[NCHHSTP] TRANSCEND: Transgender Status-neutral Community-to-clinic Models to End the HIV Epidemic

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
TRANSCEND Satisfaction Client Survey	Form and Instruction	New	Available
Client Satisfaction Survey (data manager)	Form and Instruction	New	Repair queued
TRANSCEND Satisfaction Client Survey	Form and Instruction	New	Available
Client Satisfaction Survey (client)	Form and Instruction	New	Repair queued
TRANSCEND Intake Form	Form and Instruction	New	Available
Client Intake Form (client)	Form and Instruction	New	Repair queued
TRANSCEND Intake Form	Form and Instruction	New	Available
Client Intake Form (data manager)	Form and Instruction	New	Repair queued
Att4_PD_TRANSCEND_combined.pdf	Supplementary Document	Uploaded 2023-05-25	Repair queued
Att2 60 Day FRN Pub 11-16-2022.pdf	Supplementary Document	Uploaded 2023-05-25	Repair queued
Att 1_Authorizing Legislation.docx	Supplementary Document	Uploaded 2023-05-25	Repair queued
Supporting Statement B.docx	Supporting Statement B	Uploaded 2023-05-25	Repair queued
Supporting Statement A.docx	Supporting Statement A	Uploaded 2023-05-25	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260399	Client Satisfaction Survey (data manager)	Form and Instruction	New	TRANSCEND Satisfaction Client Survey
260399	Client Satisfaction Survey (data manager)	Form and Instruction	New
260398	Client Satisfaction Survey (client)	Form and Instruction	New	TRANSCEND Satisfaction Client Survey
260398	Client Satisfaction Survey (client)	Form and Instruction	New
260397	Client Intake Form (client)	Form and Instruction	New	TRANSCEND Intake Form
260397	Client Intake Form (client)	Form and Instruction	New
260396	Client Intake Form (data manager)	Form and Instruction	New	TRANSCEND Intake Form
260396	Client Intake Form (data manager)	Form and Instruction	New
260395	Electronic Health Record Data	Other-Specification of Data Elements for Electronic Transfer	New

ICR Details

OMB Control No: 0920-1410	ICR Reference No: 202305-0920-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-23AP
Title: [NCHHSTP] TRANSCEND: Transgender Status-neutral Community-to-clinic Models to End the HIV Epidemic
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/14/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/26/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2026	36 Months From Approved
Responses	1,220	0	0
Time Burden (Hours)	295	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The TRANSCEND demonstration project supports activities involving 4 transgender-serving clinics plus collaborating community-based organizations (CBOs) to provide an integrated range of client healthcare and support services aimed at ending the HIV epidemic. Data will be collected primarily from electronic health and services records and supplemented with information obtained through client surveys. Data managers will compile and report information to CDC for the purpose of TRANSCEND program monitoring and evaluation.

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Authorizing Statute(s): US Code: 42 USC 242 (k) Name of Law: Public Health Services Act
  

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:
	87 FR 68694	11/16/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 34158	05/26/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Client Intake Form (client)	None	TRANSCEND Intake Form
Client Intake Form (data manager)	None	TRANSCEND Intake Form
Client Satisfaction Survey (client)	None	TRANSCEND Satisfaction Client Survey
Client Satisfaction Survey (data manager)	None	TRANSCEND Satisfaction Client Survey
Electronic Health Record Data

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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	1,220	0	0	1,220	0	0
Annual Time Burden (Hours)	295	0	0	295	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: This is a new information collection request.

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Annual Cost to Federal Government: $109,943

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 05/26/2023

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