Provider Information

Using data from section 1 of the CADR, this section describes characteristics of the CARE Act providers that reported data in 2004 (n=2,569). Where possible, comparisons are made with the provider organizations reporting CADR data in 2002 (n=2,696) and 2003 (n=2,647).

REPORTING SCOPE

CARE Act providers have the option of reporting on eligible or funded services. When reporting on eligible services, providers submit data on any service permitted under any title of the CARE Act, regardless of whether or not the providers use a specific title to pay for these services. Reporting eligible services provides a comprehensive picture of the services being delivered to HIVpositive clients by CARE Act-funded providers. More than threequarters (88 percent) of all CARE Act providers in 2004 reported on all eligible services.

Conversely, if providers report on funded services, the data reported by providers include only those services that were actually paid for with CARE Act funding. This latter reporting category requires prior approval from HRSA project officers. In 2004, 11 percent (n=295) of providers reported only those services funded by the CARE Act.

PROVIDER TYPE

A variety of organizations provide CARE Act services, including publicly-funded health centers, community-based organizations, and private medical practices (Figure 1 and Table 1). Almost half (45 percent) of all CARE Act providers in 2004 were communitybased service organizations (CBOs). Hospitals comprised 14 percent of all CARE Act providers, while health departments made up 13 percent of providers in 2004. Collectively, publicly-funded community health centers and community mental health centers represented 10 percent of providers (n=244). CARE Act providers identified as substance abuse treatment centers, solo/group private medical practices, multiple fee-for-service providers, people living with HIV/AIDS (PLWHA) coalitions, Veterans Administration (VA) facilities, or other provider types, comprised 18 percent (n=465) of providers in 2004. The types of organizations receiving CARE Act funding to provide services to people living with HIV/AIDS in 2002 and in 2003 were similar to those funded in 2004.

Table 1. CARE Act Provider Types, 2004

Data on provider type were missing for 2 providers in 2004.
Other facility includes substance abuse treatment centers, solo/group private medical practices, providers reporting for multiple fee-for-service providers, PLWHA coalitions, VA facilities, and provider type reported as 'other'.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.

OWNERSHIP STATUS

The ownership status of CARE Act providers includes private, public, and faith-based organizations. Close to two-thirds (65 percent) of CARE Act providers were private, nonprofit (not faithbased) organizations in 2004 (Table 2). Twenty-three percent (n=592) of providers reported their ownership status as publicly owned (local, State, or Federal), and about four percent (n=113) of CARE Act providers were faith-based organizations.

Table 2. Ownership Status of CARE Act Providers, 2004

Ownership Status	Total	Percent
Public/local	334	13%
Public/State	240	9%
Public/federal	18	1%
Private, nonprofit (not faith-based)	1,656	65%
Private, for profit	138	5%
Unincorporated	6	<1%
Faith-based organization	113	4%
Other	62	2%
Total	2,567	100%

Percentages may not sum to 100 percent due to rounding error.
Data on ownership status were missing for 2 providers in 2004.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.

SOURCE OF CARE ACT FUNDING

Organizations reported which CARE Act programs provided funding for delivery of services. Organizations may have received funding directly from the Federal government as Ryan White CARE Act grantees, through subcontracts with CARE Act grantees, and/or through Title II funding from a consortium agency. Of the 2,569 providers submitting data for 2004, 1,439 providers received Title I funds; 1,398 providers received Title II funds; 454 providers received Title III-EIS funds; and 266 providers received Title IV funds. Thirty providers received Title IV-Youth funds in 2004 (Table 3).

Table 3. Source of CARE Act Funding, 2004

Source	Total	Percent
Title I	1,439	56%
Title II	1,398	54%
Title III	454	18%
Title IV	266	10%
Title IV - Youth	30	1%

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report

Many of these provider organizations received funding from more than one CARE Act program, and they may have also received funds from additional, non-Ryan White CARE Act sources (Table 4). Among providers in 2004, 70 percent (n=1,790) received funds from a single CARE Act source; 23 percent (n=577) received funds from two CARE Act sources; 7 percent (n=166) received funds from three CARE Act sources; and 1 percent (n=35) received funds from four CARE Act sources. Only one provider received funds from all five CARE Act sources in 2004. Table 2. Ownership Status of CARE Act Providers, 2004

Table 4. Distribution of CARE Act Funding Sources Among Providers, 2004

Source	Total	Percent
One	1,790	70%
Two	577	23%
Three	166	7%
Four	35	1%
Five	1	<1%
Total	2,569	100%

Percentages may not sum to 100 percent due to rounding error.
Source: Health Resources and Services Administration, HIV/AIDSBureau, 2004 CARE Act Data Report

TARGET POPULATIONS OF INTEREST

Providers were asked to indentify any population group they specifically targeted for outreach efforts or service delivery during the reporting period. The 4 populations that providers most frequently targeted in 2004 were communities of color (65 percent), women (62 percent), injection drug users (49 percent), and gay, lesbian, and bisexual adults (49 percent). These and other target populations are shown in Table 5.

Table 5. Target Population of CARE Act Providers: 2002, 2003, and 2004

Target Populations of Interest	2004 (n=2569)		2003 (n=2647)		2002 (n=2696)
	Total	Percent	Total	Percent	Total	Percent
Migrant/farm workers	218	9%	234	9%	219	8%
Rural population other than migrant workers	515	20%	515	19%	209	19%
Women	1582	62%	1587	60%	1553	58%
Children/child	720	28%	774	29%	771	29%
Communities of color	1656	65%	1710	65%	1649	61%
Homeless	1144	45%	1186	45%	1113	41%
Gay, lesbian, bisexual youth	635	25%	662	25%	632	23%
Gay, lesbian, bisexual adults	1249	49%	1270	48%	1209	45%
Incarcerated persons	604	24%	637	24%	588	22%
All adolescents	581	23%	629	24%	569	21%
Runaway or street youth	285	11%	313	12%	292	11%
Injection drug users	1016	40%	1027	39%	971	36%
Parolees	676	26%	706	27%	626	23%
Other	293	11%	298	11%	325	12%

Providers may check as many target populations as apply.
Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2002, 2003, and 2004 CARE Act Data Reports.

RACIAL/ETHNIC MINORITY GROUP REPRESENTATION GREATER THAN 50%

For 2004, 36 percent (n=919) of all CARE Act provider organizations reported that members of racial/ethnic minority groups comprised more than 50 percent of the organization’s professional staff providing direct HIV services. Twenty-four percent (n=625) of providers reported that racial/ethnic minorities comprised more than 50 percent of their Board of Directors. Two percent (n=50) were solo or group health practices in which more than 50 percent of the clinicians were members of racial/ethnic minority groups. Thirty-four percent (n=879) of providers reported that although their boards and staffs were not composed of a majority of racial/ ethnic minority group members, they historically serve racial/ethnic minorities in communities of color. The racial/ethnic group representation reported by providers remained essentially the same from 2002 to 2004 (Table 6).

Table 6. Racial/Ethnic Minoirity Group Representation Among CARE Act Providers: 2002, 2003, and 2004

Racial/Ethnic Group Representation Greater than 50%	2004 (n=2569)		2003 (n=2647)		2002 (n=2696)
	Total	Percent	Total	Percent	Total	Percent
Board Members	625	24%	668	25%	673	25%
Professional staff members	919	36%	959	36%	945	35%
Solo/group private health practice	50	2%	55	2%	65	2%
"Traditional" provider serving people of color	879	34%	893	34%	911	34%
Other agency type	473	18%	466	18%	463	17%

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2002, 2003, and 2004 CARE Act Data Reports.

STAFFING

CARE Act providers reported the number of paid, full-time equivalent staff (FTEs) that were funded by the CARE Act along with the number of volunteer, full-time equivalent positions dedicated to HIV care. In 2004, 2,207 provider organizations reported a mean number of 7.6 paid FTE staff per provider, and 686 agencies reported a mean of 11.3 volunteer FTE staff per provider. The mean numbers of paid and volunteer FTE staffs have declined slightly since 2002 (Table 7).

Table 7. CARE Act Provider Organization Staffing: 2002, 2003 and 2004

Staff	2004			2003			2002
	No. of Providers	Mean Staff per Provider	Range	No. of Providers	Mean Staff per Provider	Range	No. of Providers	Mean Staff per Provider	Range
Paid	2207	7.6	.01 - 130	2295	7.9	.01 - 706	2339	8.4	.01 - 780
Volunteer	686	11.3	.01 - 800	747	11.4	.01 - 800	746	11.8	.02 - 750

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2002, 2003, and 2004 CARE Act Data Reports.

CARE ACT FUNDING AMOUNTS

The amount of CARE Act funds that providers reported receiving is presented in Table 8. The amounts may not match fiscal year awards because provider-reported funding may include carryover from the previous funding period and supplemental funding.

In 2004, 1,345 providers reported receiving $602,715,292 through Title I of the CARE Act with a mean award of $448,115 to deliver CARE Act services. Title II funds totaled $771,321,950 among 1,233 providers, with mean funding of $625,565. Providers in Title III-EIS (n=440) reported receiving a total of $192,813,950, with a mean award of $438,100, and providers in Title IV (n=277) reported receiving a total of $76,366,146, with a mean award of $275,690.

CARE ACT DENTAL EXPENDITURES

The dental expenditures presented in Table 8 include all CARE Act funds from all Titles that were used to pay for dental expenses incurred by CARE Act providers, excluding funds from the Dental Reimbursement Program and the Community Based Dental Partnership Program. In 2004, 585 CARE Act providers reported $47,936,428 in dental expenditures for their clients, with a mean expenditure of $81,943.

Table 8. CARE Act Funding Amounts, 2004

CARE Act Program	Total (dollars)	Mean	Median
Title I	$602,715,292	$448,115	$173,269
Title II	$771,321,950	$625,565	$95,889
Title III	$192,813,950	$438,100	$411,888
Title IV	$76,366,146	$275,690	$86,682
Dental Expenditures	$47,936,428	$81,943	$20,327

Source: Health Resources and Services Administration, HIV/AIDS Bureau, 2004 CARE Act Data Report.