[Federal Register: July 8, 2008 (Volume 73, Number 131)]
[Notices]
[Page 39018-39020]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr08jy08-72]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
In compliance with the requirement for the opportunity for public
comment on proposed data collection projects (section 3506(c)(2)(A) of
Title 44, United States Code, as amended by the Paperwork Reduction Act
of 1995, Pub. L. 104-13), the Health Resources and Services
Administration (HRSA) publishes periodic summaries of proposed projects
being developed for submission to the Office of Management and Budget
(OMB) under the Paperwork Reduction Act of 1995. To request more
information on the proposed project or to obtain a copy of the data
collection plans and draft instruments, e-mail paperwork@hrsa.gov or
call the HRSA Reports Clearance Officer on (301) 443-1129.
Comments are invited on: (a) Whether the proposed collection of
information is necessary for the proper performance of the functions of
the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on respondents,
including through the use of automated collection techniques or other
forms of information technology.
Proposed Project: Ryan White HIV/AIDS Program: Client Level Data
Reporting System: New
The Client-Level Data Reporting System (CLDRS), created in 2008 by
the Health Resources and Services Administration (HRSA), is designed to
collect information from grantees, as well as their subcontracted
service providers, funded under Parts A, B, C, D, and F of the Ryan
White HIV/AIDS Treatment Modernization Act of 2006 (Ryan White HIV/AIDS
Program). The Ryan White HIV/AIDS Program provides the Federal HIV/AIDS
Programs in the Public Health Service (PHS) Act under Title XXVI, with
the flexibility to respond effectively to the changing HIV epidemic.
Its emphasis is on providing life-saving and life-extending services
for people living with HIV/AIDS across the country, and on targeting
resources to areas that have the greatest needs.
All Program Parts of the Ryan White HIV/AIDS Program specify HRSA's
responsibilities in the administration of grant funds, the allocation
of funds, the evaluation of programs for the population served, and the
improvement of the quality of care. Accurate records of the providers
receiving Ryan White HIV/AIDS Program funding, the services provided,
and the clients served continue to be critical to the implementation of
the legislation and thus are necessary for HRSA to fulfill its
responsibilities.
Currently, the HIV/AIDS Bureau (HAB) requires that all Ryan White
HIV/AIDS Program-funded grantees and their contracted service providers
report aggregate data annually using the Ryan White Data Report.
Agencies report data related to the service provider, clients, service
visits provided/clients served, client demographics, and health
insurance payments. The limitations of aggregate data are twofold:
First, because they lack client identifiers, aggregate data by
definition cannot be merged and unduplicated across service providers
within a given geographic area. As a result, grantees, and ultimately
HAB, cannot obtain accurate counts of the number of individuals served
by the Ryan White HIV/AIDS Program. Second, aggregate data cannot be
analyzed with the detail that is required to assess quality of care or
to sufficiently account for the use of Ryan White HIV/AIDS Program
funds.
A well designed and supported client level data reporting system,
using a unique identifier that will be encrypted before transfer, would
provide the grantee and HRSA with the requisite information to assess
quality of care and unmet needs, and the ability to more accurately and
efficiently report these figures to HAB and other funding agencies. In
addition, HAB will be able to characterize accurately the number of
clients served by the Ryan White HIV/AIDS Program and the outcomes of
the program services on a national scale. The ability to perform
detailed analyses will be possible only if organizations submit data
associated with encrypted client identifiers. These unique identifiers
must be able to link data for clients across Ryan White HIV/AIDS
Program-funded grantees and their subcontracted service providers.
The CLDRS provides data on the characteristics of Ryan White HIV/
AIDS Program-funded grantees, their contracted service providers, and
the clients being served with program funds. It is intended to support
clinical quality management, performance measurement, service delivery,
and client monitoring at both the system and client levels. The
reporting system consists of two online data forms, the Grantee
Information Form and the Service Provider Form. A data file containing
the client level data elements will be submitted with the two online
data forms on a semi-annual basis.
The new legislation specifies increased grantee accountability and
linking performance to budget. The CLDRS will be used to ensure
compliance with the requirements of the reauthorized legislation,
evaluate the progress of programs, monitor grantee and provider
performance, measure the Government Performance and Result Act (GPRA)
and the Performance Assessment Rating Tool (PART) goals, and meet
reporting responsibilities to the Department, Congress, and OMB. In
addition to meeting the goal of accountability to Congress, clients,
advocacy groups, and the general public, information collected through
the CLDRS is critical for HRSA, State
[[Page 39019]]
and local grantees, and individual providers. Through the CLDRS, these
groups will assess the status of existing HIV-related service delivery
systems to investigate trends in service utilization, and to identify
areas of greatest need.
Discussions were conducted with 12 volunteer grantee agencies
representing Parts A, B, C, D, and Minority AIDS Initiatives, Parts A
and B, as a basis for the burden estimates for the CLDRS components
that follow. These burden estimates are broken out by burden to grantee
respondents and burden to provider respondents, and are presented in
two tables. The first table represents the estimated burden for the
first 6-month data submission. The second table represents the
estimated burden for each subsequent 6-month data submission. The
estimated number of visits per 6-month reporting period ranged from 1
to 17, with an average (mean) of 4 client visits per reporting period
and a median of 2 client visits per reporting period.
The number of clients is estimated two ways. The first estimate is
based on providers that reported outpatient/ambulatory medical care,
medical case management, and/or non-medical case management services in
the 2007 Ryan White Data Report. These providers will be required to
report client level data beginning in 2009. This first estimate
excludes providers of other direct client services because these
providers will not be required to report client level data until 2010.
The second estimate includes all providers that reported direct client
services in the 2007 Ryan White Data Report.
The estimated response burden for the first 6-month reporting
period CLDRS submission is as follows:
The response burden for grantees is estimated as:
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Hours to
complete/
Component Source of funding Number of Responses per coordinate Total hour
respondents grantee receipt of data burden
reports
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Grantee Form.................................. Part A.......................... 56 1 1.27 71
Part B.......................... 57 1 6.00 342
Part C.......................... 357 1 0.39 139
Part D.......................... 90 1 0.67 60
Part A MAI...................... 56 1 1.27 71
Part B MAI...................... 30 1 10.00 300
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Subtotal.................................. ................................ 646 ................ ................ 983
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Hours to develop/
Component Number of Responses per adjust CLD Total hour
respondents grantee system burden
----------------------------------------------------------------------------------------------------------------
CLD Collection System................... 563 1 1108.80 624254
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The response burden for service providers is estimated as:
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Number of Responses per Hours per Total hour
Component respondents provider response burden
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Provider Form......................... 2253 1 2.35 5295
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Responses Hours to collect/
Component Number of (clients served) Total responses report data per Total hour
respondents per provider respondent burden
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Client Data File.............................................. \*\ 1511 493.57 745784 1.65 1230544
\**\ 2112 417.47 881703 1.65 1454810
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\*\ Outpatient/ambulatory medical care, medical case management, and/or non-medical case management providers only.
\**\ All providers.
The estimated response burden for all subsequent 6-month reporting
period CLDRS submissions is as follows:
The response burden for grantees is estimated as:
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Hours to
complete/
Component Source of funding Number of Responses per coordinate Total hour
respondents grantee receipt of data burden
reports
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Grantee Form.................................. Part A.......................... 56 1 1.02 57
Part B.......................... 57 1 1.50 86
Part C.......................... 357 1 0.32 114
Part D.......................... 90 1 0.33 30
Part A MAI...................... 56 1 1.02 57
[[Page 39020]]
Part B MAI...................... 30 1 2.00 60
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Subtotal.................................. ................................ 646 ................ ................ 404
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The response burden for service providers is estimated as:
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Number of Responses per Hours per Total hour
Component respondents provider response burden
----------------------------------------------------------------------------------------------------------------
Provider Form........................... 2253 1 2.30 5182
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Responses Hours to collect/
Component Number of (clients served) Total responses report data per Total hour
respondents per provider respondent burden
--------------------------------------------------------------------------------------------------------------------------------------------------------
Client Data File............................................ \*\ 1511 493.57 745784 1.65 1230544
\**\ 2112 417.47 881703 1.65 1454810
--------------------------------------------------------------------------------------------------------------------------------------------------------
\*\ Outpatient/ambulatory medical care, medical case management, and/or non-medical case management providers only.
\**\ All providers.
E-mail comments to paperwork@hrsa.gov or mail comments to the HRSA
Reports Clearance Officer, Room 10-33, Parklawn Building, 5600 Fishers
Lane, Rockville, Maryland 20857. Written comments should be received
within 60 days of this notice. Information can also be accessed at
http://datasupport.hab.hrsa.gov/.
Dated: June 30, 2008.
Alexandra Huttinger,
Director, Division of Policy Review and Coordination.
[FR Doc. E8-15470 Filed 7-7-08; 8:45 am]
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