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RW Part B Service Delivery Project FAQ

HIV/AIDS

As the recipient of federal Ryan White Part B funding, the HIV/AIDS Section is in the process of improving the statewide service delivery model. We share periodic update emails to keep those who are interested in this process informed. These updates include recent frequently asked questions (FAQs), which we collect and archive here.

If you are interested in subscribing to our update emails, or have questions related to the Ryan White Part B service delivery project in general, please email DiseaseControl@FLhealth.gov. Your questions may show up in a future FAQ.

  • Why is Florida looking to change its Ryan White Part B service delivery model?
  • Where did the four service delivery options currently being considered come from?
  • Does the statewide fiduciary agent model meet HRSA’s requirements?
  • Do other states employ a fiduciary agent model for Ryan White service delivery?
  • Under a statewide fiduciary agent model, what role would the statewide planning body play?
  • How will positions be impacted by the transition to a fiduciary agent?
  • Will there be an implementation plan for the fiduciary agent?
The federal agency that provides funding and oversight for the Ryan White HIV/AIDS Program, the Health Resources and Services Administration (HRSA), has found Florida’s current methods of service delivery to be out of compliance with their requirements.

After receiving HRSA’s findings in 2021, the HIV/AIDS Section contracted with Mercer Government Human Services Consulting to assess Ryan White Part B service delivery in Florida. The four models suggested as part of their assessment are the models currently under consideration.

Mercer’s suggestion of these four models—consortia, consortia-lead agency hybrid, statewide enterprise, and statewide fiduciary agent—is based on information provided by HRSA.

Yes, when done correctly. HRSA includes fiduciary agent as a viable subrecipient model in their Ryan White HIV/AIDS Program Part B Manual. They define a fiduciary agent as “an entity with which the state/territory establishes a legal agreement to do one or more of the following: manage grant funds; manage procurement processes; manage payment of invoices; ensure funds are used for allowable purposes and in accordance with applicable legislative, regulatory, and programmatic requirements; and/or execute award requirements related to non-compliance.” 

The Program Manual also says that fiduciary agents “typically conduct fiscal activities on behalf of the recipient in an administrative capacity and do not provide direct services to people with HIV or have a direct relationship with direct service providers. In addition, fiduciary agents are typically not involved in programmatic decision-making (e.g., planning, priority-setting, eligibility determination).”

Yes, several—though not all of them for Part B services. Maine, New York, and Pennsylvania are among the states that use a fiduciary agent model for Ryan White services for at least one part.
A fiduciary agent is purely an administrative role that typically wouldn’t conduct needs assessments or perform priority setting for resource allocation, though they would aid with providing data for these activities. Our statewide planning body will continue to be vital to these and other activities.
We are currently conducting a full analysis of the funding sources that will be impacted by the model transition. As information becomes available, we will include it in updates and area calls.
Yes, we are currently working on developing a detailed implementation plan, which we look forward to sharing. The simplified version is that a procurement process will be completed, which will end with the selection of a vendor to serve as the statewide fiduciary agent. There will be a period of overlap to transition from the current model to the new model to ensure no lapse in client services. Policies will be written and/or adjusted as needed to ensure all needs are met. The endpoint of implementation will be when the current model is no longer maintained and we are fully transitioned to a fiduciary-only model statewide.