Regional Extension Center Cooperative Agreement Program (CRM Tool)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
PRA Clarification Addendum_CRM Tool.doc	Supplementary Document	Uploaded 2011-02-09	Available
0990-REC CRM Tool Screenshots.doc	Supplementary Document	Uploaded 2010-10-21	Available
0990-REC CRM Tool Screenshots.doc	Supplementary Document	Uploaded 2010-10-21	Available
0990-CRMTools3012 PRA Full Application_10_29-2010 (2).doc	Supporting Statement A	Uploaded 2010-10-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
195151	Community College Consortia	Other-ccc	New
195150	Regional Extenion Center	Other-crm tools	New

ICR Details

OMB Control No: 0990-0369	ICR Reference No: 201011-0990-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Regional Extension Center Cooperative Agreement Program (CRM Tool)
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: 02/09/2011
	Date Received in OIRA: 11/08/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2014	36 Months From Approved
Responses	2,400	0	0
Time Burden (Hours)	3,600	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The data collection will be used by ONC to evaluate program performance of each Regional Extension Center and track monetary draw downs for Core funding Direct Assistance allocation. Each Regional Center will have a proposed target number for priority primary care providers that they will help with EHR adoption and eventually meaningful use within their service area.

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Authorizing Statute(s): US Code: 13 USC 13301 Name of Law: Health Information Technology Regional Extension Centers Program
   PL: Pub.L. 111 - 12 3012 Name of Law: American Recovery and Reinvestment Act of 2009
  

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 37811	06/30/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 62543	10/12/2010
Did the Agency receive public comments on this ICR? Yes

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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
Regional Extenion Center
Community College Consortia

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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	2,400	0	0	2,400	0	0
Annual Time Burden (Hours)	3,600	0	0	3,600	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 collection.

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Annual Cost to Federal Government: $43,200

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)? 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: 11/08/2010

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