ADAP Manual - 2003 Version

I.  General Information  

5.  Division of Service Systems (DSS) Overview

Chapter Summary
Introduction

1. Structure of DSS
2. Requesting Technical Assistance
3. References

Chapter Summary TOP

Within the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB), the Division of Service Systems has primary responsibility for the AIDS Drug Assistance Program (ADAP) under the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act Title II Program.

This chapter highlights the Division of Service Systems--its organization, programs, and personnel. The administration of the ADAP program is described, with emphasis on grantee monitoring by ADAP Branch staff.

Introduction TOP

The Division of Service Systems (DSS) administers Titles I, II, and the AIDS Drug Assistance Program (ADAP) of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. DSS is a division of the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB).

Structure of DSS  TOP

DSS is comprised of the Office of the Director and three branches: the AIDS Drug Assistance Program (ADAP) Branch, the Eastern Services Branch, and the Western Services Branch. These three branches work with the Office of the Director to administer Titles I and II (including ADAP) of the CARE Act.

For further information about these titles, please see Section 1, Chapters 2, and 4 in this manual.

Office of the Director

The Office of the Director (OD) administers DSS programs and activities and manages funds and other resources related to the provision of coordinated comprehensive HIV health care and support services. Specifically, the OD directs and manages the implementation of Parts A and B of Title XXVI of the Public Health Service Act, including Emergency Relief Grants (Title I), HIV CARE Grants (Title II), and State ADAPs.

Project Officers

Project officers within DSS are the primary contacts for information needed by grantees, planning councils, or other Title I or Title II representatives, including ADAP coordinators. Project officers can be reached at the following address:

HRSA, HIV/AIDS Bureau, Division of Service Systems
Parklawn Building
Room 7A-55
5600 Fishers Lane
Rockville, MD 20857

Telephone (301) 443-6745
Fax (301) 443-5271

Project officers have principal responsibility for monitoring programmatic performance of grantees and orchestrating needed technical assistance. They work closely with HAB’s Office of Grants Management to monitor grantee expenditure of Titles I and II funds and to ensure compliance with various conditions of award. In fulfi lling their grantee responsibilities, project officers represent the concerns and perspectives of grantees in DSS and HAB initiatives. They actively participate on crosscutting issues within workgroups at the division, bureau, and agency levels.

Project officers communicate DSS policies and priorities to grantees for program
implementation. Specifically, project officers are responsible for the following:

• maintaining and documenting ongoing and direct interaction with grantees, including site visits and telephone contact;
• reviewing grantee-specific submissions, such as applications, needs assessments, and comprehensive plans;
• identifying and responding to specific grantee technical assistance needs; and
• monitoring grantee compliance with statutory requirements of the legislation.

ADAP Branch Staff

ADAP Branch staff partner with DSS project officers to monitor ADAP programs through activities including site visits, telephone consultations, review of ADAP related submissions to DSS, and identification and provision of technical assistance. ADAP staff members are also responsible for tracking ADAP Monthly Report (AMR) submissions and aggregating this information to determine national trends in client utilization, program funding, and other characteristics of ADAPs.

Monitoring Calls

Project officers and ADAP staff conduct regularly scheduled monitoring calls with States to review Title II and ADAP activities and assess any technical assistance needs. The following issues are frequently raised during these calls:

ADAP Monthly Report (AMR)

• clarification needed regarding specific answers on the AMR

Best Price Concerns

• Section 340B Drug Discount Program participation issues, including the ADAP rebate option
• additional rebates/discounts independently negotiated
• other administrative or distribution costs that impact best price decisions (e.g., wholesalers, shipping costs)

TA Needs

• identification of technical assistance to help in the effective administration of the ADAP Advisory Committee
• meeting schedule, recent meetings, and major issues it is addressing Clinical Guidelines
• provider education
• formulary decisions
• impact of changes

Demographics/Review of AMR Trends

• specific trends in patterns of new enrollees
• comparison of enrollment demographics to overall epidemiological demographics
• new patterns of specific drug utilization in individual State

Requesting Technical Assistance TOP

Title I and Title II grantees and planning councils may request technical assistance from DSS. Such assistance may be provided by a DSS project officer, ADAP staff member, or through peer or other expert technical assistance provided through the Technical Assistance Contract (see Section VIII, “Available ADAP Technical Assistance Materials,” in this manual). Contact your project officer at DSS to request technical assistance.

References TOP

Sources Used for This Chapter

HRSA, HIV/AIDS Bureau, Division of Service Systems. “Division of Service Systems (DSS) Overview.” Ryan White Care Act Title II Manual. Rockville, MD: U.S. Department of Health and Human Services, 1999; revised 2002.