Performance Measure: AIDS Drug Assistance Program (ADAP) Application Determination

National Quality Forum #: None

Description: Percentage of ADAP applications¹ approved or denied for new ADAP enrollment² within five business days of ADAP receiving a complete application in the measurement year

Numerator: Number of applications that were approved or denied for new ADAP enrollment² within five business days of ADAP receiving a complete application in the measurement year

Denominator: Total number of complete ADAP applications for new ADAP enrollment² received in the measurement year

Exclusions:

1. ADAP applications for new ADAP enrollment² that were incomplete or incorrectly filled out
2. Complete ADAP applications for new ADAP enrollment² received by ADAP within the last 14 days (two weeks) of the measurement year

Data Elements: Was the ADAP application for a new ADAP enrollment¹ complete (Y/N)

1. If yes, was the application the client submitted received by the ADAP program before the last 5 business days of the measurement year?
   
   1. If yes, was a determination on the application made by the ADAP program? (Y/N)
      1. If yes, was the ADAP application approved or denied within 5 business days of receiving the ADAP application?

Data Source: Recipient's ADAP data system

National goals, targets, or benchmarks for comparison

The HIV Quality Measures (HIVQM) Module is a tool within the RSR portal that allows recipients to enter aggregate data specific to the HRSA HAB Performance Measures. The HIVQM Module allows recipients to conduct point-in-time benchmarking across Ryan White HIV/AIDS Programs that use the module.

Basis for selection

The HIV/AIDS Bureau, Policy Clarification Notice 21-02: Determining Client Eligibility and Payor of Last Resort in the Ryan White HIV/AIDS Program (PDF - 68 KB) specifies that "RWHAP recipients and subrecipients must conduct timely eligibility confirmations, in accordance with their policies and procedures, to assess if the client's income and/or residency status has changed."

Department of Health and Human Services Clinical Practice Guidelines

None

References/notes

¹ Includes applications for all individuals, regardless of age.

² New ADAP enrollment "refers to individuals who applied to ADAP for the first time ever…. [This does not] include individuals who have been recertified as eligible or individuals who have been reinstated as enrolled clients after a period of having been decertified. Examples of clients who should not be included [as a new ADAP enrollment] are the following: 1) clients who have moved out of the State and then returned; and 2) clients who move on and off ADAP because of fluctuations in eligibility for a Medicaid/Medically Needy program, based on whether they met spend down requirements." ["Completing the ADR: Recipient Report & Client Level Data Upload." Available at: TargetHIV.org. Accessed August 2023.]