AIDS Drug Assistance Program (ADAP) Data Report

Forms and Documents

Document Name	Status
Form 2 ADAP Client Report Form	New
Form 1 ADAP Grantee Report Form	New
A - 2009 RWHAP Legislation.pdf Supplementary Document	2011-10-12
B - ADR Web Application Screen Shots.doc Supplementary Document	2011-10-12
OMB_ADR_Supporting_Statement_10.20.2011_HAB_FINAL.doc Supporting Statement A	2011-10-19

IC Document Collections

IC ID	Document Title	Status
199935	Data Collection System Other-ADAP Data Collection System Explanation	New
199934	ADAP Client Report Form	New
199933	ADAP Grantee Report Form	New

ICR Details

OMB Control No: 0915-0345	ICR Reference No: 201110-0915-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: AIDS Drug Assistance Program (ADAP) Data Report
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2011
	Date Received in OIRA: 10/27/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved
Responses	285	0	0
Time Burden (Hours)	52,405	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The HIV/AIDS Bureau within HRSA of the United States Department of Health and Human Services (DHHS) administers funds for the Ryan White HIV/AIDS Program. The ADAP Data Report (ADR) is designed to replace the historic ADAP Quarterly Report (AQR). The ADR will be used to collect information from grantees funded under Part B of the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Ryan White HIV/AIDS Program, as codified under title XXVI of the Public Health Service Act. The program is authorized by the Ryan White HIV/AIDS Treatment Extension Act of 2009 (Public Law 111-87) through 2013.

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Authorizing Statute(s): PL: Pub.L. 111 - 87 2 Name of Law: Ryan White HIV/AIDS Treatment Extension Act of 2009
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 44018	07/22/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 61105	10/03/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
ADAP Client Report	2	ADAP Client Report
ADAP Grantee Report	1	ADAP Grantee Report
Data Collection System

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	285	0	0	285	0	0
Annual Time Burden (Hours)	52,405	0	0	52,405	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new information collection package requesting clearance for 52,404.66 burden hours.

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Annual Cost to Federal Government: $509,403

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 10/27/2011

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