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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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Severity of Need (SON) Index - Progress


The HRSA SON Index development effort achieved the following from 2005-2007:

  • Development of a SON collaborative framework to guide the development process and assure internal and external opportunities for input.
  • Engagement of national experts, federal staff, grantees, consumers and other key stakeholders in both the development and the vetting process.
  • Utilization of existing research and analyses to identify, evaluate and apply similar efforts toward a defensible SON Index.
  • Development of the draft SON Index.
  • Engaged an objective, independent contractor with broadly acknowledged impartiality and expertise to conduct future investigations into a new SON Index.
  • Assured that the proposed SON Index has not provided incentives for jurisdictions to reduce local resource contributions to HIV/AIDS care.
  • Collected and applied current epidemiologic data from jurisdictions, for the purposes of testing the allocation impact of the index.
  • Included time for community input, so as to allow sufficient time for analysis and commentary by interested parties.


1996 – 2000

Ryan White CARE Act as reauthorized provides framework for defining severity of need, guiding ongoing efforts by HRSA to refine methods for defining severity of need.


Language in Ryan White 2000 Amendments calls for IOM study of better measures of severe need.


IOM Report Measuring What Matters published.


HRSA/HAB begins severity of need recommendations from IOM report, forms HAB SON Workgroup.


SON Framework developed and contractor retained to guide SON development process.
Contractor convenes SON panels and Collaborative meeting held.


SON Specialists’ Panels Final Meeting
Key National Stakeholders Meeting and 2nd Collaborative Council Meeting
Contractor conducted supplemental studies to strengthen SON Index


HRSA convened 3rd Collaborative Council Meeting (August)
SON Specialists’ Panels Webcast (October)
Activated SON Background Materials on HRSA/HAB Website (October)

See also: Current and Future Activities