2012 Healthy New Year Video Contest

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-Healthy New Year Challenge_OMB01092012_Emergency Justification Letter[1].doc	Supplementary Document	Uploaded 2012-01-10	Available
0990-Emergency_HealthyNewYearChallenge_ss.doc	Supporting Statement A	Uploaded 2012-01-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200729	2012 Healthy New Year Video Contest Submission Form	Other-instrument	New

ICR Details

OMB Control No: 0990-0386	ICR Reference No: 201201-0990-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: 2012 Healthy New Year Video Contest
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: 01/11/2012
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/11/2012
	Date Received in OIRA: 01/10/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2012	6 Months From Approved
Responses	300	0	0
Time Burden (Hours)	50	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: ONC is working on a number of fronts to shift attitudes and expectations about consumers being more engaged in their health and leveraging health information technology tools and services to be partners in their care. To that end, ONC is launching a series of video contests in 2012 that will invite people to submit stories about how they've leveraged health IT to improve aspects of their health, such as making a New Years' resolution, managing a chronic condition, or caring for a loved one. These videos will be used to help motivate and inspire others to use to health IT to make improvements in their health and to encourage greater adoption and use of health IT tools.

Emergency Justfication: Given the focus of the first challenge is on using technology to achieve a New Years resolution to be healthier in 2012, it is imperative that the contest be announced as close to the New Year as possible in order to capitalize on the associated media buzz about this topic which wanes as you get further into 2012. It is also imperative that the submission requirements for the contestants be adequate to accommodate the disabled and to allow the public to sort/filter videos for the purposes of public voting and judging.

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Authorizing Statute(s): PL: Pub.L. 42 - 241 301 Name of Law: PHS 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

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
2012 Healthy New Year Video Contest Submission Form

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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	300	0	0	300	0	0
Annual Time Burden (Hours)	50	0	0	50	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: New

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Annual Cost to Federal Government: $108,000

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: 01/10/2012

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