Partnerships for Care (P4C) Progress Reports

Forms and Documents

Document Name	Status
Form 1 P4C Supplemental Funding Progress Report Form and Instruction	New
P4C Partners Meeting.docx Supplementary Document	2015-05-26
201505-0906-001_OMB Supporting Statement_Final.docx Supporting Statement A	2015-06-22

IC Document Collections

IC ID	Document Title	Status
216661	P4C Supplemental Funding Progress Report Form and Instruction	New

ICR Details

OMB Control No: 0906-0011	ICR Reference No: 201505-0906-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Partnerships for Care (P4C) Progress Reports
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: 07/09/2015
	Date Received in OIRA: 05/28/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2018	36 Months From Approved
Responses	44	0	0
Time Burden (Hours)	660	0	0
Cost Burden (Dollars)	7,333	0	0

---

Abstract: Partnerships for Care (P4C) is a three-year, multi-agency project designed to support health centers in expanding their HIV service delivery. P4C progress reports will be submitted by participating health centers (22) and used to monitor and report progress toward meeting established goals and objectives, and ensure appropriate stewardship over federal funds. Collected information is not consistently captured by any other existing source

---

Authorizing Statute(s): PL: Pub.L. 111 - 87 2 Name of Law: Minority AIDS Initiative (3) HHS Report
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 63408	10/23/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 25304	05/04/2015
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
P4C Supplemental Funding Progress Report	2, 1	P4C Implementation Form ,   P4C Outcomes Form

---

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	44	0	0	44	0	0
Annual Time Burden (Hours)	660	0	0	660	0	0
Annual Cost Burden (Dollars)	7,333	0	0	7,333	0	0

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

Burden Increase Due to: Changing Regulations

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

Burden Reduction Due to:

Short Statement: The burden increase is due to the fact that this is a new program with new requirements that allow for program monitoring.

---

Annual Cost to Federal Government: $132,659

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

---

Common Form ICR:  No

---

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: 05/28/2015

---