When considering the question of surveillance capacity, there are at least two levels of system cost: one associated with the implementation of HIV reporting, and the other associated with RWCA planning efforts at state and local levels. Cost issues are relevant to the question of capacity, particularly given the pervasive fiscal austerity of states and localities.

DATA EXAMINED

Financial resources clearly affect reporting capacity. In the absence of models to estimate surveillance costs, the Committee attempted to understand more about surveillance capacity by studying the distribution of federal and state funding for surveillance programs. The Committee reviewed two sources of funding for state HIV/AIDS surveillance programs for the years 1999 through 2002: (1) self-reported state general revenue contributions for HIV and AIDS surveillance, and (2) federal core surveillance funding to states through cooperative agreements with the CDC.2

The National Alliance of State and Territorial AIDS Directors (NASTAD) administered a request for information to state AIDS directors regarding states’ general revenue contributions to their HIV/AIDS surveillance programs during fiscal years 1999–2002. Forty-one states responded to that request for information.3 States were also asked to identify expected changes in general revenue (remain constant, decrease, increase). The CDC provided data to the Committee on federal funding to states for core surveillance and for other surveillance activities for corresponding fiscal years 1999 through 2002 (CDC, 2003).

The Committee reviewed data for 1999 through 2002 for three reasons: (1) approximately one-third of states implemented HIV reporting during this time period (see Table 3-1 in chapter 3), (2) state fiscal austerity was emerging during this time period, and (3) these data were readily available from most states.

2  

CDC provides “core funding” to states for their HIV/AIDS reporting systems. CDC provides additional funds to states, based on a competitive grant application process, for supplemental surveillance activities.

3  

States were asked not to include state general revenue contributions to the six cities/counties in their jurisdiction that receive direct funding from CDC for HIV/AIDS reporting (Chicago, Houston, New York, Los Angeles, Philadelphia, and San Francisco). A separate request for information was made to those areas. States were also asked to exclude in-kind contributions (e.g., staff on loan from another division) and funding for general communicable disease or sexually transmitted disease surveillance.



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