1. December 2011
Who Reports What for the RSR: Overview of Grantee-Provider Relationships
Ryan White Services Report HIV/AIDS Bureau, Health Resources and Services Administration
(1,2) Welcome to the Ryan White Service Report video series. Each video provides an overview of a topic related to the Ryan White Services Report – otherwise known as the RSR, which is reported to the HIV/AIDS Bureau within the Health Resources and Services Administration.
This introductory video walks through grantee/provider relationships and who submits the RSR.

2. This video will cover… Who is a grantee? Who is a service provider?
Who submits the RSR?
This video will answer the following questions:
Who is a Ryan White grantee?
Who is a service provider?
And finally, who submits each of the three parts of the RSR – the Grantee Report, the Service Provider Report and the Client-Level Data File. We also discuss who can be exempt from reporting.
A lot of the information covered in this video is also covered in the RSR Instruction Manual. At the end of the video, we will give you a link for where you can download the manual from the TARGET Center Website.

3. Who is a grantee?
“…the official RWHAP grantee that receives Federal funding directly from HRSA. This agency may be the same as the provider agency or may be the agency that contracts with other agencies to provide RWHAP services.”
RSR Instruction Manual
A grantee is an organization that receives federal funding directly from HRSA.
A grantee may contract with other organizations to provide services to Ryan White clients or the grantee may serve clients itself. Either way, it is the fact that an organization receives funding directly from HRSA that defines it as a Ryan White grantee.

4. Types of grantees Part A Part B Part C Part D Part F
Metropolitan Areas
Part B
States
Types of grantees
Part C
Outpatient primary care settings
Part D
Family-center outpatient or ambulatory care settings
The Ryan White program is divided into five parts. HRSA classifies grantees into one or more Parts depending on where a grantee’s HRSA funding comes from.
(1) Part A funding goes to eligible Metropolitan Areas. (2) Part B is for state entities. (3, 4) Parts C and D fund direct service providers – often community-based organizations or clinics. (5) And Part F funds special programs, such as the Minority AIDS Initiative and the Dental Reimbursement Program. An organization or entity can receive funding from multiple Parts at once and can change the Parts it receives funding from over time.
Let’s walk through a few examples of these different types of funding scenarios.
Part F
Special program–
e.g., SPNS, MAI

5. City Health Department
HRSA
Part A grantee
Let’s start with the simple example of a Part A grantee. Remember, Part A funding is dedicated to Metropolitan Areas.
So in this scenario, (1) HRSA provides funding (2) through a grant directly to an entity acting on behalf of a Metropolitan Area (3), such as a city health department. This makes the city health department (4) a Part A grantee.
City Health Department
Part A Grantee

6. Community Health Clinic
HRSA
Part C
Part D
Part C and D grantee
This example shows how an organization can be a grantee receiving funding from multiple Parts at once.
In this scenario, (1) a single organization - a community health clinic – receives (2) HRSA funding to provide outpatient primary care through Part C; (3) AND has a second grant with HRSA for Part D funding to provide family-center outpatient care. Therefore (4) this is both a Part C and a Part D grantee.
Community Health Clinic
Part C and D Grantee

7. Multiple-Level Provider Fiscal Intermediaries
Who is a service provider?
First-Line Provider
Second-Line Provider
Multiple-Level Provider
Grantee Provider
Fiscal Intermediaries
Now let’s move to discussing service providers within the Ryan White Program
Providers are organizations that receive funding from HRSA, a grantee or another provider to deliver services to Ryan White clients.
There are several different types of providers and we will spend the next few minutes describing each type.

8. First-line provider First-line provider:
A service organization that has a contract with a grantee
HRSA
First-line provider
Grantee
First-line providers have a contract with a grantee to provide services. (1,2, 3). In this scenario, HRSA funds a grantee and that grantee provides funding to a provider to deliver care to Ryan White clients.
First-line provider

9. Multiple Second-line providers
A service organization that has a contract with a first-line provider
HRSA
Second-line provider
Grantee
Second-line providers work slightly differently. Instead of receiving funding from a grantee, second-line providers have contracts with other providers who receive funding from grantees.
In this scenario, HRSA funds a grantee (1), who funds a first-line provider (2). This first-line provider in turn contracts other providers – second-line providers - to deliver services to Ryan White clients (3, 4).
First-line provider
Second-line provider
Multiple Second-line providers

10. Multiple-Level Provider:
A service organization that is both a first and a second-line provider
HRSA
Contract A
Grantee
A third type of a provider is a multiple-level provider. These providers can act as both a first and second-line provider at the same time under different contracts.
For example, HRSA funds a grantee, who funds to a provider under contract A. So under just under contract A, the provider is a first line provider.
First-line provider

11. Multiple-Level Provider:
A service organization that is both a first and a second-line provider
HRSA
Grantee
Contract A
Contract
A+B
Contract B
Grantee
1st-line provider
HRSA funds another grantee, who funds a different provider, who gives funding to our same provider under contract B. So in this case, our provider is a second-line provider. Because the provider is both a first line a second line provider, it is a multiple-level provider.
Multiple-level provider
1st- and 2nd-line provider
First-line provider
2nd-line provider

12. Grantee-Provider:
A service organization that is both a grantee and a provider
HRSA
A fourth type of provider is a grantee-provider. A grantee-provider receives funding directly from HRSA to provide Ryan White services.
Grantee- Provider

13. Identify potential providers Distribute funding
Fiscal Intermediary: A first-line provider that performs administrative tasks on behalf of grantees
Identify potential providers
Distribute funding
Supervise provider performance
Monitor quality of care
Manage provider reporting
Required!
Now talk a minute about Fiscal Intermediaries within the Ryan White Program. These providers play a unique role within the program.
A fiscal intermediary is a first-line provider that helps a grantee manage their providers.
For example, fiscal intermediaries can perform activities such as (1) sending out RFPs to potential providers, reviewing proposals and selecting the sub-providers, (2) distributing funding, (3) supervising provider performance, (4) monitoring the quality of care and (5) managing provider reporting. It is particularly common for Part B grantees to contract fiscal intermediaries to help manage their grant.
(6) The one activity that is required of fiscal intermediaries is that they distribute funding.
Although fiscal intermediaries can be very useful to grantees in provider management, they are not the ones ultimately responsible for funding allocation, service provision, or reporting to HRSA. As states in the Instruction Manual, grantees of record are responsible for managing and monitoring each project, program, subaward, function or activity supported by the award of funding from HRSA.

14. Client-Level Data File
Grantee Report
All grantees
One report per Part
Provider Report
Who submits what?
All providers
One report per provider
Client-Level Data File
Now that we have gone through the different types of grantees and providers within the Ryan White Program, let’s turn to the RSR, and discuss who has to report what.
The RSR includes three reports: the Grantee Report, the Service Provider Report, and the Client-Level Data File.
(1) All grantees must submit at least one Grantee Report. If you are a grantee that receives funding from more than one Part, you must submit a different report for each Part.
(2) All agencies that provide direct client services need to complete the Provider Report, no matter whether you are a first-line, second-line or multiple-level provider. This includes fiscal intermediaries and grantee-providers. Each provider submits only one Service Provider Report, even if you are funded by multiple Parts.
(3) The third report within the RSR is the Client-Level Data File. Each provider that delivers core medical or support services to Ryan White clients must submit this report. Providers only need to submit one Client-Level Data File for all their clients served during the reporting period, even if these clients were funded from different Parts. Providers can submit more than one Client-Level Data File. This may be easier for providers who use more than one data system. HAB can merge these files once they are submitted.
All providers
One report per provider unless the provider uses more that one system and it is easier to submit multiple reports

15. they fulfill one of the following conditions….
Providers are exempt from reporting if…
Submit only vouchers or invoices
Do not see clients on a regular basis
Offer services on a “fee-for-service” basis
they fulfill one of the following conditions….
Did not provide services during the period
There are several situations under which a provider may not need to submit a Service Provider Report or a Client-Level Data File. In these cases, a grantee must submit data on behalf of the provider to ensure that the organization’s service provision is reported to HAB.
We will now walk through the conditions that may exempt a service provider from submitting data.
(1) The provider submits only vouchers or invoices for payment
(2) It does not see clients on a regular and sustained basis. For example, it only sees clients on an emergency basis.
(3) It offers services to clients on a “fee-for-service” basis
(4) It did not provide any services during the reporting period
(5) It received less than $10,000 in Ryan White funding during the reporting period
(6) It sees a small number of clients -- less than 25
Finally, a provider does not have to report if it is no longer is funded by Ryan White or is no longer is in business.
Receive less than $10,000
See a small number of clients

16. Contact us with questions: Data.TA@cicatelli.org
More Questions?
Read the Instruction Manual: _Instruction_Manual.pdf
Contact us with questions:
Now we have come to the end of our video.
If you have more questions:
(1) Please read the Instruction Manual posted on the TARGET Center website or contact us via the address listed here.
Thanks for joining us!