
Code (NDC)
All drugs paid by ADAP
will be reported rather
than a subset (A1OIs,
Hep B, Hep C and ARVs)

The NASTAD RFI
indicated that 75% of
recipients would see no
additional burden or
would experience a
reduction in burden if
HAB required NDCs
rather than Dcodes. In
addition, this will
improve our ability to
analyze some drug class
information (TAF and
TDF drugs) and it would
be timelier than Dcodes.
Internally, we will map
NDCs to RxNorm to
reduce our internal
analysis burden. DPD
will also work with our
contractor to ensure
that data volume can be
received. The RFI also
indicated that 75% of
recipients would not
experience an increased
burden by reporting

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
27

Medication
Start Dates

Mmddyy

Remove

28

Medication
days
Medication
Cost

0-365

Remove

29

0-100,000

Total ADAP only
expenditures for
Prescription
Drugs; Individual
Medication costs

No change

information on all drugs
paid by ADAP.
This variable is
challenging to analyze
and not currently used.
This information will be
detailed in the NDCs
Since we decided to
change reporting to
include all medications,
we plan to keep this
variable as is.

Client-Level Data – Clinical Information
#
32

Current
CY 2017
Variable
Last CD4
Date

Rationale / Where and
how used

mm,dd,yyyy

Change to: CD4 Date
Report all CD4s for all
clients, regardless of
the type of service that
the clients receive
Change to: CD4 Count
Report all CD4s for all
clients, regardless of
the type of service that
the clients receive

We assume that the
impact for CD4s will be
similar to the impact for
viral loads. To ensure
consistency, we are
proposing to include
CD4s for all clients.
We assume that the
impact for CD4s will be
similar to the impact for
viral loads. To ensure
consistency, we are
proposing to include
CD4s for all clients.
The NASTAD RFI
indicated that 75% of
recipients would see no
additional burden or

33

Last CD4
Count

0-100,000,000

34

Last VL
Date

mm,dd,yyyy

Final, December 26, 2019

Corresponding
NASTAD variable

Final decision on
variable and coding

Current Coding

N/A

Recommendatio
n

Change to: VL Date
Report all VLs for all
clients, regardless of
the type of service that

10

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
#

35

Current
CY 2017
Variable

Last VL
Count

Final, December 26, 2019

Current Coding

Corresponding
NASTAD variable

Recommendatio
n

Final decision on
variable and coding
the clients receive

0-100,000,000

<=200
>200
Unknown/Unrep
orted

11

Change to: VL Count
Report all VL for all
clients, regardless of
the type of service that
the clients receive

Rationale / Where and
how used
would experience a
reduction in burden if
HAB required reporting
of viral loads for all
clients. In addition, this
will support our
understanding of client
outcomes and program
impact
The NASTAD RFI
indicated that 75% of
recipients would see no
additional burden or
would experience a
reduction in burden if
HAB required reporting
of viral loads for all
clients. In addition, this
will support our
understanding of client
outcomes and program
impact

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
Grantee Report

Current
CY 2016 Variable

Current Coding

Grantee Name

Corresponding NASTAD
variable

State/Territory for which this
information is reported

Recommendation

Final decision on
variable and
coding
No Change

Grant Number

No Change

DUNS Number

No Change

Grantee Address
Street
City
State
Zip code
Contact information of
person responsible for
submission
Name
Title
Email
Phone
Fax
ADAP Limits: Indicate
whether your program has
adopted any of the
following limits to control
cost

No Change

Name of person completing this
survey; email address of the
person completing this survey

Select all that apply:
• Waiting list;
• Enrollment cap;
• Capped number of
prescriptions per month;
• Capped expenditures;
• Drug-Specific Enrollment
caps for ARVs, Heb/C
meds;
• Formulary Reduction;
• Decrease in financial
eligibility criteria;
• None of these limits were
applied to the ADAP

Final, December 26, 2019

No Change

No Change

12

Rationale / Where
and how used

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
during the reporting
period
NEW

Has your ADAP
experienced an
unexpected increase in
enrolled clients
If yes, how many new
clients were enrolled

NEW
If your ADAP has capped
expenditures, enter the
monetary cap per client
If your ADAP has capped
expenditures, enter
whether the cap applies
monthly/annually
If your ADAP has adopted
drug-specific enrollment
caps, indicate the
medications for which you
have enrollment caps.
ADAP income eligibility

Yes/No

Integer
No Change
No Change

Month
Annual

No Change

% (of FPL)

Final, December 26, 2019

Full-Pay Medications Program
• 100% FPL
• 200% FPL
• 250% FPL
• 300% FPL
• 350% FPL
• 400% FPL
• 450% FPL
• 500% FPL
• Other
ADAP Funded Insurance
Program
• 100% FPL
• 200% FPL
• 250% FPL
• 300% FPL
• 350% FPL

13

No Change

*NASTAD collects
a separate question:
How client’s
income is
calculated (check
all that apply)

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting

Clinical criteria required to
access ADAP

If CD4 criteria, please
specify the CD4 count
requirement
If Viral load criteria,
please specify the VL
count requirement
If other clinical
criteria, please
specify
Drug pricing cost-saving
strategies

ADAP funding received
during the reporting
period

Select all that apply:
• CD4
• Viral load
• Other
• No clinical eligibility
criteria are required
to enroll in ADAP

•
•
•
•

400% FPL
450% FPL
500% FPL
Other

Remove

Remove
Remove
Remove

Select all that apply:
• 340B Rebate
• 340B Direct Purchase
• 340 B Direct
Purchase Prime
vendor
• Department of
defense
Enter amounts received for:
-Total contributions from Part
A EMA(s)/TGA(s)
-Total contributions from Part
B Base Funding

Final, December 26, 2019

No Change

Amount Received or
Anticipated*:
FY2018 Part A
contribution allotted to
ADAP

No Change

FY2018 Part B Base allotted to
ADAP (local decision)

14

Remove

This can be taken
from the allocations
reports.

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting

- Total contributions from
Part C/D grantees

FY2018 Part B Supplemental
allotted to ADAP (local
decision)
*Would be included in Other
ADAP funds

State General fund
contributions

State general revenue funding
allocated to ADAP

Carry-over of Ryan White
funds from previous year

Federal carry-over to be used
for ADAP – from prior Part B
base or ADAP awards
Estimated rebates/wholesaler
credits to be used for ADAP,
including rebates on partial
payments (for both rebate and
direct purchase states)

- Total contributions from Part
B Supplemental Funding

Manufacture Rebates
reinvested in the ADAP

All insurance reimbursements,
excluding Medicaid
Medicaid reimbursements
Expenditures Category

Enter total expenditures for:
• Full pay medication
assistance
• Dispensing costs
• Other administrative
costs
• Health insurance
assistance (including
co-pays, deductibles
and premiums)

ADAP Formulary

List of generic, brand name,
Dcodes, box to indicate that it

Final, December 26, 2019

Private Insurance
Reimbursements; Other (e.g.
Medicare and the Veterans
Administration)
Medicaid Reimbursements,
including back-billing
Total ADAP Program
Expenditures:
• Prescription drugs
• Prescription
dispensing costs
• Insurance Premiums
• Insurance Deductibles
• Insurance Copayments
• Program Insurance

Remove
Change variable
name to: Total
contributions from
Part C and/or D
grantees
No Change
No Change
Change to:
Manufacture
rebates and
program income
reinvested in
ADAP
No change

No change
No change

Add additional
medications to

15

This can be taken
from the allocations
reports.

Explore costs
associated with

HRSA HAB’s AIDS Drug Assistance Report Office of Management and Budget Data Reporting Changes –
2021 Reporting
selectable drugs for
formulary

was added in the grant year
and date added

Does your ADAP
have an open
formulary,
inclusive of all
FDA approved
medications

New

*Budgeted not expenditures

Final, December 26, 2019

16

uploading a
standardized list of
drugs on formulary