Hepatitis B and C Among Health Care for the Homeless Program Clients

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
6511	Hepatitis B and C Among Health Care for the Homeless Program Clients	Migrated

ICR Details

OMB Control No: 0915-0261	ICR Reference No: 200203-0915-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Hepatitis B and C Among Health Care for the Homeless Program Clients
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/28/2002
	Date Received in OIRA: 03/29/2002
Terms of Clearance: Approved consistent with changes in memo dated 5/20/02, including the following: (1) Addition of different categories of "Hispanic" (2) Deletion of "best race" question (3) Various corrections to language/questions. In addition, in any report regarding this data collection, HHS shall discuss the limitations of the non-probability sampling method used and clearly state that the data should not be generalized to HCH clients or sites nationally. It should be noted that the selection of sites depended on the presence of "highly motivated clinicians" at the selected sites, which likely introduced some additional bias in site selection. HHS has also agreed to add a confidentiality statement in the interview process, per the memo dated 5/23/02. If the response rate falls below 80%, HHS will immediately contact OMB to determine additional methods of boosting response rates or next steps in data collection process/reporting of data.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2005	05/31/2005
Responses	400	0	0
Time Burden (Hours)	400	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The survey is designed to study homeless adults being served by grantees specifically looking at the issues surrounding Hepatitis B and C. This will further hope to improve access care for the homeless individuals and families.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Hepatitis B and C Among Health Care for the Homeless Program Clients

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ICR Summary of Burden

	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	400	0	0	400	0	0
Annual Time Burden (Hours)	400	0	0	400	0	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:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 03/29/2002

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