Information Collection

Local and State Health Department Involvement wit Health Care Coalitions (HCCs)

IC 206683 under ICR 201203-0990-001 · OMB 0990-0391.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0391 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
0990-0391 ASTHO HPP Project Proposed Discussion Questions 4 18 2013 (2).docx	Other-form
0990-0391 Generic Clearance HPP ASTHO NACCHO Task G Tobin 4 18 2013 (3).docx 0990-0391 Generic Clearance HPP ASTHO NACCHO Task G Tobin 4 18 2013 (3)	IC Document

IC Title:

Local and State Health Department Involvement wit Health Care Coalitions (HCCs)

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-form			0990-0391 ASTHO HPP Project Proposed Discussion Questions 4 18 2013 (2).docx		No	No	Paper Only

Line of Business: Health

Subfunction: Illness Prevention

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 64

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	64	0	0	0	0	0
Annual IC Time Burden (Hours)	96	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
0990-0391 Generic Clearance HPP ASTHO NACCHO Task G Tobin 4 18 2013 (3)	0990-0391 Generic Clearance HPP ASTHO NACCHO Task G Tobin 4 18 2013 (3).docx	04/24/2013

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.