Ryan White HIV/AIDS Program Expenditure Forms

Forms and Documents

Document Name	Status
Form 5 EHE Expenditures Reports Form	Unchanged
Form 4 Part D Expenditure Report Form	Unchanged
Form 3 Part C Expenditure Report Form	Unchanged
Form 2 Part B Expenditures Report Form	Modified
Form 1 Part A Expenditures Report Form	Unchanged
Non Substantive Change Request_0915 0390_FINAL.docx Justification for No Material/Nonsubstantive Change	2023-08-01
Attachment A - legislation-title-xxvi.pdf Supplementary Document	2023-05-31
Expenditures Supporting Statement Final - OIRA - 07.21.23 Revised.docx Supporting Statement A	2023-07-21

IC Document Collections

IC ID	Document Title	Status
260461	EHE Expenditures Reports Form	Unchanged
260460	Part D Expenditure Report Form	Unchanged
260459	Part C Expenditure Report Form	Unchanged
260458	Part B Expenditures Report Form	Modified
260457	Part A Expenditures Report Form	Unchanged

ICR Details

OMB Control No: 0915-0390	ICR Reference No: 202308-0915-002
Status: Received in OIRA	Previous ICR Reference No: 202305-0915-007
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Ryan White HIV/AIDS Program Expenditure Forms
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/01/2023

	Requested	Previously Approved
Expiration Date	07/31/2026	07/31/2026
Responses	615	615
Time Burden (Hours)	2,568	2,568
Cost Burden (Dollars)	0	0

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Abstract: HRSA administers the Ryan White HIV/AIDS Program (RWHAP) authorized under Title XXVI of the Public Health Service Act. The RWHAP Allocations and Expenditures Reports (A&E Reports) allow HRSA to monitor and track the use of grant funds for compliance with program and grants policies, and requirements as outlined in the legislation. Recipients funded under RWHAP Parts A, B, C, and D are required to report financial data to HRSA at the beginning (Allocations Report) and at the end (Expenditures Report) of their grant budget period. The A&E Reports request information recipients already collect, including the use of RWHAP grant funds for core medical and support services; and on various program components, such as administration, planning and evaluation, and clinical quality management. RWHAP Parts A and B recipients funded under the Ending the HIV Epidemic in the U.S. (EHE) initiative are also required to report allocations and expenditures of the grant budget period in the EHE A&E Reports. This allows HRSA to track and report progress toward meeting the EHE goals. The reports are similar in content; however, in the first report, recipients document the allocation of their RWHAP or EHE grant award at the beginning of their grant budget period. In the second report, recipients document actual expenditures of their RWHAP or EHE grant award (including any carryover dollars) at the end of their grant budget period. This package only includes the Expenditures Report. The Allocations Report revision package was approved by OMB under 0915-0318

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Authorizing Statute(s): PL: Pub.L. 111 - 87 0 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:
	88 FR 14625	03/09/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 34867	05/31/2023
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
EHE Expenditures Reports	5	EHE Expenditures Reports
Part A Expenditures Report	1	Part A Expenditures Report and Changes Summary
Part B Expenditures Report	2, 2.1	Part B Expenditures Report and Changes Summary ,   Part B X08 Expenditures Report
Part C Expenditure Report	3	Part C Expenditure Report
Part D Expenditure Report	4	Part D Expenditure Report

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ICR Summary of Burden

	Total Request	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	615	615	0	0	0	0
Annual Time Burden (Hours)	2,568	2,568	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: $125,219

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: 08/01/2023

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