[Federal Register Volume 84, Number 131 (Tuesday, July 9, 2019)]
[Notices]
[Pages 32752-32753]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-14535]



[[Page 32752]]

-----------------------------------------------------------------------

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; 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

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

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: In compliance with of the Paperwork Reduction Act of 1995, 
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 no later than August 8, 
2019.

ADDRESSES: Submit your comments, including the ICR 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 Lisa Wright-Solomon, the 
HRSA Information Collection Clearance Officer at [email protected] or 
call (301) 443-1984.

SUPPLEMENTARY INFORMATION:
    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.
    Abstract: RWHAP is administered by HRSA's HIV/AIDS 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, RWHAP has developed a comprehensive system of nearly 2,000 
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). 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 interviews and medical chart reviews at 30 
sites. Sites include RWHAP-funded providers that are 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. At 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.
    A 60-day Federal Register Notice was published in the Federal 
Register on April 8, 2019, vol. 84, No. 67; pp. 13934-35. There were no 
public comments.
    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.

[[Page 32753]]



                                     Total Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         hours
----------------------------------------------------------------------------------------------------------------
Program Manager.................              30               1              30            1.00           30.00
Case Manager....................              30               1              30            1.00           30.00
Medical Director................              40               1              40            1.00           40.00
Client..........................             120               1             120             .50           60.00
Medical Record Abstraction......              30              50           1,500             .08          120.00
Telephone Screening.............              45               1              45             .25           11.25
                                 -------------------------------------------------------------------------------
    Total.......................             295  ..............           1,765  ..............          291.25
----------------------------------------------------------------------------------------------------------------


Maria G. Button,
Director, Division of the Executive Secretariat.
[FR Doc. 2019-14535 Filed 7-8-19; 8:45 am]
 BILLING CODE 4165-15-P