Enhancing HIV Care of Women, Infants, Children and Youth Building Capacity through Communities of Practice

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 6 (Revised) Foundational TA Assessment	Form and Instruction	Modified	Available
Form 6 Foundational TA Assessment	Form and Instruction	Modified	Available
Form 6 Foundational TA Assessment	Form and Instruction	Modified	Repair queued
Form 5 (Redline) Targeted and Intensive TA Assessment	Form and Instruction	Modified	Available
Form 5 Targeted and Intensive TA Assessment	Form and Instruction	Modified	Available
Form 5 Targeted and Intensive TA Assessment	Form and Instruction	Modified	Repair queued
Form 3 (revised) Community of Practice Post-Assessment	Form and Instruction	Modified	Available
Form 3 Community of Practice Post-Assessment	Form and Instruction	Modified	Available
Form 3 Community of Practice Post-Assessment	Form and Instruction	Modified	Repair queued
Form 4 (Revised) Community of Practice Session Assessment	Form and Instruction	Modified	Available
Form 4 Community of Practice Session Assessment	Form and Instruction	Modified	Available
Form 4 Community of Practice Session Assessment	Form and Instruction	Modified	Repair queued
Form 2 (Revised) Community of Practice Pre-Assessment	Form and Instruction	Modified	Available
Form 2 Community of Practice Pre-Assessment	Form and Instruction	Modified	Available
Form 2 Community of Practice Pre-Assessment Instrument	Form and Instruction	Modified	Repair queued
Form 1 (Revised) Pre-conception Counseling Community of Practice Retrospective Pretest-Post Assessment	Form and Instruction	Modified	Available
Form 1 Pre-conception Counseling Community of Practice Retrospective Pretest-Post Assessment	Form and Instruction	Modified	Available
Form 1 Pre-Conception Counseling Community of Practice Retrospective Pre-Post-Assessment Instrument	Form and Instruction	Modified	Repair queued
HAB0915-0391 _OMB NonSubstantive Change Request_07072025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-10	Available
HAB0915-0391 _OMB NonSubstantive Change Request_07072025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-10	Repair queued
OMB Supporting Statement B 5.24.23.docx	Supporting Statement B	Uploaded 2023-05-24	Available
OMB Supporting Statement B 5.24.23.docx	Supporting Statement B	Uploaded 2023-05-24	Repair queued
OMB Part A Supporting Statement 05122023.docx	Supporting Statement A	Uploaded 2023-05-12	Available
OMB Part A Supporting Statement 05122023.docx	Supporting Statement A	Uploaded 2023-05-12	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260190	Foundational TA Assessment	Form and Instruction	Modified	Foundational TA Assessment
260190	Foundational TA Assessment	Form and Instruction	Modified	Foundational TA Assessment
260190	Foundational TA Assessment	Form and Instruction	Modified
260189	Targeted and Intensive TA Assessment	Form and Instruction	Modified	Targeted and Intensive TA Assessment
260189	Targeted and Intensive TA Assessment	Form and Instruction	Modified	Targeted and Intensive TA Assessment
260189	Targeted and Intensive TA Assessment	Form and Instruction	Modified
260188	Community of Practice Post-Assessment	Form and Instruction	Modified	Community of Practice Post-Assessment
260188	Community of Practice Post-Assessment	Form and Instruction	Modified	Community of Practice Post-Assessment
260188	Community of Practice Post-Assessment	Form and Instruction	Modified
260187	Community of Practice Session Assessment	Form and Instruction	Modified	Community of Practice Session Assessment
260187	Community of Practice Session Assessment	Form and Instruction	Modified	Community of Practice Session Assessment
260187	Community of Practice Session Assessment	Form and Instruction	Modified
260186	Community of Practice Pre-Assessment Instrument	Form and Instruction	Modified	Community of Practice Pre-Assessment
260186	Community of Practice Pre-Assessment Instrument	Form and Instruction	Modified	Community of Practice Pre-Assessment
260186	Community of Practice Pre-Assessment Instrument	Form and Instruction	Modified
260185	Pre-Conception Counseling Community of Practice Retrospective Pre-Post-Assessment Instrument	Form and Instruction	Modified	Pre-conception Counseling Community of Practice Retrospective Pretest-Post Assessment
260185	Pre-Conception Counseling Community of Practice Retrospective Pre-Post-Assessment Instrument	Form and Instruction	Modified	Pre-conception Counseling Community of Practice Retrospective Pretest-Post Assessment
260185	Pre-Conception Counseling Community of Practice Retrospective Pre-Post-Assessment Instrument	Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0391	ICR Reference No: 202507-0915-001
Status: Active	Previous ICR Reference No: 202305-0915-004
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Enhancing HIV Care of Women, Infants, Children and Youth Building Capacity through Communities of Practice
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/15/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/10/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2026	07/31/2026	07/31/2026
Responses	2,340	0	2,340
Time Burden (Hours)	306	0	306
Cost Burden (Dollars)	0	0	0

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Abstract: HRSA aims to increase delivery of evidence-based interventions that enhance client outcomes, increase the skill level of the HIV workforce providing care and treatment to Women, Infants, Children and Youth (WICY), and involve partnerships for dissemination of best practices to Ryan White HIV/AIDS Program (RWHAP) Part D participants. To that end, HRSA seeks to implement a Communities of Practice (CoP) platform for RWHAP Part D recipients. A CoP engages recipient teams in improvement learning sessions using subject matter experts along with application experts who help recipient teams select, test and implement changes on the front line of care. Through organizational self-assessments, didactic learning on specific care topics, goals setting and work plan development, each team can strategically benefit their organization. CoPs afford participants the opportunity to work in a group to solve a recognized challenge related to a CoP domain and support dialogue among participants and the consultant/subject matter experts. Recipient teams commit to working over a period of 12 months, alternating between Learning Sessions in which teams come together to learn about the chosen topic and to plan changes, and Action Periods in which the teams return to their respective organizations and test those changes in their clinic settings. The domains for the proposed CoPs are trauma informed care, pre-conception counseling and youth transitioning into adult HIV care services.

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Authorizing Statute(s): PL: Pub.L. 111 - 87 XXVI Name of Law: Public Health Service 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:
	88 FR 12386	02/27/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 30767	05/12/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Community of Practice Post-Assessment	3 (revised), 3	Community of Practice Post-Assessment ,   Community of Practice Post-Assessment
Community of Practice Pre-Assessment Instrument	2, 2 (Revised)	Community of Practice Pre-Assessment ,   Community of Practice Pre-Assessment
Community of Practice Session Assessment	4, 4 (Revised)	Community of Practice Session Assessment ,   Community of Practice Session Assessment
Foundational TA Assessment	6, 6 (Revised)	Foundational TA Assessment ,   Foundational TA Assessment
Pre-Conception Counseling Community of Practice Retrospective Pre-Post-Assessment Instrument	1, 1 (Revised)	Pre-conception Counseling Community of Practice Retrospective Pretest-Post Assessment ,   Pre-conception Counseling Community of Practice Retrospective Pretest-Post Assessment
Targeted and Intensive TA Assessment	5, 5 (Redline)	Targeted and Intensive TA Assessment ,   Targeted and Intensive TA Assessment

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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	2,340	2,340	0	0	0	0
Annual Time Burden (Hours)	306	306	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: $132,035

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: 07/10/2025

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