COVID-19 Data Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Coronavirus 2019 (COVID-19) Data Report Form.docx	Form	Modified	Available
Form 1 _HRSA RWHAP COVID-19 Data Report	Form	Modified	Repair queued
Attachment B - 2020_CDR_Instruction_Manual_08_03_20_508.pdf	Supplementary Document	Uploaded 2020-11-15	Repair queued
Attachment A - 60 Day FRN.pdf	Supplementary Document	Uploaded 2020-11-15	Repair queued
Supporting Statement B.docx	Supporting Statement B	Uploaded 2020-11-15	Repair queued
Supporting Statement A.docx	Supporting Statement A	Uploaded 2020-11-15	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
241923	_HRSA RWHAP COVID-19 Data Report	Form	Modified	Coronavirus 2019 (COVID-19) Data Report Form.docx
241923	_HRSA RWHAP COVID-19 Data Report	Form	Modified

ICR Details

OMB Control No: 0906-0053	ICR Reference No: 202011-0906-001
Status: Historical Active	Previous ICR Reference No: 202005-0906-002
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: COVID-19 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: 01/27/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/17/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2024	36 Months From Approved	01/31/2021
Responses	24,540	0	24,540
Time Burden (Hours)	78,528	0	49,080
Cost Burden (Dollars)	0	0	0

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Abstract: The Health Resources and Services Administration (HRSA) HIV/AIDS Bureau (HAB) is requesting approval from the Office of Management and Budget (OMB) to extend the expiration date of a monthly, aggregate data report to collect information on activities funded under the FY 2020 Coronavirus Aid, Relief, and Economic Security (CARES) Act. Respondents will be providers who use CARES Act funding to provide Ryan White HIV/AIDS Program (RWHAP) core medical or support services to eligible clients and immediate household members. The information collected assists HRSA HAB in understanding how CARES Act funding is being used to support RWHAP clients and immediate household members and ensures that HRSA HAB is compliant with federal reporting requirements.

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Authorizing Statute(s): US Code: 42 USC 300ff-11 et seq Name of Law: HIV Health Care Services Program
   PL: Pub.L. 111 - 352 0 Name of Law: GPRA Modernziation Act of 2010
  

Citations for New Statutory Requirements: PL: Pub.L. 116 - 136 0 Name of Law: Coronavirus Aid, Relief, and Economic Security Act

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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 54390	09/01/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 73060	11/16/2020
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
_HRSA RWHAP COVID-19 Data Report	1	Coronavirus 2019 (COVID-19) Data Report Form.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	24,540	24,540	0	0	0	0
Annual Time Burden (Hours)	78,528	49,080	0	29,448	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: Burden increase due to an increase in burden per response; a more accurate estimate to burden per response than the original emergency request.

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Annual Cost to Federal Government: $595,819

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? Yes

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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: 11/17/2020

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