Health Center Controlled Networks Progress Reports

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 001_HCCN_PR Health Center Controlled Networks Progress Report	Form	Modified	Available
Attach D_HIT_Planning.pdf	Supplementary Document	Uploaded 2011-01-24	Available
Attach B_EHR_IMPL.pdf	Supplementary Document	Uploaded 2011-01-24	Available
Attach A_Summary_of_Health_Center_Controlled_Networks_2011.doc	Supplementary Document	Uploaded 2011-01-24	Available
Attach C_HIT_Innovation.pdf	Supplementary Document	Uploaded 2011-01-24	Available
HCCN PIMS Grantee Manual_R 2 1.pdf	Supplementary Document	Uploaded 2011-01-24	Available
ss_0915-0315_final_Amended.docx	Supporting Statement A	Uploaded 2011-05-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
182775	Health Center Controlled Networks Progress Report	Form	Modified

ICR Details

OMB Control No: 0915-0315	ICR Reference No: 201101-0915-004
Status: Historical Active	Previous ICR Reference No: 200711-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Health Center Controlled Networks Progress Reports
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/25/2011
	Date Received in OIRA: 01/31/2011
Terms of Clearance: HRSA shall exercise caution when inferring a causal relatinship between the implementation of health IT and performance measures. All data limitations shall be publicly disclosed along with the reporting of such inferences and disclaimers shall be used accordingly.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2014	36 Months From Approved	05/31/2011
Responses	178	0	92
Time Burden (Hours)	3,188	0	552
Cost Burden (Dollars)	0	0	0

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Abstract: The Health Resources and Services Administration's Office of Health Information Technology is requesting approval to collect progress reports from grantees for the following grants: Health Information Technology Planning Grant, Health Information Technology Innovations for Health Center Controlled Networks, Electronic Health Records Implementation for Health Center Controlled Networks, and High Impact Electronic Health Records Implementation for Health Center Controlled Networks and Large Multi Sites Health Centers.

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Authorizing Statute(s): US Code: 42 USC 254(b) 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 58395	09/24/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 1440	01/10/2011
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Health Center Controlled Networks Progress Report	001_HCCN_PR	001_HCCN_PR

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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	178	92	0	0	86	0
Annual Time Burden (Hours)	3,188	552	0	0	2,636	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: $350,000

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: 01/31/2011

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