HRSA HAB Client-Level Data Reporting System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form D HRSA Client-Level Data Reporting System: Client Report	Form	Unchanged	Available
Form C HRSA Client-Level Data Reporting System: Service Provider Report	Form	Unchanged	Available
Form B HRSA Client-Level Data Reporting System: Grantee Report	Form	Unchanged	Available
C - 2017_Service_Provider_Form_Screenshots_4242018_updated_final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-04-24	Available
Non Substantitive Change 0323 RSR_Opioid Questions_final.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-04-24	Available
FINALRSR SupportingStatement_with edits_5-31-2017_OMB (003).docx	Supporting Statement A	Uploaded 2017-07-19	Available
F - 0915-0323 60-Day FRN RSR pub 3272017.pdf	Supplementary Document	Uploaded 2017-06-02	Available
E - 2016 RSR Manual 508.pdf	Supplementary Document	Uploaded 2017-06-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
187336	HRSA Client-Level Data Reporting System: Client Report	Form	Unchanged
187334	HRSA Client-Level Data Reporting System: Service Provider Report	Form	Unchanged
187332	HRSA Client-Level Data Reporting System: Grantee Report	Form	Unchanged

ICR Details

OMB Control No: 0915-0323	ICR Reference No: 201804-0915-005
Status: Historical Active	Previous ICR Reference No: 201706-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: HRSA HAB Client-Level Data Reporting System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/25/2018
	Date Received in OIRA: 04/25/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	07/31/2020	07/31/2020
Responses	3,700	0	3,700
Time Burden (Hours)	122,550	0	122,550
Cost Burden (Dollars)	0	0	0

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Abstract: The Ryan White HIV/AIDS Program’s client-level data reporting system was created in 2009 by HRSA. It is designed to collect information from grantees and their subcontracted service providers. The Ryan White HIV/AIDS Program provides funded entities with a flexibility to respond effectively to the changing HIV epidemic, with an emphasis on providing life-saving and life-extending services for people living with HIV across this country.

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Authorizing Statute(s): PL: Pub.L. 111 - 87 2610-2623-2655-2671-2693 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 15226	03/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 26498	06/06/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
HRSA Client-Level Data Reporting System: Grantee Report	B	B - 2017_RSR_Grantee_Report_Screenshots.docx
HRSA Client-Level Data Reporting System: Service Provider Report	C	C - 2017_Service_Provider_Form_Screenshots.docx
HRSA Client-Level Data Reporting System: Client Report	D	D- 2017 RSR Client Level Data Elements_Final 4-22-17_OMB (002).docx

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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	3,700	3,700	0	0	0	0
Annual Time Burden (Hours)	122,550	122,550	0	0	0	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:

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Annual Cost to Federal Government: $1,299,445

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: 04/25/2018

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