HRSA Ryan White HIV/AIDS Program Part F Regional AIDS Education and Training Center Program Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 6 IPE-Long-Term_finaldraftOMB 05.29.2025	Form and Instruction	New	Repair queued
Form 6 IPE, Long-Term	Form and Instruction	New	Repair queued
Form 5 PPA_finaldraftOMB 05.29.2025	Form and Instruction	New	Repair queued
Form 5 Participant Post-Activity Immediate Survey	Form and Instruction	New	Repair queued
Form 4 IPE-HC_draftfinalOMB 05.29.2025	Form and Instruction	New	Repair queued
Form 4 IPE, Site Characteristics and Outcomes	Form and Instruction	New	Missing upstream
Form 3 PT-SC_finaldraftOMB 05.29.2025	Form and Instruction	New	Repair queued
Form 3 PT, Site Characteristics and Outcomes	Form and Instruction	New	Repair queued
Form 2 TAR_finaldraftOMB 05.29.2025	Form and Instruction	New	Repair queued
Form 2 Training Activity Record	Form and Instruction	New	Repair queued
Form 1 IND-PAR_draftfinalOMB 05.29.2025	Form and Instruction	New	Repair queued
Form 1 Individual Participant Record	Form and Instruction	New	Repair queued
Comment 21_Wagner_IND-PAR_30 day_final_MAETC feedback.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 21_Wagner_IPE-HC_30 day_final_MAETC feedback.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 21_Wagner_IPE-Long Term_30 day_final_MAETC feedback.pdf	Public Comments	Uploaded 2025-01-08	Repair queued
Comment 21_Wagner_PPA_30 day_Final_MAETC feedback.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 21_Wagner_PT-SC_30 day_final_MAETC feedback.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 21_Wagner_TAR_30 day_final_MAETC feedback.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 21_Wagner_Transmittal.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 20_Morris.docx	Public Comments	Uploaded 2025-01-08	Repair queued
Comment 20_Morris_Transmittal.pdf	Public Comments	Uploaded 2025-01-08	Available
Comment 19_Ha.pdf	Public Comments	Uploaded 2025-01-10	Repair queued
Comment 19_Ha_Transmittal.pdf	Public Comments	Uploaded 2025-01-10	Repair queued
Comment 18_Harris_IPE-Long Term_30 day_final.pdf	Public Comments	Uploaded 2025-01-07	Available
Comment 18_Harris_PT-SC_30 day_final.pdf	Public Comments	Uploaded 2025-01-07	Available
Comment 18_Harris_IPE-HC_30 day_final.pdf	Public Comments	Uploaded 2025-01-07	Available
Comment 18_Harris_IND-PAR_30 day_final.pdf	Public Comments	Uploaded 2025-01-07	Available
Comment 18_Harris PPA_30 day_Final.docx	Public Comments	Uploaded 2025-01-07	Repair queued
Comment 18_Harris Transmittal.pdf	Public Comments	Uploaded 2025-01-07	Available
Comment 17_Cook Transmittal.pdf	Public Comments	Uploaded 2024-12-20	Available
Comment 17_Cook.docx	Public Comments	Uploaded 2024-12-20	Repair queued
HRSA proposed eval tools public comment due 1.8.24.docx	Public Comments	Uploaded 2025-01-08	Repair queued
Response to AETC data tools.pdf	Public Comments	Uploaded 2025-01-08	Available
PC_202412-0906-005_010825_053853_1.pdf	Public Comments	Uploaded 2025-01-08	Repair queued
Suggestions for All Proposed Forms NEAETC v4.docx	Public Comments	Uploaded 2025-01-08	Repair queued
Millery comments 1-8-25.docx	Public Comments	Uploaded 2025-01-08	Repair queued
PC_202412-0906-005_010825_033824_1.pdf	Public Comments	Uploaded 2025-01-08	Repair queued
Comment 16_Public.pdf	Public Comments	Uploaded 2024-12-09	Available
Comment 15_Morris.pdf	Public Comments	Uploaded 2024-09-18	Available
Comment 15_AETC new reporting tools feedback.docx	Public Comments	Uploaded 2024-09-18	Repair queued
Comment 14_MWAETC comments on evaluation forms.docx	Public Comments	Uploaded 2024-09-12	Repair queued
Comment 14_Cook.pdf	Public Comments	Uploaded 2024-09-12	Repair queued
Comment 13_McKinnon.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 13_IND-PAR_60 day_finaldraft copy comments.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 12_PPA 2025 (SE AETC Edits).docx	Public Comments	Uploaded 2024-09-16	Repair queued
Comment 12_Harris.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 11_Leon.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 10_Suggestions for All Proposed Forms NEAETC.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 10_Scott.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 9_JSI_AETC_Tool_Review_9.16.24.xlsx	Public Comments	Uploaded 2024-09-16	Repair queued
Comment 9_Day 2.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 8_JSI_CROSSWALK_New AETC Tools_9.16.24.xlsx	Public Comments	Uploaded 2024-09-16	Repair queued
Comment 8_Day 1.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 7_Cournos.pdf	Public Comments	Uploaded 2024-09-16	Available
Comment 6_AETC new forms feedback Sept 2024 Millery.docx	Public Comments	Uploaded 2024-09-17	Repair queued
Comment 6_MIllery.pdf	Public Comments	Uploaded 2024-09-17	Available
Comment 5_Feedback Midwest AETC on New HRSA Evaluation.xlsx	Public Comments	Uploaded 2024-09-17	Repair queued
Comment 5_Wagner.pdf	Public Comments	Uploaded 2024-09-17	Available
Comment 4_MAAETC comments on evaluation tools.pdf	Public Comments	Uploaded 2024-09-17	Available
Comment 4_Toan.pdf	Public Comments	Uploaded 2024-09-17	Available
Comment 3_Nader.pdf	Public Comments	Uploaded 2024-09-17	Available
Comment 2_Abousleman.pdf	Public Comments	Uploaded 2024-09-17	Available
Comment 1_PT-SC_60 day_finaldraft_jn.pdf	Public Comments	Uploaded 2024-07-29	Available
Comment 1_PPA_60 day_finaldraft_jn.pdf	Public Comments	Uploaded 2024-07-29	Available
Comment 1_IPE-SC_60 day_finaldraft_jn.pdf	Public Comments	Uploaded 2024-07-29	Available
Comment 1_IND-PAR_60 day_finaldraft_jn.pdf	Public Comments	Uploaded 2024-07-29	Repair queued
Comment 1_Nelson.pdf	Public Comments	Uploaded 2024-07-29	Repair queued
Supporting Statement A - Regional AETC 2024_v1.4 Final Draft (Clean).docx	Supporting Statement A	Uploaded 2025-06-10	Repair queued
Supporting Statement A - Regional AETC 2024_12.2.2024 Final Draft.docx	Supporting Statement A	Uploaded 2024-12-11	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
272961	Combined Data Set	Other-Codebook (“Participant List” section ONLY)	New
272960	IPE, Long-Term	Form and Instruction	New	IPE-Long-Term_finaldraftOMB 05.29.2025
272960	IPE, Long-Term	Form and Instruction	New
272958	Participant Post-Activity Immediate Survey	Form and Instruction	New	PPA_finaldraftOMB 05.29.2025
272958	Participant Post-Activity Immediate Survey	Form and Instruction	New
272957	IPE, Site Characteristics and Outcomes	Form and Instruction	New	IPE-HC_draftfinalOMB 05.29.2025
272957	IPE, Site Characteristics and Outcomes	Form and Instruction	New
272956	PT, Site Characteristics and Outcomes	Form and Instruction	New	PT-SC_finaldraftOMB 05.29.2025
272956	PT, Site Characteristics and Outcomes	Form and Instruction	New
272955	Training Activity Record	Form and Instruction	New	TAR_finaldraftOMB 05.29.2025
272955	Training Activity Record	Form and Instruction	New
272954	Individual Participant Record	Form and Instruction	New	IND-PAR_draftfinalOMB 05.29.2025
272954	Individual Participant Record	Form and Instruction	New

ICR Details

OMB Control No: 0906-0108	ICR Reference No: 202412-0906-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: HRSA Ryan White HIV/AIDS Program Part F Regional AIDS Education and Training Center Program Activities
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: 07/03/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/12/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2028	36 Months From Approved
Responses	255,155	0	0
Time Burden (Hours)	30,245	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Ryan White HIV/AIDS Program’s (RWHAP) AIDS Education and Training Center (AETC) Program, authorized under Title XXVI of the Public Health Service Act, supports a network of regional centers that conduct targeted, multi-disciplinary education and training programs for health care providers treating people with HIV. The RWHAP Regional AETC Program’s purpose is to increase the number of healthcare providers who are effectively educated and motivated to counsel, diagnose, treat, and medically manage people with HIV. The RWHAP Regional AETC Program recipients are required to report data on the training activities and trainees to HRSA once a year. HRSA is requesting the approval of new AETC data collection forms to accurately capture data relating to Regional AETC activities, participants, and site information for both Practice Transformation and Interprofessional Education sites as well as involvement in the HIV care and treatment workforce (1-year post-participation), knowledge gained through participating in an activity, and satisfaction with the activity.

---

Authorizing Statute(s): PL: Pub.L. 118 - 87 000 Name of Law: Ryan White HIV/AIDS Treatment Extension Act of 2009
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 58744	07/19/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 97627	12/09/2024
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Combined Data Set
IPE, Long-Term	6	IPE-Long-Term_finaldraftOMB 05.29.2025
IPE, Site Characteristics and Outcomes	4	IPE-HC_draftfinalOMB 05.29.2025
Individual Participant Record	1	IND-PAR_draftfinalOMB 05.29.2025
PT, Site Characteristics and Outcomes	3	PT-SC_finaldraftOMB 05.29.2025
Participant Post-Activity Immediate Survey	5	PPA_finaldraftOMB 05.29.2025
Training Activity Record	2	TAR_finaldraftOMB 05.29.2025

---

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	255,155	0	0	255,155	0	0
Annual Time Burden (Hours)	30,245	0	0	30,245	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 collection.

---

Annual Cost to Federal Government: $1,840,498

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.     Yes

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

---

Common Form ICR:  No

---

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: 12/12/2024

---