Uniform Data System

Forms and Documents

Document Name	Status
Form Table 3B Uniform Data System Form	Modified
Memo for nonsubstantive change to UDS.doc Justification for No Material/Nonsubstantive Change	2008-12-23
nonsubstantive change - ss_0193_2008.doc Supporting Statement A	2008-12-23

IC Document Collections

IC ID	Document Title	Status
6420	Uniform Data System Form	Modified

ICR Details

OMB Control No: 0915-0193	ICR Reference No: 200901-0915-001
Status: Historical Active	Previous ICR Reference No: 200708-0915-005
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Uniform Data System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/12/2009
	Date Received in OIRA: 01/05/2009
Terms of Clearance: This change request is approved. Further, we understand that HRSA intends to carry this revised race/ethnicity data collection template through to the rest of the UDS wherever race/ethnicity data is collected: this is also approved. Previous terms of clearance remain in effect.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	01/31/2011	01/31/2011
Responses	1,076	0	1,076
Time Burden (Hours)	67,988	0	66,912
Cost Burden (Dollars)	97,300	0	97,300

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Abstract: The Uniform Data System (UDS) is the Bureau of Primary Health Care's annual reporting system for grantees. The UDS includes reporting requirements for grantees of the following programs: the Community Health Center program, the Migrant Health Center program, the Health Care for the Homeless program, and other 330 funded grantees. The UDS is the tool that is used for monitoring and evaluating health center performance, and for ensuring compliance with legislative mandates.

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Authorizing Statute(s): PL: Pub.L. 107 - 251 1533 Name of Law: Health Care Safety Net Amendments
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 18661	04/13/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 41759	07/27/2007
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Uniform Data System	Table 3B	Race Ethnicity Collection

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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	1,076	1,076	0	0	0	0
Annual Time Burden (Hours)	67,988	66,912	0	1,076	0	0
Annual Cost Burden (Dollars)	97,300	97,300	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: This request for a nonsubstantive change includes a nominal increase in burden based on reporting using a revised race/ethnicity UDS table.

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Annual Cost to Federal Government: $559,350

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]? 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: 01/05/2009

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