[Federal Register Volume 84, Number 67 (Monday, April 8, 2019)]
[Notices]
[Pages 13934-13936]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-06767]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Public Comment Request; Information Collection Request Title: Assessing 
Care and Health Outcomes Among Ryan White HIV/AIDS Program (RWHAP) 
Clients Who Do Not Receive RWHAP-Funded Outpatient Ambulatory Health 
Services (OAHS), OMB No. 0906-xxxx-New

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services (HHS).

ACTION: Notice.

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SUMMARY: In compliance with the requirement for opportunity for public 
comment on proposed data collection projects of the Paperwork Reduction 
Act of 1995, 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 ICR should be received no later than June 7, 
2019.

ADDRESSES: Submit your comments to [email protected] or mail the HRSA 
Information Collection Clearance

[[Page 13935]]

Officer, Room 14N39, 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 Lisa Wright-
Solomon, 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: Assessing Care and Health 
Outcomes Among Ryan White HIV/AIDS Program Clients Who Do Not Receive 
RWHAP-Funded Outpatient Ambulatory Health Services, OMB No. 0906-xxxx-
New.
    Abstract: RWHAP is administered by HRSA's HIV/ADS Bureau. RWHAP 
funds and coordinates with cities, states, and local clinics and 
community-based organizations to deliver HIV care, treatment, and 
support to low-income people living with HIV (PLWH). Nearly two-thirds 
of RWHAP clients live at or below 100 percent of the federal poverty 
level and about three-quarters are racial or ethnic minorities. Since 
1990, the RWHAP has developed a comprehensive system of nearly 2,000 
safety net provider organizations that deliver high quality health care 
and support services to more than 500,000 PLWH, more than 50 percent of 
all diagnosed PLWH in the United States. Recipients and subrecipients 
funded to provide direct services must submit client-level data 
annually to HRSA as part of their RWHAP Services Report (RSR). The RSR 
(0906-0039) contains a single record for each RWHAP-eligible client who 
received a service during the calendar year. Providers report 
demographic and service use data for all their clients. However, they 
report clinical data (including lab results) only for those who 
received RWHAP-funded OAHS.
    HRSA is embarking on a 24-month study called Assessing Care and 
Health Outcomes Among RWHAP Clients Who Do Not Receive RWHAP-Funded 
OAHS. The purpose of the study is to learn about the quality of care 
and health outcomes among the one-third of clients for whom HRSA does 
not collect clinical information--that is, for the 164,000 clients who 
do not receive directly funded OAHS under the RWHAP. HRSA will use the 
findings to (1) assess HIV care and health outcomes among its non-OAHS 
clients, (2) determine if and where these clients receive OAHS, (3) 
identify any unmet HIV care and treatment needs faced by this 
population, and (4) develop strategies to better coordinate services 
between RWHAP-funded and nonfunded providers. To meet these objectives, 
HRSA proposes to conduct 30 site visits. Each site visit will include 
one RWHAP-funded provider that is not directly funded to deliver OAHS 
and, if necessary for accessing the medical records of their non-OAHS 
clients, up to two non-RWHAP medical providers. During each site visit, 
HRSA will collect qualitative and quantitative information via (1) 
semistructured interviews with program managers, clinicians, and 
frontline service providers, as well as with non-OAHS clients and (2) 
medical chart reviews for clients who do not receive directly funded 
OAHS under the RWHAP.
    Need and Proposed Use of the Information: The interviews with 
provider staff and clients will provide qualitative information on HIV-
related medical service use, process, and health outcomes; barriers to 
care; unmet needs; provider referral relationships; and opportunities 
to improve care and outcomes among clients who do not receive directly 
funded OAHS under the RWHAP. The medical chart reviews will provide 
quantitative information on medical visits, prescription medications, 
and clinical outcomes for a representative sample of non-OAHS clients. 
HRSA will use the data to estimate three main outcomes for the study 
population: (1) Retention in care, (2) initiation of antiretroviral 
therapy, and (3) viral suppression. This information will supplement 
data available from the RSR on OAHS clients and enable HRSA for the 
first time to measure the quality of care and health outcomes for its 
entire client population, an important step toward ending the HIV 
epidemic in the United States.
    Likely Respondents: HRSA plans to conduct individual interviews 
with two groups of informants: (1) Program managers, case managers or 
other frontline service providers, and medical directors or clinicians; 
and (2) RWHAP clients. HRSA also plans to review and abstract key data 
elements from non-OAHS client medical records from providers.
    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 name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         hours
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Program manager.................              30               1              30            1.00              30
Case manager....................              30               1              30            1.00              30
Medical director................              40               1              40            1.00              40
Client..........................             120               1             120            0.50              60
Chart abstraction...............              30              50           1,500            0.08             120
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                                             250  ..............           1,720  ..............             280
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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

[[Page 13936]]

or other forms of information technology to minimize the information 
collection burden.

Amy P. McNulty,
Acting Director, Division of the Executive Secretariat.
[FR Doc. 2019-06767 Filed 4-5-19; 8:45 am]
 BILLING CODE 4165-15-P