Ryan White HIV/AIDS Program Part F Dental Services Report

Forms and Documents

Document Name	Status
Form 1 Ryan White HIV/AIDS Program Dental Services Report. Form	Modified
Data Variable Recommendations DSR 2019.docx Supplementary Document	2020-06-01
TAB D - 60-Day FRN - DSR 2019.pdf Supplementary Document	2020-06-01
TAB A - 2009 RWHAP Legislation.pdf Supplementary Document	2020-06-01
Supporting Statement DSR 2019.docx Supporting Statement A	2020-06-01

IC Document Collections

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

ICR Details

OMB Control No: 0915-0151	ICR Reference No: 202006-0915-001
Status: Active	Previous ICR Reference No: 201705-0915-003
Agency/Subagency: HHS/HSA	Agency Tracking No: 21572
Title: Ryan White HIV/AIDS Program Part F Dental Services Report
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/07/2020
	Date Received in OIRA: 06/02/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	07/31/2020
Responses	68	0	68
Time Burden (Hours)	2,988	0	2,940
Cost Burden (Dollars)	0	0	0

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Abstract: 1. The Dental Reimbursement Program (DRP) and the Community-Based Dental Partnership Program (CBDPP) serve to expand the availability of oral health care to patients with HIV/AIDS through the training of dental professionals. The DRP reimburses dental education programs for uncompensated funds to provide oral health services. The CBDPP funds entities in their efforts to increase access to oral health care.

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Authorizing Statute(s): 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:
	85 FR 5969	02/03/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 33688	06/02/2020
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	TAB B - DSR Form 2019.pdf

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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	68	0	0	0	0
Annual Time Burden (Hours)	2,988	2,940	0	48	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Increase in burden is due to non-substantive changes in the form.

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Annual Cost to Federal Government: $91,261

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 06/02/2020

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