[Federal Register Volume 78, Number 192 (Thursday, October 3, 2013)]
[Notices]
[Pages 61367-61368]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-24251]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Health Resources and Services Administration

Agency Information Collection Activities; Proposed Collection; 
Public Comment Request

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.

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SUMMARY: In compliance with the requirement for opportunity for public 
comment on proposed data collection projects (Section 3506(c)(2)(A) of 
the Paperwork Reduction Act of 1995), the Health Resources and Services 
Administration (HRSA) announces plans to submit an Information 
Collection Request (ICR), described below, to the Office of Management 
and Budget (OMB). Prior to submitting the ICR to OMB, HRSA seeks 
comments from the public regarding the burden estimate, below, or any 
other aspect of the ICR.

DATES: Comments on this Information Collection Request must be received 
within 60 days of this notice.

ADDRESSES: Submit your comments to [email protected] or mail the HRSA 
Information Collection Clearance Officer, Room 10-29, Parklawn 
Building, 5600 Fishers Lane, Rockville, MD 20857.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the data collection plans and 
draft instruments, email [email protected] or call the HRSA 
Information Collection Clearance Officer at (301) 443-1984.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the information request collection title 
for reference.
    Information Collection Request Title: Understanding and Monitoring 
Funding Streams in Ryan White Clinics.
    OMB No. 0915-xxxx--New.
    Abstract: The HRSA's HIV/AIDS Bureau (HAB) administers the Ryan 
White HIV/AIDS Program (RWHAP) authorized under Title XXVI of the 
Public Health Service Act as amended by the Ryan White HIV/AIDS 
Treatment Extension Act of 2009. Established in 1990, the RWHAP is a 
federally funded program designed to provide HIV-related medical care 
and treatment as well as support service for individuals and families 
affected by the disease who are uninsured or underinsured. The Program 
consists of several ``Parts,'' corresponding to sections of the 
statute, through which funding is provided to states, cities, 
providers, and other organizations. Part A provides emergency relief 
for areas with substantial need for HIV/AIDS care and support services 
that are most severely affected by the HIV/AIDS epidemic, including 
eligible metropolitan areas (EMAs) and transitional grant areas (TGAs). 
Part B provides grants to states and U.S. territories to improve the 
quality, availability, and organization of HIV/AIDS health care and 
support services. Part B grants include a base grant; the AIDS Drug 
Assistance Program (ADAP) award; ADAP Supplemental Drug Treatment 
Program funds; and supplemental grants to states with ``emerging 
communities,'' defined as jurisdictions reporting between 500 and 999 
cumulative AIDS cases over the most recent 5 years. The Part C Early 
Intervention Services (EIS) component of the Ryan White HIV/AIDS 
Program funds comprehensive primary health care in outpatient settings 
for people living with HIV disease. Part D grantees provide outpatient 
or ambulatory family-centered primary medical care for women, infants, 
children, and youth with HIV/AIDS.
    In 2010, the Patient Protection and Affordable Care Act (ACA) was 
enacted into law. The ACA is expansive and will likely impact the 
RWHAP. Some of the reforms have already been implemented (including the 
creation of Pre-Existing Insurance Plans) and the barring of insurance 
carriers from denying coverage to children with pre-existing conditions 
such as HIV/AIDS, cancelling coverage for adults with health conditions 
because of unintentional mistakes on the application, and imposing 
lifetime dollar caps on essential health benefits. Effective January 
2014, states will have the option to expand Medicaid to individuals 
younger than 65 years of age with incomes up to 133 percent of the 
federal poverty level (FPL). On October 1, 2013, insurance marketplaces 
(exchanges) from which individuals can purchase health insurance will 
begin open enrollment, with coverage to begin as early as January 1, 
2014. Individuals with incomes from up to 400 percent FPL may be 
eligible for tax credits to reduce premium costs. Individuals with 
lower incomes may also be eligible for reductions in cost-sharing.
    The proposed study will provide HAB and policymakers with a better 
understanding of how the RWHAP currently provides primary outpatient 
health care and essential support services to both uninsured and 
underinsured clients. It will identify what types of core medical 
services and subservices, and support services are currently not 
covered or not fully covered by Medicaid, Medicare, and private 
insurance, which are needed to provide high quality HIV/AIDS care. The 
study also will provide information on how grantees monitor patient

[[Page 61368]]

healthcare coverage (e.g., payer source, type of insurance) and the 
cost of care. Together, this information will help HAB understand the 
abilities of Part C and Part D grantees to support and track expanded 
health insurance enrollment for their clients and to adapt to the 
changing funding landscape. The study will also collect information on 
what processes are used and what types of data are stored within their 
data information systems. Information about data information systems 
will be used to support the development of a technical assistance 
tracker for RWHAP grantees to monitor and assess changes in the mix of 
funding sources used to pay for primary health care and essential 
support services to PLWHA as the ACA is fully implemented.
    Lastly, the study will gather information regarding Part C and Part 
D grantees' level of participation in state-sponsored initiatives for 
the development of health homes, their relationship with managed care 
organizations, and their status regarding recognition as a Patient 
Centered Medical Home. This information will provide some basic 
information regarding grantees' abilities to continue to service PLWHA 
as the ACA is implemented differently among the states.
    The Ryan White Funding Streams Survey (Survey) will be used to 
collect this information. The survey will collect both qualitative and 
quantitative data and will be administered online to program directors 
from a representative sample of Part C and Part D grantees. The Survey 
contains 32 questions that capture information about the different 
funding streams used for the provision of services to PLWHA; grantees' 
abilities to track health insurance, funding sources, and costs of 
care; and their relationship with managed care organizations. The data 
provided through the survey will not contain individual or personally 
identifiable information. This information will inform HAB in the 
development of future RWHAP policy. It will also assist HAB in the 
final development of the technical assistance tracking tool for 
grantees.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose or provide the 
information requested. This includes the time needed to review 
instructions; to develop, acquire, install and utilize technology and 
systems for the purpose of collecting, validating and verifying 
information, processing and maintaining information, and disclosing and 
providing information; to train personnel and to be able to respond to 
a collection of information; to search data sources; to complete and 
review the collection of information; and to transmit or otherwise 
disclose the information. The total annual burden hours estimated for 
this Information Collection Request are summarized in the table below.
    Total Estimated Annualized burden hours:

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                                                                                         Number of                       Average burden
                                Form                                    Number of      responses per   Total responses    per response     Total burden
                                                                       respondents       respondent                        (in hours)         hours
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Survey.............................................................             120                1              120              4.7              564
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    HRSA specifically requests comments on (1) the necessity and 
utility of the proposed information collection for the proper 
performance of the agency's functions, (2) the accuracy of the 
estimated burden, (3) ways to enhance the quality, utility, and clarity 
of the information to be collected, and (4) the use of automated 
collection techniques or other forms of information technology to 
minimize the information collection burden.

    Dated: September 26, 2013.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-24251 Filed 10-2-13; 8:45 am]
BILLING CODE 4165-15-P