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H H S Department of Health and Human Services
Health Resources and Services Administration
HIV/AIDS Programs

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ADAP Manual - 2003 Version

VIII.  Available ADAP Technical Assistance Materials

1.  HIV/AIDS Bureau Technical Assistance Contract (TAC)

Chapter Summary
Introduction

  1. Legislative Background
  2. TAC Contract History
  3. TA Philosophy
  4. TA Topic Areas
  5. How TA is Provided
  6. References

 Chapter Summary  TOP

This chapter explains how the Health Resources and Services Administration’s (HRSA) HIV/AIDS Bureau (HAB) utilizes the Technical Assistance Contract (TAC) to provide Technical Assistance (TA)—including on-site TA and TA products—to Ryan White Comprehensive AIDS Resources Emergency (CARE) Act grantees, including AIDS Drug Assistance Programs (ADAPs).

 Introduction  TOP

The Technical Assistance Contract (TAC) is a tool for the Health Resources and Services Administration's (HRSA) HIV/AIDS Bureau (HAB). The TAC is utilized—typically by HAB's Division of Service Systems (DSS) project officers—to provide CARE Act grantees and planning bodies with on-site technical assistance (TA) and to develop TA products that have usefulness across all of HRSA's HIV/AIDS programs. For State ADAPs, The Technical Assistance Contract (TAC) assistance focuses primarily on implementing CARE Act requirements, in order to improve health care access and the quality of life for persons living with HIV (PLWH). Technical Assistance is defined by HRSA/HAB as identifying TA needs and delivering program and technical support to the CARE Act community for their planning and primary care service delivery systems.

The TAC is administered by HRSA's HAB's Division of Training and Technical Assistance (DTTA). The contractor responsible for coordinating and administering the TAC on behalf of DTTA is BETAH, Associates, Inc.

 Legislative Background  TOP

The CARE Act calls for HRSA to provide TA—including assistance through grantees (peer consultation)—to CARE Act programs (e.g., Title I, Section 2606; Title II, Section 2619; Title II, Section 2654(b); Title IV, Section 2671(I)). DTTA supports and manages the training and TA needs of CARE Act entities under Titles I, II, III, IV, Special Projects of National Significance (SPNS), AIDS Education Training Centers (AETCs), and the HIV/AIDS Dental Reimbursement Program.

 TAC Contract History  TOP

From 1993 to 1997, the TAC provided TA to CARE Act Title I and II grantees, planning bodies, and groups serving or comprised of people living with HIV disease (PLWH). Since 1998, the TAC has been providing cross-Title TA services to all of HRSA's HIV/AIDS programs. TA services are provided nationwide by peers and other professional consultants.

 TA Philosophy  TOP

The TAC assists programs; it does not do the work of the TA recipient. TA provided by the TAC is intended to do the following:

  • Assure compliance with legislative and HRSA requirements;
  • Improve treatment/adherence;
  • Ensure access to care for underserved individuals;
  • Ensure that grantees achieve a basic level of functioning; and
  • Assist grantees in addressing the following four factors—identified by HAB—that have significant implications for CARE Act programs:
    1. The growing impact of the HIV/AIDS epidemic upon traditionally underserved and hard-to-reach populations, which requires programs to assess the shifting demographics of new HIV/AIDS cases and adapt care systems to the needs of emerging communities and populations;
    2. The quality of emerging HIV/AIDS therapies and the difference they make in the lives of PLWH;
    3. Changes in health care financing, including the advent of managed care, that necessitate linkages among funding sources and participation in managed care plans; and
    4. Policy and funding decisions that increasingly are based upon demonstrated outcomes, meaning that programs need to clearly document their outcomes and provide attention to quality assurance and evaluation mechanisms that will provide information to assess outcomes.

 TA Topic Areas TOP

The TAC provides assistance in various areas, all of which are related to the CARE Act legislative mandates and programmatic requirements of the CARE Act. Sample TA areas include but are not limited to the following:

  • AIDS Drug Assistance Programs (ADAPs);
  • new treatment advances and clinical guidelines;
  • full and effective participation of PLWH in program implementation;
  • evaluation and outcome measures;
  • cultural competency;
  • planning council development;
  • case management;
  • conflict of interest;
  • managed care;
  • needs assessment;
  • grievance procedures;
  • fiscal/program management;
  • comprehensive planning;
  • unit cost development;
  • primary care;
  • consortia development;
  • management information systems; and
  • access to care.

 How TA is Provided TOP

TA and training activities to support CARE Act-funded programs are directed by HAB's Division of Training and Technical Assistance (DTTA). TA includes on-site TA, written products, and special initiatives. TA is delivered through the following channels:

  • HRSA/HAB Project Officers and ADAP Representatives. In day-to-day interaction with grantees, project officers and ADAP representatives assess TA needs and respond accordingly. Project officers and ADAP representatives can either provide direct to grantees or planning bodies (such as training sessions or site visits) or serves as the contact point in securing TA to address their needs.
  • Technical Assistance Contract (TAC). The TAC is a project used by HAB to provide an array of TA services to CARE Act grantees and planning bodies. Project officers, ADAP representatives, peers, and other professional consultants provide TA via on-site consultation, written TA products, and other TA efforts such as the HAB E-Mail, teleconferences, and meetings.

On-site TA is provided by peers (individuals who currently work in CARE Act-funded programs or are members of planning councils/consortia) and other professional consultants. The nature of the TA request determines the type of consult utilized. The TAC maintains a roster of consultants to work directly with grantees. Timelines and benchmarks are used to monitor each on-site TA project.

SUGGESTIONS FOR PLANNING ON-SITE TA

Grantees planning a TA request should assess the following issues before requesting TA in order to ensure TA recipient "readiness" for TA services:

  • What is needed? For example, what program or clinical improvements are needed?
  • How can TA best be met? Possible approaches include one, or a combination, of the following: telephone consultations or on-site training.
  • What are the desired outcomes of the TA? Describe how the TA activity relates to basic functioning of the grantee. Identify ways in which TA will impact the grantee or TA recipient and how the TA is related to the four factors previously described in the "TA Philosophy" section of this chapter.
  • When is the most appropriate time (date) for the TA activity to take place and for what estimated duration?
  • Which consultant(s) or team(s) might be the most effective to address the stated TA needs? What type of expertise is needed by consultant(s) who provide TA to meet the needs?
  • Are the appropriate people available to participate in the TA and to complete follow-up?
  • Is there agreement about the TA scope of work and expectations related to the TA?

These issues should be addressed in the TA request letter to the DSS project officer. DSS project officers will provide guidance to the grantee or planing body regarding the TA request process, if needed. The grantee or planning body may request written materials on the TA topic (e.g. TA reports, manuals, conference call reports, Self-Assessment Modules) in order to self-assess their needs.

TA products available to ADAP grantees include manuals/TA guides, conference calls and follow-up call reports, and special projects. TA product concepts are identified through HRSA/HABs TA priorities plan and ideas raised throughout the year based upon ongoing feedback (e.g., national conference evaluations, project officer input, evaluation of on-site TA, etc.). The TAC develops products with input from HRSA/HAB staff, ADAP representatives, PLWH, and consultants.

The following is a listing of other TA products and services that HAB provides grantees:

  • Consultation Meetings. These meetings cover such topics as how to address legislative requirements, grants administration, and the development of strategies to enhance ADAP service delivery. Meetings are held with grantees, providers, representatives of professional and political organizations, and advocacy groups.
  • AIDS Education and Training Centers. AETCs focus on provider training through regional and national resource centers.
  • Special Initiatives. These efforts include national meetings with all CARE Act grantees and in-depth exploration of topics such as the weekly ADAP Forum and the Quarterly ADAP Technical Assistance Conference Calls.

Evaluation of TA

The HIV AIDS Bureau evaluates TA against measurable outcomes and objectives. The evaluation examines grantee satisfaction with the TA and systems change related to the TA. Evaluation is conducted during and immediately after the delivery of TA and approximately six months after it has concluded. This includes written and telephone interview follow-up.

TECHNICAL ASSISTANCE CONTRACT (TAC)
ON-SITE SERVICE ACQUISITION PROCESS

  1. Ryan White Grantee or Planning Council with grantee approval submits written request to project officer if TA cannot be provided locally. In some instances, DSS project officers may initiate on-site TA services in conjunction with the grantee.
  2. DSS Project Officer determines if grantee’s TA needs can be met by the TAC and submits a TAC TA form request to their DSS Branch Chief for approval.
  3. DSS Branch Chief reviews and authorizes TA request. Approved requests are forwarded to the DSS Director and then sent to the DTTA TAC project officer.
  4. DTTA TAC Project Officer reviews and forwards approved TA request to TAC project director at BETAH Associates, Inc.
  5. BETAH TAC Project Director assigns project to the appropriate TA coordinator or staff member.
  6. BETAH TA Coordinator provides consultation services or recommends potentialconsultants for DSS project officer and grantee review in accordance with TAC benchmarks and timelines.
  7. Peer or other Professional Consultant is selected and provides TA. A team consisting of HRSA staff, BETAH Associates, Inc. TAC staff, and consultants may also provide TA.
  8. Project Officer, Grantee, TA Coordinator, and Consultant develop a responsive TA plan to assure successful project planning, implementation, and outcome evaluation.

 References TOP

How To Obtain TA

To obtain more information about TA, contact your ADAP representative or call the Division of Training and Technical Assistance at: (301) 443-9091. A list of TA products is available at the TA Library. Go to exit disclaimer. Materials can be ordered by calling the HRSA Information Center at: (888) ASK-HRSA.