May 23, 2012
On Monday, April 25, 2012, representatives of the six federal agencies designated by the President as lead agencies with responsibility for implementing the National HIV/AIDS Strategy (NHAS) met to continue our collaborative efforts to implement the Strategy and discuss plans for possible cross-departmental activities.
Dr. Grant Colfax, Director of the Office of National AIDS Policy at the White House, addressed the group, which is charged with better coordinating HIV/AIDS activities across departments and agencies. He expressed appreciation for the perseverance of the Federal Leads in their work to implement the NHAS.
Dr. Howard Koh, Assistant Secretary for Health, chaired the meeting and engaged participants in a discussion about opportunities to advance their collaboration with a cross-departmental project(s) that would involve many or all of the lead federal agencies working together. Two potential projects were then outlined.
Dr. Ronald Valdiserri.
The goal of this proposed initiative is to bring together the resources of each of the Federal Leads to enhance the health aspects of the re-entry experience of people living with HIV coming out of state prisons and returning to their communities. This project would require that the Federal Leads identify and document best practices and facilitate strengthened collaborations across relevant programs and with state and local stakeholders addressing the health, housing, and employment or job skill training needs of this population at risk of falling out of HIV care. Activities being contemplated include a consultation on best practices with federal and community-based stakeholders, development of a web-based training for service providers and a resource document for use by correctional facilities, state and local departments of health and departments of corrections and community-based organizations serving the targeted population. In pursuing this project, the Federal Leads would engage colleagues from specific agencies with relevant expertise and responsibility for oversight of specific related activities.
The second proposed area for broader collaboration across the Federal Leads involves building on an effort already underway at HHS to establish a set of common core indicators to be used across HIV programs to better capture data and reduce grantee reporting burden. The Federal Leads discussed the possibility of engaging in further dialogue about the feasibility and potential benefits of adopting the indicators being developed by HHS for use across other federal departments.
The seven domains in which HHS is working to develop specific common program indicators are: HIV diagnosis, early HIV diagnosis, initial linkage to care, sustained engagement in care, initiation of antiretroviral treatment, viral load suppression, and housing status. During the discussion among the Federal Leads it was acknowledged that not every federal HIV program collects nor would they be expected to start collecting information related to all of these measures. However, the idea is that for those that do collect similar information, using a common measure across programs not only helps establish a richer, more clear national picture of our progress, but also reduces grantee burden by making standard the data elements requested and fosters the opportunity to more readily share and analyze data across programs at the local, state and national levels.
Dr. Colfax expressed gratitude to the Federal Leads for considering this important collaboration and to OHAIDP for taking the lead on this effort at HHS. He observed that an important goal of this undertaking must be to help better measure outcomes on the local level. He shared that based on his experience as a local health department administrator, he is aware that grantees are asked to gather and report on quite a lot of data, which may not be fed back to them in a way that is helpful for improving programs and services. He noted that the recent Institute of Medicine (IOM) report commissioned by ONAP, "Monitoring HIV Care in the United States: Indicators and Data Systems," specifically calls for more coordination, collaboration and integration across federal agencies on these issues.
We agreed, as a group, to move forward with an active process to identify opportunities to adopt common HIV program measures across federal departments. We look forward to sharing news of our progress in a future blog post. In the meantime, please feel free to share your recommendations about these efforts by leaving a comment below.
Ronald Valdiserri, M.D., M.P.H., is the Deputy Assistant Secretary for Health, Infectious Diseases, and Director, Office of HIV/AIDS Policy, U.S. Department of Health and Human Services.