Children's Hospital Graduate Medical Education Program Annual Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BHPR_CHGME_100-1_F Children's Hospital GME Annual Report Screeing Instrument	Form	Modified	Available
Public Law 109-307.docx	Supplementary Document	Uploaded 2010-08-16	Available
ss_chgme_0313_2010.doc	Supporting Statement A	Uploaded 2010-08-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
182196	Children's Hospital GME Annual Report Program Information	Other-checklist	Modified
182195	Children's Hospital GME Annual Report Screeing Instrument	Form	Modified

ICR Details

OMB Control No: 0915-0313	ICR Reference No: 201008-0915-003
Status: Historical Active	Previous ICR Reference No: 200709-0915-004
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Children's Hospital Graduate Medical Education Program Annual Report
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/19/2010
	Date Received in OIRA: 08/30/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2013	36 Months From Approved	11/30/2010
Responses	112	0	114
Time Burden (Hours)	4,922	0	4,834
Cost Burden (Dollars)	0	0	0

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Abstract: The Children's Hospital BME Support Reauthorization Act of 2006 (P.L. 109-307) requires an annual report and a special Report to Congress for all hospitals participating in the CHGME Payment Program. The legislation requires an annual report that includes information for the residency training academic year completed immediately prior to each fiscal year for which the hospital applies for funds. The reauthorizing statute also requires a Report to Congress describing the results of the program and making recommendations for program improvement.

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Authorizing Statute(s): PL: Pub.L. 109 - 307 2 Name of Law: Children's Hospital GME Support Reauthorization Act of 2006
   US Code: 42 USC 256e Name of Law: Public Health Service Act
  

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:
	75 FR 23771	05/04/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 43529	07/26/2010
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Children's Hospital GME Annual Report Screeing Instrument	BHPR_CHGME_100-1_FY2011, HRSA100-1	BHPR_CHGME_100-1_FY2011 ,   FY2011 HRSA100-1 10-29-10
Children's Hospital GME Annual Report Program Information	chgme 100-2, chgme_100-3, HRSA100-3, HRSA100-2	chgme 100-2 ,   chgme_100-3 ,   FY2011 HRSA100-2 10_29_10 ,   FY2011 HrSA100-3 10_29_10

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ICR Summary of Burden

table that charts list 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	112	114	0	0	-2	0
Annual Time Burden (Hours)	4,922	4,834	0	0	88	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

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: $32,166

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]? 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? 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: 08/30/2010

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