Information Collection Request

Red Carpet Entry (RCE) Program Implementation Project

ICR 202202-0920-001 · OMB 0920-1379 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920 RCE Report Card Form and Instruction New Missing upstream
Form 0920- Screener Form and Instruction New Repair queued
Form 0920 Clinic Leadership Interview Guide Form and Instruction New Repair queued
Form 0920- Staff Interview Guide – Preparation Phase Form and Instruction New Repair queued
Form 0920- Staff Interview Guide– Implementation Phase (months 2,4,6) Form and Instruction New Repair queued
Form 0920- Staff Interview Guide – Implementation Phase (months 1,3,5) Form and Instruction New Repair queued
Form 0920- Staf fSurvey– Implementation Phase [Months 2, 4, 6] Form and Instruction New Missing upstream
Form 0920- Staff Survey – Implementation Phase [Months 1, 3, 5] Form and Instruction New Repair queued
Form 0920- Staff Survey – Preparation Phase Form and Instruction New Repair queued
SSB.docx Supporting Statement B Uploaded 2022-03-28 Repair queued
SSA.docx Supporting Statement A Uploaded 2022-03-28 Repair queued
Att 4d HIPAA (Span).docx Supplementary Document Uploaded 2022-03-09 Repair queued
Att 4c HIPAA (Eng).docx Supplementary Document Uploaded 2022-03-09 Repair queued
Att 4b Client Inf Con (Span).docx Supplementary Document Uploaded 2022-03-09 Repair queued
Att 4a Client Inf Con (Eng).docx Supplementary Document Uploaded 2022-03-09 Repair queued
Att 9 PrivacyImpactAssessment_PIA.pdf Supplementary Document Uploaded 2022-03-09 Repair queued
Att 8b Readiness Worksheet.docx Supplementary Document Uploaded 2022-02-07 Repair queued
Att 8a Quick Guide.docx Supplementary Document Uploaded 2022-02-07 Missing upstream
Att 8 RCE Impl Manual.docx Supplementary Document Uploaded 2022-02-07 Repair queued
Att 6c Staff Palm Cards.pdf Supplementary Document Uploaded 2022-02-07 Missing upstream
Att 6a Social Media Posts.docx Supplementary Document Uploaded 2022-02-07 Repair queued
Att 6b Client Palm Cards.pdf Supplementary Document Uploaded 2022-02-07 Repair queued
Att 5 RTI IRB Decision.pdf Supplementary Document Uploaded 2022-02-07 Repair queued
Att 1 Auth Legislation.docx Supplementary Document Uploaded 2022-02-07 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
252010 RCE Report Card Form and Instruction New
252009 Screener Form and Instruction New
252008 Non-Labor Cost Questionnaire Other-EXCEL New
252006 Clinic Leadership Interview Guide Form and Instruction New
252005 Staff Interview Guide – Preparation Phase Form and Instruction New
252004 Staff Interview Guide– Implementation Phase (months 2,4,6) Form and Instruction New
252002 Staff Interview Guide – Implementation Phase (months 1,3,5) Form and Instruction New
251473 Labor Cost Questionnaire Other-EXCEL New
251472 Staf fSurvey– Implementation Phase [Months 2, 4, 6] Form and Instruction New
251470 Staff Survey – Implementation Phase [Months 1, 3, 5] Form and Instruction New
251468 Staff Survey – Preparation Phase Form and Instruction New
ICR Details
202202-0920-001
Received in OIRA
HHS/CDC 0920-21HI
Red Carpet Entry (RCE) Program Implementation Project
New collection (Request for a new OMB Control Number)   No
Regular 03/29/2022
  Requested Previously Approved
24 Months From Approved
342 0
127 0
0 0

This project will implement the Red Carpet Entry (RCE) program (a structural level intervention developed by DC Department of Health in 2009) in two (2) clinics. An implementation toolkit will be created, used by staff to implement RCE, and evaluated by the contractor. Up to 126 clinic patients will be consented for medical record abstraction. Interview and survey data will be collected from clinic staff (n=10) on RCE implementation. The toolkit will be finalized based on the study's findings. The final toolkit will be shared with health departments to enhance HIV care linkage and re-engagement.

None
None

Not associated with rulemaking

  86 FR 46852 08/20/2021
87 FR 17295 03/28/2022
Yes

  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 342 0 0 342 0 0
Annual Time Burden (Hours) 127 0 0 127 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New collection (Request for a new OMB Control Number.

$662,634
No
    Yes
    No
No
No
No
No
Thelma Sims 4046394771

  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.
03/29/2022