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Later Implementation Site Staff Interview Guide
Special Study - Emerging Issues Related to Affordable Care Act Implementation: The Future of Ryan White HIV/AIDS Services: A Snapshot of Outpatient Ambulatory Medical Care
OMB: 0915-0381
IC ID: 210745
OMB.report
HHS/HSA
OMB 0915-0381
ICR 201403-0915-004
IC 210745
( )
Documents and Forms
Document Name
Document Type
Attachment B - Later Implementation Site Visit Interview Guide_rev.docx
Other-Interview
Information Collection (IC) Details
View Information Collection (IC)
IC Title:
Later Implementation Site Staff Interview Guide
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Voluntary
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Other-Interview
Attachment B - Later Implementation Site Visit Interview Guide_rev.docx
Yes
Yes
Paper Only
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
90
Number of Respondents for Small Entity:
0
Affected Public:
Private Sector
Private Sector:
Businesses or other for-profits, Not-for-profit institutions
Percentage of Respondents Reporting Electronically:
0 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
90
0
90
0
0
0
Annual IC Time Burden (Hours)
90
0
90
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
No associated records found
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.