AIDS Drug Assistance Program (ADAP) Data Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 ADR 2020 EHE Question in Recipient Report.docx	Form and Instruction	Modified	Available
Form 1 ADR variable changes Instrument.pdf	Form and Instruction	Modified	Available
ADAP Supporting Statement A HRSA RESPONSE CLEAN.docx	Supporting Statement A	Uploaded 2020-05-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
199933	AIDS Drug Assistance Program (ADAP) Data Report (ADR)	Form and Instruction	Modified	ADR 2020 EHE Question in Recipient Report.docx
199933	AIDS Drug Assistance Program (ADAP) Data Report (ADR)	Form and Instruction	Modified	ADR variable changes Instrument.pdf

ICR Details

OMB Control No: 0915-0345	ICR Reference No: 202004-0915-002
Status: Historical Active	Previous ICR Reference No: 201708-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: AIDS Drug Assistance Program (ADAP) Data 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: 06/04/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/08/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2023	36 Months From Approved	10/31/2020
Responses	54	0	54
Time Burden (Hours)	4,698	0	4,698
Cost Burden (Dollars)	0	0	0

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Abstract: The RWHAP ADAP is a state and territory-administered program that provides Food and Drug Administration (FDA)-approved medications to low-income people with HIV who have limited or no health coverage from private insurance, Medicaid, or Medicare. RWHAP ADAP funds may also be used to purchase health insurance for eligible clients and for services that enhance access, adherence, and monitoring of drug treatments. The HRSA HAB uses the ADR to evaluate the national impact of the RWHAP ADAP, by providing client-level data on individuals being served, services being delivered, and costs associated with these services.

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Authorizing Statute(s): PL: Pub.L. 116 - 94 2611 Part B Ryan White HIV/AID Name of Law: Public Health Service Act 2019
  

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:
	84 FR 66202	12/03/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 19494	04/07/2020
Did the Agency receive public comments on this ICR? Yes

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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
AIDS Drug Assistance Program (ADAP) Data Report (ADR)	1, 2	ADR variable changes Instrument.pdf ,   ADR 2020 EHE Question in Recipient Report.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	54	54	0	0	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: 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: $139,900

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: 04/08/2020

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