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OMB Control No: 0915-0151	ICR Reference No: 201403-0915-006
Status: Historical Active	Previous ICR Reference No: 201104-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No: 21572
Title: Ryan White HIV/AIDS Program Part F Dental Services Report
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/03/2014
	Date Received in OIRA: 03/21/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2017	36 Months From Approved	06/30/2014
Responses	68	0	70
Time Burden (Hours)	2,940	0	1,400
Cost Burden (Dollars)	0	0	0

Abstract: Under the Ryan/White HIV/AIDS Treatment Modernization Act, accredited schools of dentistry, pre- and post-doctoral dental training programs, and dental hygiene education programs may apply for reimbursement of uncompensated costs for providing oral health care to HIV infected individuals. The Dental Services Form provides information on unreimbursed expenses and descriptions of selected program components in order to determine the reimbursement award amount and to report on provided services under the Act.

Authorizing Statute(s): PL: Pub.L. 106 - 345 101-401 Name of Law: Ryan White CARE Act Amendments of 2000
   PL: Pub.L. 109 - 415 101-401 Name of Law: Ryan White HIV/AIDS Treatment Modernization Act of 2006
   PL: Pub.L. 101 - 381 2601 Name of Law: Ryan White Comprehensive AIDS Resources Emergency (CARE) Act
   PL: Pub.L. 111 - 87 2 Name of Law: Ryan White HIV/AIDS Treatment Extension Act of 2009

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 399	01/03/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 15350	03/19/2014
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
Ryan White HIV/AIDS Program Dental Services Report.	1

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	68	70	-2
Annual Time Burden (Hours)	2,940	1,400	1,540
Annual Cost Burden (Dollars)	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: The current OMB inventory of burden hours for this activity is 45 hours for DRP applicants and 35 hours for CBDPP grantees. This is an increase from the previous 20 hours for all respondents. Most of the respondents we contacted this year did not have data collection systems in place and cited this as a reason for the higher burden estimate. We had one CBDPP who did have systems in place and stated that the Dental Services Form was easy to complete and took them one hour and 30 minutes. Another CBDPP stated it took them 80 hours to complete the Dental Services Form because they had to reach out to multiple service providers to report demographic and clinical data. Two respondents said that the additional data elements would increase their burden. See Tab E for a list of burden estimates and comments. The Dental Services Form has been revised to comply with the National HIV/AIDS Strategy directive to standardize data collection and reduce grantee reporting burden. The revised form implements data collection standards for race, ethnicity, and sex and eliminates some narrative description items.

Annual Cost to Federal Government: $228,468

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

Agency Contact: Jodi Duckhorn 301 443-1984

View ICR - OIRA Conclusion