Assess Your Readiness: Sustainability

If a program is begun as part of a research project or pilot test, how will you sustain it when the original project or test ends? Factors that can ensure sustainability include:

• Funding for ED HIV testing comes from state and local pools of HIV prevention and care funds.
• Program is demonstrated to be cost efficient.
• Partnership is established with local health department which can provide test kits, training, lab, and funding.
• Program costs are absorbed by existing hospital budgets, such as supplies and laboratory.
• Public health, ED, laboratory, and infectious disease departments contribute infrastructure and resources to the testing process.
• Program staff participate in HIV planning councils/advisory groups.
• Data are collected to monitor and promote track record.

Factors that threaten sustainability include:

• Budget is cut at the federal level for HIV prevention and care.
• Nonrenewable funding sources support program.
• Testing is part of research study and attached to certain investigators and grants.
• Priority shifts for public health interventions or research conducted in the ED.
• No clear accountability or ownership of the testing process exists.
• Testing process is part of a parallel effort and is not integrated into ED operations.
• Program relies on one person to champion the effort after it has launched.

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