AIDS Drug Assistance Program (ADAP) Data Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form B ADAP Grantee Report and Client Level Data Elements Report	Form	Modified	Available
E - 60 Day Federal Registry.pdf	Supplementary Document	Uploaded 2017-08-08	Available
Supporting Statement A_08072017.docx	Supporting Statement A	Uploaded 2017-08-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
199934	ADAP Client Report	Instruction	Removed
199933	ADAP Grantee Report and Client Level Data Elements Report	Form	Modified

ICR Details

OMB Control No: 0915-0345	ICR Reference No: 201708-0915-001
Status: Historical Active	Previous ICR Reference No: 201408-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: AIDS Drug Assistance Program (ADAP) Data 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: 10/02/2017
	Date Received in OIRA: 08/09/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved	10/31/2017
Responses	54	0	108
Time Burden (Hours)	4,698	0	4,698
Cost Burden (Dollars)	0	0	0

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Abstract: ADAP grantees are required to annually submit the ADR that include information on patients served, pharmaceuticals dispensed, pricing, sources of support to provide HIV/AIDs medications, eligibility requirements, cost data, and coordination with Medicaid. The report represents the best method for HRSA to determine how grant funds are expended and to provide answers to requests from Congress and other organizations.

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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:
	82 FR 18918	04/24/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 36801	08/07/2017
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
ADAP Grantee Report and Client Level Data Elements Report	B, C	B - ADR Grantee Report.docx ,   C - ADR Client-Level Data Elements 2017.docx
ADAP Client Report

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ICR Summary of Burden

table that charts list 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	54	108	0	-54	0	0
Annual Time Burden (Hours)	4,698	4,698	0	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: an IC was deleted and combined with the 1st ICR, making it look like there was a burden increase and decrease. This is an extension, no actual change in burden hours.

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Annual Cost to Federal Government: $211,942

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? 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: 08/09/2017

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