Integrating Community Pharmacists and Clinical Sites for Patient-Centered HIV Care

ICR 201505-0920-005

OMB: 0920-1019

Federal Form Document

Forms and Documents
Document
Name
Status
Form
New
Form
New
Form
New
Form
New
Supplementary Document
2015-05-19
Supplementary Document
2015-05-19
Supplementary Document
2015-05-19
Supporting Statement B
2015-05-19
Supporting Statement A
2015-08-06
Supplementary Document
2014-03-25
ICR Details
0920-1019 201505-0920-005
Historical Active 201406-0920-009
HHS/CDC 21630
Integrating Community Pharmacists and Clinical Sites for Patient-Centered HIV Care
Revision of a currently approved collection   No
Regular
Approved with change 08/17/2015
Retrieve Notice of Action (NOA) 06/04/2015
  Inventory as of this Action Requested Previously Approved
08/31/2018 36 Months From Approved 05/31/2017
10,400 0 10,060
6,043 0 5,113
0 0 0

The Centers for Disease Control and Prevention (CDC) has started the development and implementation of a model of HIV care that integrates community pharmacists with primary medical providers for patient-centered HIV care. This revision request will help CDC determine changes to clinic and pharmacy work systems, processes and outcomes in relation to the model project and how and if the model program improves patient outcomes through improved communication and collaboration between patients' clinical providers and pharmacists.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  80 FR 5114 01/30/2015
80 FR 30682 05/29/2015
Yes

  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 10,400 10,060 0 340 0 0
Annual Time Burden (Hours) 6,043 5,113 0 930 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This revision request includes new data collection instruments that cause an increase in the total burden hours.

$990,016
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Carol Marsh 404 639-4773 cww6@cdc.gov

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/04/2015


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