HRSA AIDS Education and Training Centers (AETCs) Evaluation Activities

Forms and Documents

Document Name	Status
Form D Participant Information Form (PIF) Form	Removed
Form C Event Record (ER) Form Form	Removed
Participation Information Form_Final 5.4.2022.docx Supplementary Document	2022-06-30
E_AETC OMB Pilot Respondents.docx Supplementary Document	2022-06-30
B_Event Record Form_2021.pdf Supplementary Document	2022-06-30
C_Participation Information Form_2021.pdf Supplementary Document	2022-06-30
AETC Supporting Statement Extension.xml Supporting Statement A	2022-06-30
A_2009 RWHAP Legislation.pdf Supplementary Document	2019-05-01

IC Document Collections

IC ID	Document Title	Status
254444	Event Record Instruction	New
254443	Participant Information Form Instruction	New
221598	Participant Information Form (PIF) Form	Removed
221597	Event Record (ER) Form Form	Removed

ICR Details

OMB Control No: 0915-0281	ICR Reference No: 202206-0915-001
Status: Received in OIRA	Previous ICR Reference No: 202006-0915-005
Agency/Subagency: HHS/HSA	Agency Tracking No: 19770
Title: HRSA AIDS Education and Training Centers (AETCs) Evaluation Activities
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/30/2022

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2022
Responses	177,815	71,810
Time Burden (Hours)	30,069	4,432
Cost Burden (Dollars)	0	0

---

Abstract: Information collection is needed to evaluate AETC training sessions, consultations, and technical assistance activities. Aggregate data from the AETCs allows HRSA HAB to report the number and types of training activities provided to RWHAP recipients to Congress as well as inform resource allocation and capacity expansion. Trainees complete the Participant Information Form (PIF) and trainers complete an Event Record (ER).

---

Authorizing Statute(s): PL: Pub.L. 111 - 87 000 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:
	87 FR 31	02/15/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 111	06/09/2022
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Event Record
Event Record (ER) Form	C	FINAL Event Record Form.docx Change memo version
Participant Information Form
Participant Information Form (PIF)	D	Participation Information Form 218

---

ICR Summary of Burden

	Total Request	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	177,815	71,810	0	177,815	-71,810	0
Annual Time Burden (Hours)	30,069	4,432	0	30,069	-4,432	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: The increase in burden hours occurred due to more respondents projected to respond this year.

---

Annual Cost to Federal Government: $205,000

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? Yes

---

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: 06/30/2022

---