Fiscal Health: Systems to Sustainability(TM)

Fiscal Health: Systems to SustainabilityTM is an education, training, and technical assistance  program that addresses the fiscal sustainability of Ryan White-funded recipients by building their organizational fiscal management capacity. This HealthHIV-led and Health Resources and Services HIV/AIDS Bureau (HRSA/HAB) supported program utilizes a diverse and culturally competent team of fiscal management experts to design and implement effective trainings and technical assistance. The program focuses on HRSA fiscal and program requirements and contracts management with specifications for the states in which recipients reside.


An enhanced approach to building the organizational, and specifically the fiscal health, of Ryan White-funded organizations and providers, the Fiscal Health: Systems to SustainabilityTM trainings help develop and/or enhance operational fiscal systems, with emphasis on monitoring standards, budgeting, fiscal standards, diversifying income streams, uniform guidance and quality controls for subrecipients and contractors.


This program focuses on the aggregate and individual-level fiscal management capacity building needs identified by HealthHIV and collected over the past ten years. The program considers the current and future healthcare funding and organizational environment in which programs operate. HealthHIV utilizes a diverse and culturally competent team of fiscal management experts to design and implement their effective training curricula and technical assistance workplans targeting Ryan White providers. The current funding cycle is from the period 2014 to 2017.

HealthHIV meets this goal through multiple activities offering various ways for individuals to learn. HealthHIV provides onsite group trainings, individualized technical assistance, and online components.


Participants at a recent Fiscal Health: Systems to Sustainability Training. 

Regional Trainings

HealthHIV conducts three regional trainings annually in jurisdictions across the United States. Trainings are free of charge to participants through a cooperative agreement with HRSA/HAB.  Topics covered depend on the needs of the jurisdiction, and have included the following:

– Budget development and management
– Maximizing third party reimbursement
– Income diversification
– Responding to audit findings
– Uniform Guidance
– Implementing sliding fee scales and caps on charges
– Impact of Medicaid and the ACA on RWHAP Provision
– Tracking and reporting program income

The trainings are open to organizations that receive Ryan White Parts A, B, C, D, and F funding. Those who engage in fiscal and programmatic oversight of their organization’s Ryan White activities are particularly encouraged to attend.

Upcoming Trainings

Registration for HealthHIV’s next Fiscal Health Regional Training is now open. The Training will be held in Kent, WA, on April 5-6, 2017. For more information on training topics and to register, visit our registration page.



For more information – or to request a regional training or offer to host a training – should contact HealthHIV at or 202-507-4739.


Individualized Technical Assistance
HealthHIV provides tailored technical assistance to Ryan White recipients and subrecipients across all parts on issues related to fiscal management and sustainability. HealthHIV will develops action plans specific to the organization’s needs and leads them through the implementation process. In addition to our in-house fiscal expertise, we also engage consultants to provide our clients with the most current and effective fiscal management and growth strategies.

HealthHIV works with Ryan White providers to prepare for and respond to site visits, integrate updated federal requirements into policies and procedures, implement requirements such as sliding fee scales and caps on charges, and negotiate challenges related to billing and tracking program income, among other areas.  In addition to compliance issues, HealthHIV works with organizations to strengthen their fiscal health and sustainability through strategic planning and income diversification.

Technical assistance is free to Ryan White recipients through a cooperative agreement with HRSA/HAB.

Email or call 202-507-4739 for more information.





  • Impact of ACA, Medicaid and Medicare on RWHAP Provision
  • Marketing Program Services to Insurance Payers
  • Program and Fiscal Monitoring & Quality Management
  • Insurance Coverage and Program Incom
  • Systems Development to Improve Reimbursement and Service Delivery
  • Transitioning to a Medical Billing System
  • HRSA/HAB Fiscal Monitoring Standards and Compliance
  • Determining Client Eligibility: Applying Sliding Fee Scale
  • Income Verification & Eligibility Requirements
  • Program Income & Diversification
  • The Fundamentals of Financial Management in an ACA Environment
  • Fiscal Management and Accountability for Non-Profits
  • Developing Indirect Cost Rates
  • Preparing for A133 Audit


For additional information about HealthHIV’s programs, initiatives, or coalitions, please click here to email, or call 202.232.6749.