[Federal Register Volume 78, Number 250 (Monday, December 30, 2013)]
[Notices]
[Pages 79470-79471]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-31158]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request

AGENCY: Health Resources and Services Administration, HHS.

ACTION: Notice.

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SUMMARY: In compliance with Section 3507(a)(1)(D) of the Paperwork 
Reduction Act of 1995, the Health Resources and Services Administration 
(HRSA) has submitted an Information Collection Request (ICR) to the 
Office of Management and Budget (OMB) for review and approval. Comments 
submitted during the first public review of this ICR will be provided 
to OMB. OMB will accept further comments from the public during the 
review and approval period.

DATES: Comments on this ICR should be received within 30 days of this 
notice.

ADDRESSES: Submit your comments, including the Information Collection 
Request Title, to the desk officer for HRSA, either by email to [email protected] or by fax to 202-395-5806.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email the HRSA Information 
Collection Clearance Officer at [email protected] or call (301) 443-
1984.

SUPPLEMENTARY INFORMATION: Information Collection Request Title: 
Understanding and Monitoring Funding Streams in Ryan White Clinics
    OMB No:. 0915-xxxx--New
    Abstract: 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 services 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 Condition 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, began open enrollment, with coverage to begin as 
early as January 1, 2014. Individuals with incomes 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 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 people living with HIV/AIDS (PLWHA) as the ACA is fully 
implemented.
    Lastly, the study will gather information regarding Part C and Part 
D grantees' levels 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.
    Need and Proposed Use of the Information: The information collected 
will help HAB understand how the RWHAP currently provides primary 
outpatient health care and essential support services to both uninsured 
and underinsured clients and which of these are currently not covered 
or not fully covered by Medicaid, Medicare, and private insurance. It 
will help HAB understand how grantees monitor

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patient healthcare coverage (e.g., payer source, type of insurance) and 
the cost of care. Together, this information will help HAB gain 
knowledge on 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. This will inform HAB in the 
development of future RWHAP policies.
    In addition, 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. Information about 
Part C and Part D grantees' levels of participation in state-sponsored 
initiatives will provide some basic information regarding grantees' 
abilities to continue to service PLWHA as the ACA is implemented 
differently among the states.
    Likely Respondents: The survey will be administered online to 
program directors from a representative sample of Part C and Part D 
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 ICR 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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    Dated: December 23, 2013.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-31158 Filed 12-27-13; 8:45 am]
BILLING CODE 4165-15-P