Ryan White HIV/AIDS Program Part F Dental Services Report

Forms and Documents

Document Name	Status
E - Respondents on Burden Estimates in Completing the DSR Form.docx Supplementary Document	2014-03-12
A - 2009 RWHAP Legislation.pdf Supplementary Document	2014-03-12
Supporting Statement.docx Supporting Statement A	2014-05-27

IC Document Collections

IC ID	Document Title	Status
6384	Ryan White HIV/AIDS Program Dental Services Report. Instruction	Modified

ICR Details

OMB Control No: 0915-0151	ICR Reference No: 201403-0915-006
Status: Historical Active	Previous ICR Reference No: 201104-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No: 21572
Title: Ryan White HIV/AIDS Program Part F Dental Services Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/03/2014
	Date Received in OIRA: 03/21/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	68	0	70
Time Burden (Hours)	2,940	0	1,400
Cost Burden (Dollars)	0	0	0

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Abstract: Under the Ryan/White HIV/AIDS Treatment Modernization Act, accredited schools of dentistry, pre- and post-doctoral dental training programs, and dental hygiene education programs may apply for reimbursement of uncompensated costs for providing oral health care to HIV infected individuals. The Dental Services Form provides information on unreimbursed expenses and descriptions of selected program components in order to determine the reimbursement award amount and to report on provided services under the Act.

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Authorizing Statute(s): PL: Pub.L. 106 - 345 101-401 Name of Law: Ryan White CARE Act Amendments of 2000
   PL: Pub.L. 109 - 415 101-401 Name of Law: Ryan White HIV/AIDS Treatment Modernization Act of 2006
   PL: Pub.L. 101 - 381 2601 Name of Law: Ryan White Comprehensive AIDS Resources Emergency (CARE) Act
   PL: Pub.L. 111 - 87 2 Name of Law: Ryan White HIV/AIDS Treatment Extension Act of 2009
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 399	01/03/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 15350	03/19/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Ryan White HIV/AIDS Program Dental Services Report.	1	Ryan White HIV/AIDS Program Dental Services Report

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	68	70	0	0	-2	0
Annual Time Burden (Hours)	2,940	1,400	0	0	1,540	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The current OMB inventory of burden hours for this activity is 45 hours for DRP applicants and 35 hours for CBDPP grantees. This is an increase from the previous 20 hours for all respondents. Most of the respondents we contacted this year did not have data collection systems in place and cited this as a reason for the higher burden estimate. We had one CBDPP who did have systems in place and stated that the Dental Services Form was easy to complete and took them one hour and 30 minutes. Another CBDPP stated it took them 80 hours to complete the Dental Services Form because they had to reach out to multiple service providers to report demographic and clinical data. Two respondents said that the additional data elements would increase their burden. See Tab E for a list of burden estimates and comments. The Dental Services Form has been revised to comply with the National HIV/AIDS Strategy directive to standardize data collection and reduce grantee reporting burden. The revised form implements data collection standards for race, ethnicity, and sex and eliminates some narrative description items.

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Annual Cost to Federal Government: $228,468

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 03/21/2014

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