[Federal Register Volume 73, Number 131 (Tuesday, July 8, 2008)]
[Notices]
[Pages 39018-39020]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E8-15470]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection; 
Comment Request

    In compliance with the requirement for the opportunity for public 
comment on proposed data collection projects (section 3506(c)(2)(A) of 
Title 44, United States Code, as amended by the Paperwork Reduction Act 
of 1995, Pub. L. 104-13), the Health Resources and Services 
Administration (HRSA) publishes periodic summaries of proposed projects 
being developed for submission to the Office of Management and Budget 
(OMB) under the Paperwork Reduction Act of 1995. To request more 
information on the proposed project or to obtain a copy of the data 
collection plans and draft instruments, e-mail [email protected] or 
call the HRSA Reports Clearance Officer on (301) 443-1129.
    Comments are invited on: (a) Whether the proposed collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
proposed collection of information; (c) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (d) ways 
to minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques or other 
forms of information technology.

Proposed Project: Ryan White HIV/AIDS Program: Client Level Data 
Reporting System: New

    The Client-Level Data Reporting System (CLDRS), created in 2008 by 
the Health Resources and Services Administration (HRSA), is designed to 
collect information from grantees, as well as their subcontracted 
service providers, funded under Parts A, B, C, D, and F of the Ryan 
White HIV/AIDS Treatment Modernization Act of 2006 (Ryan White HIV/AIDS 
Program). The Ryan White HIV/AIDS Program provides the Federal HIV/AIDS 
Programs in the Public Health Service (PHS) Act under Title XXVI, with 
the flexibility to respond effectively to the changing HIV epidemic. 
Its emphasis is on providing life-saving and life-extending services 
for people living with HIV/AIDS across the country, and on targeting 
resources to areas that have the greatest needs.
    All Program Parts of the Ryan White HIV/AIDS Program specify HRSA's 
responsibilities in the administration of grant funds, the allocation 
of funds, the evaluation of programs for the population served, and the 
improvement of the quality of care. Accurate records of the providers 
receiving Ryan White HIV/AIDS Program funding, the services provided, 
and the clients served continue to be critical to the implementation of 
the legislation and thus are necessary for HRSA to fulfill its 
responsibilities.
    Currently, the HIV/AIDS Bureau (HAB) requires that all Ryan White 
HIV/AIDS Program-funded grantees and their contracted service providers 
report aggregate data annually using the Ryan White Data Report. 
Agencies report data related to the service provider, clients, service 
visits provided/clients served, client demographics, and health 
insurance payments. The limitations of aggregate data are twofold: 
First, because they lack client identifiers, aggregate data by 
definition cannot be merged and unduplicated across service providers 
within a given geographic area. As a result, grantees, and ultimately 
HAB, cannot obtain accurate counts of the number of individuals served 
by the Ryan White HIV/AIDS Program. Second, aggregate data cannot be 
analyzed with the detail that is required to assess quality of care or 
to sufficiently account for the use of Ryan White HIV/AIDS Program 
funds.
    A well designed and supported client level data reporting system, 
using a unique identifier that will be encrypted before transfer, would 
provide the grantee and HRSA with the requisite information to assess 
quality of care and unmet needs, and the ability to more accurately and 
efficiently report these figures to HAB and other funding agencies. In 
addition, HAB will be able to characterize accurately the number of 
clients served by the Ryan White HIV/AIDS Program and the outcomes of 
the program services on a national scale. The ability to perform 
detailed analyses will be possible only if organizations submit data 
associated with encrypted client identifiers. These unique identifiers 
must be able to link data for clients across Ryan White HIV/AIDS 
Program-funded grantees and their subcontracted service providers.
    The CLDRS provides data on the characteristics of Ryan White HIV/
AIDS Program-funded grantees, their contracted service providers, and 
the clients being served with program funds. It is intended to support 
clinical quality management, performance measurement, service delivery, 
and client monitoring at both the system and client levels. The 
reporting system consists of two online data forms, the Grantee 
Information Form and the Service Provider Form. A data file containing 
the client level data elements will be submitted with the two online 
data forms on a semi-annual basis.
    The new legislation specifies increased grantee accountability and 
linking performance to budget. The CLDRS will be used to ensure 
compliance with the requirements of the reauthorized legislation, 
evaluate the progress of programs, monitor grantee and provider 
performance, measure the Government Performance and Result Act (GPRA) 
and the Performance Assessment Rating Tool (PART) goals, and meet 
reporting responsibilities to the Department, Congress, and OMB. In 
addition to meeting the goal of accountability to Congress, clients, 
advocacy groups, and the general public, information collected through 
the CLDRS is critical for HRSA, State

[[Page 39019]]

and local grantees, and individual providers. Through the CLDRS, these 
groups will assess the status of existing HIV-related service delivery 
systems to investigate trends in service utilization, and to identify 
areas of greatest need.
    Discussions were conducted with 12 volunteer grantee agencies 
representing Parts A, B, C, D, and Minority AIDS Initiatives, Parts A 
and B, as a basis for the burden estimates for the CLDRS components 
that follow. These burden estimates are broken out by burden to grantee 
respondents and burden to provider respondents, and are presented in 
two tables. The first table represents the estimated burden for the 
first 6-month data submission. The second table represents the 
estimated burden for each subsequent 6-month data submission. The 
estimated number of visits per 6-month reporting period ranged from 1 
to 17, with an average (mean) of 4 client visits per reporting period 
and a median of 2 client visits per reporting period.
    The number of clients is estimated two ways. The first estimate is 
based on providers that reported outpatient/ambulatory medical care, 
medical case management, and/or non-medical case management services in 
the 2007 Ryan White Data Report. These providers will be required to 
report client level data beginning in 2009. This first estimate 
excludes providers of other direct client services because these 
providers will not be required to report client level data until 2010. 
The second estimate includes all providers that reported direct client 
services in the 2007 Ryan White Data Report.
    The estimated response burden for the first 6-month reporting 
period CLDRS submission is as follows:
    The response burden for grantees is estimated as:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                          Hours to
                                                                                                                          complete/
                   Component                            Source of funding             Number of       Responses per      coordinate        Total hour
                                                                                     respondents         grantee      receipt of  data       burden
                                                                                                                           reports
--------------------------------------------------------------------------------------------------------------------------------------------------------
Grantee Form..................................  Part A..........................                56                 1              1.27                71
                                                Part B..........................                57                 1              6.00               342
                                                Part C..........................               357                 1              0.39               139
                                                Part D..........................                90                 1              0.67                60
                                                Part A MAI......................                56                 1              1.27                71
                                                Part B MAI......................                30                 1             10.00               300
                                               ---------------------------------------------------------------------------------------------------------
    Subtotal..................................  ................................               646  ................  ................               983
--------------------------------------------------------------------------------------------------------------------------------------------------------


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                                                                              Hours to develop/
                Component                     Number of      Responses  per      adjust  CLD       Total hour
                                             respondents         grantee           system            burden
----------------------------------------------------------------------------------------------------------------
CLD Collection System...................               563                 1           1108.80            624254
----------------------------------------------------------------------------------------------------------------

    The response burden for service providers is estimated as:

----------------------------------------------------------------------------------------------------------------
                                            Number of       Responses  per        Hours per        Total hour
               Component                   respondents         provider           response           burden
----------------------------------------------------------------------------------------------------------------
Provider Form.........................              2253                   1              2.35              5295
----------------------------------------------------------------------------------------------------------------


--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                      Responses                       Hours to collect/
                           Component                                Number of     (clients served)   Total responses  report  data per     Total hour
                                                                   respondents       per provider                         respondent         burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
Client Data File..............................................          \*\ 1511            493.57            745784              1.65           1230544
                                                                       \**\ 2112            417.47            881703              1.65          1454810
--------------------------------------------------------------------------------------------------------------------------------------------------------
\*\ Outpatient/ambulatory medical care, medical case management, and/or non-medical case management providers only.
\**\ All providers.

    The estimated response burden for all subsequent 6-month reporting 
period CLDRS submissions is as follows:
    The response burden for grantees is estimated as:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                                                          Hours to
                                                                                                                          complete/
                   Component                            Source of funding             Number of       Responses per      coordinate        Total hour
                                                                                     respondents         grantee      receipt of  data       burden
                                                                                                                           reports
--------------------------------------------------------------------------------------------------------------------------------------------------------
Grantee Form..................................  Part A..........................                56                 1              1.02                57
                                                Part B..........................                57                 1              1.50                86
                                                Part C..........................               357                 1              0.32               114
                                                Part D..........................                90                 1              0.33                30
                                                Part A MAI......................                56                 1              1.02                57

[[Page 39020]]

 
                                                Part B MAI......................                30                 1              2.00                60
                                               ---------------------------------------------------------------------------------------------------------
    Subtotal..................................  ................................               646  ................  ................               404
--------------------------------------------------------------------------------------------------------------------------------------------------------

    The response burden for service providers is estimated as:

----------------------------------------------------------------------------------------------------------------
                                              Number of      Responses  per       Hours per        Total hour
                Component                    respondents        provider          response           burden
----------------------------------------------------------------------------------------------------------------
Provider Form...........................              2253                 1              2.30              5182
----------------------------------------------------------------------------------------------------------------


--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                     Responses                        Hours to collect/
                          Component                               Number of      (clients served)    Total responses  report  data per     Total hour
                                                                 respondents       per provider                           respondent         burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
Client Data File............................................          \*\ 1511              493.57            745784              1.65           1230544
                                                                     \**\ 2112              417.47            881703              1.65          1454810
--------------------------------------------------------------------------------------------------------------------------------------------------------
\*\ Outpatient/ambulatory medical care, medical case management, and/or non-medical case management providers only.
\**\ All providers.

    E-mail comments to [email protected] or mail comments to the HRSA 
Reports Clearance Officer, Room 10-33, Parklawn Building, 5600 Fishers 
Lane, Rockville, Maryland 20857. Written comments should be received 
within 60 days of this notice. Information can also be accessed at 
http://datasupport.hab.hrsa.gov/.

    Dated: June 30, 2008.
Alexandra Huttinger,
Director, Division of Policy Review and Coordination.
 [FR Doc. E8-15470 Filed 7-7-08; 8:45 am]
BILLING CODE 4165-15-P