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Severity of Need (SON) Index - Recommendations

The draft SON Index was developed from multiple sources: deliberations and recommendations of the Panels; input and consensus from advising bodies (HRSA Implementation Workgroup and Collaboration Council) and recommendations in a series of supplemental studies conducted to explore data issues in greater detail. The below chart summarizes recommendations from all these sources and is followed by a more detailed discussion of recommendations from these sources.

Measures to Include in SON Index

Observations from the April 2006 Panel Meeting

Areas with Stronger Data: Case counts Total cases Prevalence rates Deaths among patients from all causes Demographics characteristics of infected patients Exposure category of infected patients Area characteristics Poverty Differences in medical labor costs Population level lack of insurance Access to/lack of access to medical providers	Areas with Weaker Data: Socioeconomic characteristics of patients Patient poverty Patient insurance status Patient immigration status Patient homelessness Clinical characteristics of patients Disease stage/progression Crack cocaine, and non-injecting methamphetamine abuse Mental illness
Strong Ability to Adjust For: Burden of disease Aggregate case counts Rates of disease Area differences in overall medical costs Area differences in poverty Area differences in overall access to care IDU exposure category	More Challenging to Adjust For: Differences in patient clinical stage of disease Differences in patient socioeconomic status Level of unmet need Medicaid enrollment Medicaid adequacy

Severity of Need (SON) Index