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HIV/AIDS Bureau, Division of State HIV/AIDS ProgramsNational Monitoring Standards for Ryan White Part B Grantees:Program – Part BTable of ContentsSection A: Allowable Uses of Part B Service FundsSection B: Core Medical-related ServicesSection C: Support ServicesSection D: Quality ManagementSection E: AdministrationSection F: Other Service RequirementsSection G: Prohibition on Certain ActivitiesSection H: Chief Elected Official (CEO) Agreements & AssurancesSection I: Minority AIDS InitiativeSection J: Data Reporting RequirementsSection K: ConsortiaSection L: AIDS Drug Assistance Program (ADAP)Section M: State ApplicationStandardPerformance Measure/Method“On December 26, 2013, the Office of Management and Budget (OMB) published newguidance for Federal award programs, OMB Uniform Guidance: AdministrativeRequirements, Cost Principles, and Audit Requirements for Federal Awards (Guidance),2 CFR Part 200. The Guidance will supersede and streamline requirements from OMBCirculars A-21, A-87, A-110, A-122, A-89, A-102 and A-133 and the guidance in CircularA-50 on Single Audit Act follow-up. It is a key component of a larger Federal effort tomore effectively focus Federal grant resources on improving performance andoutcomes while ensuring the financial integrity of taxpayer dollars. Please note thatthe Uniform Guidance will not apply to grants made by the Department of Health andHuman Services until adopted by HHS through a Federal Register Notice. That Notice,which will be published in late 2014, will indicate the date on which the Guidanceapplies to HHS grant funds. Until that time HRSA grantees must comply with therequirements in the current circulars listed esponsibilitySourceCitationSection A:Allowable Uses ofPart B Service Funds1. Use of Part B fundsonly to support:1RFP, contract, MOU/LOAand/or statements of workInclude in RFP, contract,MOU/LOA and/or Provide the servicesdescribed in the in1* PHS ACT 2612(a-d)All statutory citations are to title XXVI of the Public Health Service Act, 42 U.S.C. § 300ff-11 et seq, and are abbreviated with “PHS ACT XXXX” and the section reference.HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 20131
Standard Core medical servicesSupport services thatare needed byindividuals withHIV/AIDS to achievemedical outcomesrelated their HIV/AIDSrelated clinical status(Note: All servicesprovided throughconsortia areconsidered to besupport services)Clinical qualitymanagement activitiesPlanning and evaluationPart B base servicesshall be providedthrough the followingPart B Components:o HIV Consortiao Home andcommunity basedcareo Provision oftreatmentso State DirectServicesPerformance nteeResponsibilitylanguage that describes anddefines Part B services withinthe range of activities and usesof funds allowed under thelegislation and defined inHRSA Policy Notices includingcore and support services,quality management activities,administration, and planningand evaluationstatements of worklanguage that allows use ofPart B funds only for theprovision of services andactivities allowed under thelegislation and defined inreferenced Policy NoticesRFP, contract,MOU/LOA and/orstatements of worklanguage Bill only for allowableactivities Maintain in files, andshare with the granteeon request,documentation thatonly allowable activitiesare being billed to thePart B grantSection B: CoreMedical-relatedSourceCitationPHS ACT 2618 (45)HAB Policy Notices97-01, 97-02, and10-02Dr. ParhamHopson Letter8/14/09, 4/8/10PHS ACT 2612(b)(1)2HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
StandardPerformance nteeResponsibilitySourceCitationDocumentation of thefollowing: Care is provided by healthcare professionals certifiedin their jurisdictions toprescribe medications in anoutpatient setting such as aclinic, medical office, ormobile van Only allowable services areprovided Services are provided aspart of the treatment of HIVinfection Specialty medical carerelates to HIV infectionand/or conditions arisingfrom the use of HIVmedications resulting inside effects Services are consistent withHHS Guidelines Service is not beingprovided in an emergencyroom, hospital or any othertype of inpatient treatmentcenter Include the definition,allowable services, andlimitations of outpatientambulatory medicalservices in the RFP,contract, MOU/LOAand/or statements ofwork language Require subgrantees toprovide assurances thatcare is provided only inan outpatient setting, isconsistent with HRSAand HHS Guidelines,and is chronicled in clientmedical records Review client medicalrecords to ensurecompliance with contractconditions and RyanWhite programrequirements Review the licensure ofhealth care professionalsproviding ambulatorycare Ensure that clientmedical recordsdocument servicesprovided, the dates andfrequency of servicesprovided, that serviceare for the treatment ofHIV infection Include clinician notesin patient records thatare signed by thelicensed provider ofservices Maintain professionalcertifications andlicensure documentsand make themavailable to the granteeon requestPHS ACT 2612(b)(3)(A)Services1. Provision of Outpatientand AmbulatoryMedical Care, definedas the provision ofprofessional diagnosticand therapeuticservices rendered by alicensed physician,physician's assistant,clinical nurse specialist,or nurse practitioner inan outpatient setting(not a hospital, hospitalemergency room, orany other type ofinpatient treatmentcenter), consistent withPublic Health Service(PHS) guidelines andincluding access toantiretroviral and otherdrug therapies,including prophylaxisand treatment ofopportunistic infectionsand combinationantiretroviral therapiesAllowable services include: Diagnostic testing Early intervention and3HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
StandardPerformance nteeResponsibilitySourceCitationrisk assessment, Preventive care andscreening Practitioner examination,medical history taking,diagnosis and treatmentof common physical andmental conditions Prescribing andmanaging of medicationtherapy Education andcounseling on healthissues Well-baby care Continuing care andmanagement of chronicconditions Referral to and provisionof HIV-related specialtycare (includes allmedical subspecialtieseven ophthalmic andoptometric services)4HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Performance nteeResponsibility2. As part of Outpatientand Ambulatory MedicalCare, provision oflaboratory testsintegral to the treatmentof HIV infection andrelated complicationsDocumentation that tests are: Integral to the treatment ofHIV and relatedcomplications, necessarybased on establishedclinical practice, andordered by a registered,certified, licensed provider Consistent with medical andlaboratory standards Approved by the Food andDrug Administration (FDA)and/or Certified under theClinical LaboratoryImprovement Amendments(CLIA) ProgramDocument, include inclient medical records, andmake available to thegrantee on request: The number oflaboratory testsperformed The certification,licenses, or FDAapproval of thelaboratory from whichtests were ordered The credentials of theindividual ordering thetestsHAB Policy Notice07-023. Funding allocated to aState-supported AIDSDrug AssistanceProgram (ADAP) thatprovides an approvedformulary ofmedications to HIVinfected individuals forthe treatment of HIVdisease or theprevention ofopportunistic infections,based on eligibilitydetermination criteria,Documentation by the State of: A medication formulary thatincludes pharmaceuticalagents from all the classesapproved in PHS ClinicalPractice Guideliness for useof Antiretroviral Agents inHIV-1 infected Adults andAdolescentsA medicationformulary that meets theminimum requirements fromall approved classes ofmedications according toPHS treatment guidelines. Include the HRSAapproved servicecategory definition,requirements, andlimitations of testing inmedical servicescontract Develop and share withproviders a listing oflaboratory tests thatmeet these definitions Document the number oflaboratory testsperformed Review client records toensure requirements aremet and match quantityof tests with reportsProvide documentation thatthe ADAP program meetsfederal requirements,including:o Use of an approvedmedical formularybased on purchase ofHIV medicationsincluded in the list ofclasses of coreantiretroviral foreligible clients in acost-effective mannero Use of medications Provide to the Part Bgrantee, on request,documentation that theADAP program meetsHRSA/HABrequirements Maintaindocumentation, andmake available to thePart B grantee onrequest, proof of clientADAP eligibility thatincludes HIV status,residency, and low-PHS ACT 2612(b)(3)(B)StandardSourceCitationPHS ACT 2616HAB Policy Notice07-035HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Performance Measure/MethodStandardincome guidelines andFederal Poverty Level(FLP) threshold set bythe State4. Implementation of aLocal AIDSPharmaceuticalAssistance Program(LPAP) for the provision Policies and procedures toassure adherence to 5-10percent of the State’s totalADAP funding An eligibility determinationprocess requiringdocumentation in clientmedical records of lowincome status and eligibilitybased on a specifiedpercent of the FPL andproof of an individual’s HIVpositive status, residency. A process used to securethe best price available forall products including 340Bpricing or better Documentation that the(LPAP) program’s drugdistribution system has:o A client enrollment andeligibility determinationGranteeResponsibilitythat are FDAapprovedo Use of Federal fundsto match and expandthe purchase of HIVmedications and notdisplace State fundingfor the same purposeo Determination anddocumentation ofclient eligibility everysix ionincome status asdefined by the Statebased on a specifiedpercent of the FPL Provide reports to thePart B program ofnumber of individualsserved and themedications providedRequire reporting on clienteligibility, clients served,and medications providedNote: In cases whereConsortium contributes tothe State ADAP, theConsortium becomes a PartB provider and must providedocumentation to the Part BProgram to ensureallowable use of funds,report costs, and ensureclient eligibility Include a statement ofneed in the RFP,contract, MOU/LOAand/or statements ofwork language Provide to the Part Bgrantee, on request,documentation that theLPAP program meetsHRSA/HABPHS ACT 2612(b)(3)(C)HAB plans to issuefuture guidanceregarding this6HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Performance Measure/MethodStandard of HIV/AIDSmedications using adrug distribution systemthat has:A client enrollment andeligibility determinationprocess that includesscreening for ADAP andLPAP eligibility withrescreening at minimumof every six monthsA LPAP advisory boardUniform benefits for allenrolled clientsthroughout theConsortium regionCompliance with RyanWhite requirement ofpayer of last resortUniform benefits for allenrolled clientsA drug formularyapproved by the localadvisorycommittee/boardA recordkeeping systemfor distributedmedicationsA drug distributionsystemLPAP does not dispenseooooo process that includesscreening for ADAP andLPAP eligibility withrescreening every sixmonthsA LPAP advisory boardUniform benefits for allenrolled clientsthroughout theConsortium regionCompliance with RyanWhite requirement ofpayer of last resortA recordkeeping systemfor distributedmedicationsA drug distributionsystem that includes adrug formulary approvedby the local advisorycommittee/boardDocumentation that theLPAP is not dispensingmedications as:o A result or component ofa primary medical visito A single occurrence ofshort duration (anemergency) withoutarrangements for longerterm access toGranteeResponsibility Specify in the RFP,contract, MOU/LOAand/or statements ofwork language all applicable federal,state, and localrequirements forpharmaceuticaldistribution systems andthe geographic area tobe covered Ensure that the program:o Meets federalrequirementsregarding clientenrollment, uniformbenefits,recordkeeping, anddrug distributionprocess, consistencywith current HIV/AIDSTreatment Guidelines,consistency withpayer of last resorto Has consistentprocedures/ systemsthat account fortracking and reportingof expenditures andincome, drug pricing,client utilization, clienteligibility and ts Maintaindocumentation, andmake available to thePart B grantee onrequest, proof of clientLPAP eligibility thatincludes HIV status,residency, medicalnecessity, and lowincome status asdefined by theConsortium or Statebased on a specifiedpercent of the FederalPoverty Level (FPL) Provide reports to thePart B program ofnumber of individualsserved and themedications providedSourceCitationservice category.7HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standardmedications as: A result or componentof a primary medicalvisit A single occurrence ofshort duration (anemergency) Vouchers to clients onan emergency basisA Program that is: Consistent with themost current HIV/AIDSTreatment Guidelines Coordinated with theState’s Part B AIDSDrug AssistanceProgram Implemented inaccordance withrequirements of the340B Drug PricingProgram, Prime VendorProgram and/orAlternative MethodsProjectPerformance Measure/MethodGranteeResponsibilitymedicationo Vouchers to clients on asingle occurrencewithout arrangements forlonger-term access tomedications Documentation that theLPAP Program is:o Consistent with the mostcurrent HIV/AIDSTreatment Guidelineso Coordinated with theState’s Part B AIDS DrugAssistance Programo Implemented inaccordance with5requirements of 340BDrug Pricing Program,Prime Vendor Programand/or AlternativeMethods Projectclinical qualitymanagemento Defines thegeographic areacovered by the localpharmacy program,which must be eithera TGA/EMA orconsortium area Does not dispensemedication as the resultof a primary care visit, inemergency situations orin the form of medicationvouchers to clients on asingle occurrencewithout arrangementsfor longer term accessto medications Review program files toensure that distributedmedications meet federaland contractrequirements Review client records toensure properenrollment, eligibilitydetermination, uniformbenefit, no dispensing ofmedications forunallowable purposes,no duplication of ation8HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standard5. Support for Oral HealthServices includingdiagnostic, preventive,and therapeutic dentalcare that is incompliance with dentalpractice laws, includesevidence-based clinicaldecisions that areinformed by theAmerican DentalAssociation DentalPractice Parameters,is based on an oralhealth treatment plan,adheres to specifiedservice caps, and isprovided by licensedand certified dentalprofessionalsPerformance Measure/MethodGranteeResponsibilityDocumentation that: Oral health services areprovided by general dentalpractitioners, dentalspecialists, dentalhygienists and auxiliariesand meet current dentalcare guidelines Oral health professionalsproviding the services haveappropriate and validlicensure and certification,based on State and locallaws An oral health treatmentplan is developed for eacheligible client and signed bythe oral health professionalrendering the services Services fall within specifiedservice caps, expressed by LPAPs need to beimplemented inaccordance withrequirements of the 340BDrug Pricing Program,Prime Vendor Programand/or AlternativeMethods Project in orderto ensure “best Price” tomaximize theseresources. Develop a RFP, contract,MOU/LOA, and/orscopes of work for theprovision of oral healththat:o Specify allowablediagnostic, preventive,and therapeuticserviceso Define and specify thelimitations or caps onproviding oral healthserviceso Ensure that servicesare provided by dentalprofessionals certifiedand licensedaccording to stateguidelines Review client recordsand treatment plans forProvider/SubgranteeResponsibilitySourceCitation Maintain a dental file foreach client that issigned by the licensedprovider and includes atreatment plan, servicesprovided, and anyreferrals made Maintain, and provideto grantee on request,copies of professionallicensure andcertificationPHS ACT 2612(b)(3)(D)9HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standard6. Support of EarlyIntervention Services(EIS) that includeidentification ofindividuals at points ofentry and access toservices and provisionof: HIV Testing andTargeted counseling Referral services Linkage to care Health education andliteracy training thatenable clients tonavigate the HIV systemof careNote: All four componentsmust be present, but Part Bfunds to be used for HIVtesting only as necessary tosupplement, not supplant,existing fundingPerformance Measure/Methoddollar amount, type ofprocedure, limitations on thenumber of procedures, or acombination of any of theabove, as determined bythe granteeDocumentation that: Part B funds are used forHIV testing only whereexisting federal, state, andlocal funds are notadequate, and Ryan Whitefunds will supplement andnot supplant existing fundsfor testing Individuals who test positiveare referred for and linkedto health care andsupportive services Health education andliteracy training is providedthat enables clients tonavigate the HIV system EIS is provided at or incoordination withdocumented key points ofentry EIS services arecoordinated with HIVprevention efforts eResponsibilitySourceCitation Establish memorandaof understanding(MOUs) with key pointsof entry into care tofacilitate access to carefor those who testpositive Document provision ofall four required EISservice components,with Part B or otherfunding Document and reporton numbers of HIVtests and positives, aswell as where andwhen Part B-fundedHIV testing occurs Document that HIVtesting activities andmethods meet CDCand state requirements Document the numberof referrals for healthcare and supportiveservicesPHS ACT 2612(b)(3)(E)compliance with contractconditions and RyanWhite programrequirements Include the RFP,contract, MOU/LOAand/or statements ofwork language that: Specifies that Part Bfunding is to be used tosupplement and notsupplant existing federal,state, or local funding forHIV testing Provides definitions anddescription of EISservices (funded throughRyan White or othersources) that include andare limited to counselingand HIV testing, referralto appropriate servicesbased on HIV status,linkage to care, andeducation and healthliteracy training forclients to help themnavigate the HIV caresystemPHS ACT 2612 (d)(1-2)Additional policyguidanceforthcoming,includingexpectations forHealth educationand literacytraining, which arenot covered in thelegislation.10HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standard7. Provision of HealthInsurance Premiumand Cost-sharingAssistance thatprovides a cost effective alternative toADAP by: Purchasing healthinsurance that providesPerformance Measure/Method Documentation of anannual cost-benefitanalysis illustrating thegreater benefit inpurchasing public or privatehealth insurance, pharmacybenefits, co-pays and ordeductibles for eligible lowincome clients, sponsibility Specifies that servicesshall be provided atspecific points of entry Specifies requiredcoordination with HIVprevention efforts andprograms Requires coordinationwith providers ofprevention services Requires monitoring andreporting on the numberof HIV tests conductedand the number ofpositives found Requires monitoring ofreferrals into care andtreatment Document referralsfrom key points of entryto EIS programs Document training andeducation sessionsdesigned to helpindividuals navigateand understand the HIVsystem of care Establish linkageagreements with testingsites where Part B isnot funding testing butis funding referral andaccess to care,education, and systemnavigation services Obtain written approvalfrom the grantee toprovide EIS services inpoints of entry notincluded in originalscope of work Conduct an annual costbenefit analysis (if notdone by the grantee)that addresses notedcriteria Where premiums arecovered by Ryan Whitefunds, provide proofthat the insuranceInclude RFP, contract,MOU/LOA and/or statementof work language that: Specify that Part Bfunding is to be used tosupplement and notsupplant existingfederal, state, or localfunding for HealthSourceCitationPHS ACT 2612(b)(3)(F)PHS ACT 2615HAB Policy Notice10-02Affordable Care Actof 201011HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standardcomprehensive primarycare and pharmacybenefits for low incomeclients that provide a fullrange of HIVmedications Paying co-pays(including co-pays forprescription eyewear forconditions related to HIVinfection) anddeductibles on behalf ofthe client Providing funds tocontribute to a client’sMedicare Part D trueout-of-pocked (TrOOP)costs 2Performance Measure/Method 2to the costs of having theclient in the ADAP programWhere funds are coveringpremiums, documentationthat the insurance planpurchased providescomprehensive primarycare and a full range of HIVmedicationsWhere funds are used tocover co-pays forprescription eyewear,documentation including aphysician’s writtenstatement that the eyecondition is related to HIVinfectionAssurance that any costassociated with thecreation, capitalization, oradministration of a liabilityrisk pool is not beingfunded by Ryan WhiteAssurance that Ryan Whitefunds are not being used tocover costs associated withSocial SecurityDocumentation of clients’low income status asdefined by the State RyanGranteeResponsibility Insurance Premium andcost-sharing assistanceEnsure an annual costbenefit analysis thatdemonstrates the greaterbenefit of using RyanWhite funds forInsurance/Cost-SharingProgram versus havingthe client on ADAPMonitor providerdocumentation of the lowincome status of theclientWhere funds are used tocover the costsassociated withinsurance premiums,ensure thatcomprehensive primarycare services and a fullrange of HIV medicationsare available to clientsEnsure RFP, contract,MOU/LOA and/orstatement of worklanguage contains cleardirectives on thepayment of premiums,co-pays (including co-Provider/SubgranteeResponsibilitypolicy providescomprehensive primarycare and a formularywith a full range of HIVmedications Maintain proof of lowincome status, Provide documentationthat demonstrates thatfunds were not used tocover costs associatedwith the creation,capitalization oradministration of aliability risk pools, orsocial security costs When funds are used tocover co-pays forprescription eyewear,provide a physician’swritten statement thatthe eye condition isrelated to HIV infectionSourceCitationDr. ParhamHopson Letter3/15/2011Allowable use of Ryan W hite funds as of January 1, 2011 as specified in the Affordable Care Act.12HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
StandardPerformance Measure/MethodGranteeResponsibilityWhite Program 8. Support for HomeHealth Care servicesprovided in the patient’shome by licensed healthcare workers such asnurses; services toexclude personal careand to include: The administration ofintravenous andaerosolized treatment Parenteral feeding Diagnostic testing Other medical therapiesAssurance that: Services are limited tomedical therapies in thehome and exclude personalcare services Services are provided byhome health care workerswith appropriate licensureas required by State andlocal laws9. Provision of Home andCommunity-basedHealth Services, Documentation that:o All services are providedbased on a written care pays for prescriptioneyewear for conditionsrelated to HIV infection)and deductiblesMonitoring systems tocheck that funds areNOT being used for thecreation, capitalization,or administration ofliability risk pools, socialsecurity and or MedicarePart D costs includingTrOOP or donut holecostsSpecify in the RFP,contract, MOU/LOAand/or statement of worklanguage cleardefinitions of services tobe provided and staffingand licensurerequirementsReview client records todetermine compliancewith contract conditionsand Ryan White programrequirementsReview licenses andcertificatesSpecify in the RFP,contract, MOU/LOAand/or statement of n Document the numberand types of services inthe client records, withthe provider’s signatureincluded Maintain on file andprovide to the granteeon request copies ofthe licenses of homehealth care workersPHS ACT 2612(b)(3)(G) Ensure that written careplans with appropriatecontent and signaturesPHS ACT 2612(b)(3)(J)PHS ACT 261413HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standarddefined as skilled healthservices furnished in thehome of an HIV-infectedindividual, based on awritten plan of careprepared by a casemanagement team thatincludes appropriatehealth careprofessionalsAllowable services toinclude: Durable medicalequipment Home health aide andpersonal care services Day treatment or otherpartial hospitalizationservices Home intravenous andaerosolized drug therapy(including prescriptiondrugs administered aspart of such therapy) Routine diagnostictesting Appropriate mentalhealth, developmental,and rehabilitationservices Specialty care andPerformance Measure/MethodGranteeResponsibilityplan signed by a casemanager and a clinicalhealth care professionalresponsible for theindividual’s HIV care andindicating the need forthese serviceso The care plan specifiesthe types of servicesneeded and the quantityand duration of serviceso All planned services areallowable within theservice category Documentation of servicesprovided that:o Specifies the types,dates, and location ofserviceso Includes the signature ofthe professional whoprovided the service ateach visito Indicates that all servicesare allowable under thisservice category Provides assurance that theservices are provided inaccordance with allowablemodalities and locationsunder the definition of homeand community basedlanguage of whatservices are allowable,the requirement that theybe provided in the homeof a client with HIV/AIDS,and the requirement for awritten care plan signedby a case manager anda skilled health careprofessional responsiblefor the individual’s HIVcare Review program files andclient records to ensurethat treatment plans areprepared for all client andthat they include:o Need for home andcommunity-basedhealth serviceso Types, quantity andlength of time servicesare to be provided Review client records todetermine:o Services provided,dates, and locationso Whether servicesprovided wereallowableo Whether they wereProvider/SubgranteeResponsibility SourceCitationare consistentlyprepared, included inclient records, andupdated as neededEstablish and maintaina program and clientrecordkeeping systemto document the typesof home servicesprovided, datesprovided, the location ofthe service, and thesignature of theprofessional whoprovided the service ateach visitMake available to thegrantee program filesand client records asrequired for monitoringProvide assurance thatthe services are beingprovided only in anHIV-positive client’shomeMaintain, and makeavailable to the granteeon request, copies ofappropriate licensesand certifications forprofessionals providingservices14HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standardvaccinations for hepatitisco-infection, provided bypublic and privateentities10. Provision of HospiceCare provided bylicensed hospice careproviders to clients inthe terminal stages ofillness, in a home orPerformance Measure/Methodhealth servicesDocumentation ofappropriate licensure andcertifications for individualsproviding the services, asrequired by local and statelaws Documentation includingthe following:o Physician certificationthat the patient’s illnessis terminal as definedunder Medicaid ponsibilityconsistent with thetreatment plano Whether the fileincludes the signatureof the professionalwho provided theservice Require assurance thatthe service is beingprovided in accordancewith the type of locationsallowable under thedefinition of Home andCommunity BasedHealth Services. Reviewlicensure andcertifications to ensurecompliance with localand state laws Give priorities in fundingto entities that will assureparticipation in HIV careconsortia where theyexist and provide theservice to low-incomeindividuals Specify in the RFP,contract, MOU/LOAand/or statements ofwork language onallowable services,service standards, Obtain and haveavailable for inspectionappropriate and validlicensure to providehospice care Maintain and provideSourceCitationPHS ACT 2612(b)(3)(I)HAB Policy Notice10-0215HRSA/HAB Division of State HIV/AIDS ProgramsNational Monitoring Standards – Program Part BApril, 2013
Standardother residential setting,including a non-acutecare section of
an ou tpa ient se ng, s cons is tent w h HRSA and HHS Guidelines, and is chron led n lient medical reco ds Review client medical records to ensure compliance with contract conditions and Ryan White program requirements Review the licensure of health care professionals providing ambulatory . care Ensure that client edical reco ds
