Beacon Community Cooperative Agreement Program

Forms and Documents

Document Name	Status
Form 1 Beacon Community Application Form Form and Instruction	New
3016 Beacon PRA Application ver3 11.24.2009.doc Supporting Statement A	2009-11-24

IC Document Collections

IC ID	Document Title	Status
191378	Beacon Community Application Form Form and Instruction	New

ICR Details

OMB Control No: 0990-0348	ICR Reference No: 200911-0990-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Beacon Community Cooperative Agreement Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 11/25/2009
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/24/2009
	Date Received in OIRA: 11/23/2009
Terms of Clearance: Approved as revised by HHS. HHS will send a separate request for clearance for any reporting or evaluation requirements associated with this funding opportunity.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2010	6 Months From Approved
Responses	50	0	0
Time Burden (Hours)	42,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Beacon Community Program will fund innovative proposals to utilize a foundation of health information technology to promote performance monitoring and feedback, practice redesign and care coordination efforts in order to achieve sustainable, specific and measurable health outcome improvement goals and health system cost-savings. The Beacon Communities will demonstrate the feasibility of achieving these goals, and each Community will provide a compelling example of the specific, measurable and achievable gains enabled by standards-based interoperable health information technology systems in the short term, thereby demonstrating in selected communities by 2012 some of the health system improvements the nation intends to achieve by 2015. As such, this work is critical for national health care reform efforts and the federal stimulus initiative.

Emergency Justfication: The Office of National Coordinator for Health Information Technology (ONC) is requesting emergency action for this clearance by the Office of Management and Budget no later than 11/25/2009. ONC is requesting emergency processing procedures for this application because this information is needed immediately to assure that ARRA funds are used timely and effectively to support healthcare quality and systems improvement through the use of health information technology.

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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:
	Not associated with rulemaking

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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
Beacon Community Application Form	1	Beacon Community Application Form

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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	50	0	0	50	0	0
Annual Time Burden (Hours)	42,000	0	0	42,000	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new Emergnecy clearance request.

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Annual Cost to Federal Government: $6,890

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)? Yes

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: 11/23/2009

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