241.006 Reallocation of HIV Client Services Funds

1.0 Purpose

To provide direction to Administrative Agencies (AA) in the reallocation of HIV client services funds.
 

2.0 Authority

Ryan White Care Act, 2000; Texas Health and Safety Code, Chapter 12, §12.052, §12.083, Chapter 85, §85.032
 

3.0 Definitions

HIV Service Delivery Area (HSDA) – Geographic service area set by the Department of State Health Services for the purposes of allocating federal and state funds for HIV medical and psychosocial support services.

Administrative Service Area – The HSDAs served by the AA in its contract.

High Priority Critical Service Needs – Service categories that are both high priority and have strong relation to enrolling clients in and maintaining access to HIV related medical services.

Reallocation of Funds – Movement of funds between service priorities (e.g. case management to food pantry) within or across providers.

Redistribution of Funds – Movement of funds from one contract to a different contract within the same service priority (e.g. housing agency A to housing agency B).
 

4.0 Responsibilities

The AA is responsible for assessing the needs of persons living with HIV/AIDS in the HSDAs included in its administrative service area and setting priorities and allocations for the use of funds directed to the HSDAs, including consideration of critical service needs, as defined above. It is also responsible for monitoring the budgets of all contractors within the administrative service area and ensuring efficient use of state and federal funds.
 

5.0 Policy

AA’s should examine services expenditures by category on at least a quarterly basis. After two quarters of expenditure, it is often apparent that funds are being expended at a rate that will exhaust them by the end of the year. If in the course of a funding cycle it becomes apparent that funds will be unexpended within an HSDA, the AA is to first explore redistribution of funds within the service category to other providers in the HSDA. If redistribution is not appropriate, the AA should consider reallocating the funds across all HSDAs in the service area to meet critical service needs. Such a reallocation will not affect the set point used for hold harmless calculations in DSHS’s funding formula; such reallocations are not considered permanent changes to the expected allocation for HSDAs in that administrative service area. Reallocations cannot be made to increase the administrative budget of the AA.
 

6.0 Procedure

If during the course of a year it becomes apparent a service contractor will not expend all the funds in a service category:

1. Redistribution of Funds within the Current HSDA and Service Category

The AA should first determine if the funds surplus is due to lower than expected demand for the service or an inability of the service provider to meet demands for the service due to staffing shortages or other capacity issues. In the former case, it would be inappropriate to redistribute the funds within the service category, as utilization does not support it. In the second instance, however, the AA should redistribute the funds to other organizations providing that service within the HSDA, following local procedures, to meet client demand for services. The AA should inform their field operations consultant of the nature of the redistributions prior to execution, and subcontractor data sheets for all affected agencies should be submitted within 30 days of the redistribution.

2. Reallocation across HSDAs to Address High Priority Critical Service Needs

If there is no need or capacity within the HSDA to absorb the funds within the service category, the AA should consider gaps in meeting high priority critical service needs across all HSDAs in the planning area. Critical services are not limited to the so-called core services (i.e., ambulatory care, oral health, substance abuse services, mental health services, drugs, and case management) but also include consideration of health insurance reimbursement and ancillary and supportive services with high priority ratings and that are strongly related to client maintenance in HIV care systems.

Reallocation should be made only to service categories where there is:

1. A high priority need, and
2. An anticipated shortfall or lower than desired initial allocation.

The decision should be justified and submitted to the appropriate DSHS planning staff and field operations consultant for approval via email. DSHS will respond within 3 working days. Within 30 days of the effective date of the reallocation, the AA must submit amended subcontractor data sheets for each provider affected by the change in funding.
 

7.0 Additional Resources

8.0 Revision History