Survey on Rural Community Wealth and Health Care Provision

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
30-day FRN_07162012.pdf	Supplementary Document	Uploaded 2012-07-17	Available
60-day Federal Register notice.docx	Supplementary Document	Uploaded 2012-07-05	Available
ICR Supporting Statement_Section A_7-12.docx	Supporting Statement A	Uploaded 2012-07-05	Available
NASS comments & ERS responses.docx	Supplementary Document	Uploaded 2012-05-24	Available
Annex I_Formulas for estimating means and variances_5-12.pdf	Supplementary Document	Uploaded 2012-05-24	Available
Annex E_Report on cognitive interviews_5-12.pdf	Supplementary Document	Uploaded 2012-05-24	Available
Annex C_Letter from Thomas Morris_5-12.pdf	Supplementary Document	Uploaded 2012-05-24	Available
Annex B_Experts consulted_5-12.pdf	Supplementary Document	Uploaded 2012-05-24	Available
Annex A_References.pdf	Supplementary Document	Uploaded 2012-05-24	Available
ICR Supporting Statement_Section B_5-12.pdf	Supporting Statement B	Uploaded 2012-05-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202492	Survey on Rural Community Wealth and Health Care Provision - community leaser nonrespondents in full study	Other-Advance letter, disclosures, & brochure	New
202491	Survey on Rural Community Wealth and Health Care Provision - community leaser respondents in full study	Other-Community Leader questionnaie in full study	New
202490	Survey on Rural Community Wealth and Health Care Provision - health care provider nonrespondents in full study	Other-Advance letter, disclosures, & brochure for full study	New
202489	Survey on Rural Community Wealth and Health Care Provision - health care provider respondents in full study	Other-Health Care Provider Questionnaire for full study	New
202488	Survey on Rural Community Wealth and Health Care Provision - community leader nonrespondents in pilot study	Other-Advance letter, disclosures, & brochure for pilot study	New
202487	Survey on Rural Community Wealth and Health Care Provision - nonrespondents in full study screening	Other-Screen Script for full study	New
202486	Survey on Rural Community Wealth and Health Care Provision - respondents in full study screening	Other-Screen script for full study	New
202485	Survey on Rural Community Wealth and Health Care Provision - community leader respondents in pilot study	Other-Community Leader Questionnaire for pilot study	New
202484	Survey on Rural Community Wealth and Health Care Provision - health provider nonrespondents in pilot study	Other-Advance letter, disclosures, & brochure for pilot study	New
202483	Survey on Rural Community Wealth and Health Care Provision - health provider respondents in pilot study	Other-Health Care Provider Questionnaire for pilot study	New
202481	Survey on Rural Community Wealth and Health Care Provision - nonrespondents in pilot study screening	Other-Screen Script for pilot study	New
202475	Survey on Rural Community Wealth and Health Care Provision - respondents in pilot study screening	Other-Screen sript for pilot study	New

ICR Details

OMB Control No: 0536-0072	ICR Reference No: 201205-0536-002
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: USDA/ERS	Agency Tracking No:
Title: Survey on Rural Community Wealth and Health Care Provision
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: Withdrawn	Conclusion Date: 12/05/2012
	Date Received in OIRA: 07/17/2012
Terms of Clearance: As discussed with the agency 10/25.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This survey will collect information on the assets and investments of rural communities and their influence on recruitment and retention of rural health care providers, and on the effects of rural health care provision on economic development of rural communities. This information will contribute to a better understanding of the roles that rural communities play in promoting or retarding the provision of health care services, and of how improved health care provision contributes to development of these communities.

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Authorizing Statute(s): US Code: 7 USC 2204 Name of Law: General duties of Secretary; Advisory functions; research and development
   US Code: 7 USC 2661 Name of Law: Statement of purposes and goals
  

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:
	76 FR 176	09/12/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 136	07/16/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
Survey on Rural Community Wealth and Health Care Provision - nonrespondents in pilot study screening
Survey on Rural Community Wealth and Health Care Provision - health care provider respondents in full study
Survey on Rural Community Wealth and Health Care Provision - health care provider nonrespondents in full study
Survey on Rural Community Wealth and Health Care Provision - community leaser respondents in full study
Survey on Rural Community Wealth and Health Care Provision - community leaser nonrespondents in full study
Survey on Rural Community Wealth and Health Care Provision - respondents in pilot study screening
Survey on Rural Community Wealth and Health Care Provision - health provider respondents in pilot study
Survey on Rural Community Wealth and Health Care Provision - health provider nonrespondents in pilot study
Survey on Rural Community Wealth and Health Care Provision - community leader respondents in pilot study
Survey on Rural Community Wealth and Health Care Provision - respondents in full study screening
Survey on Rural Community Wealth and Health Care Provision - nonrespondents in full study screening
Survey on Rural Community Wealth and Health Care Provision - community leader nonrespondents in pilot study

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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 reseulting in a program change of 1,865 burden hours. This information is critical to develop effective policies to address the challenge of inadequate access to health care services in many rural communities, and to realize the opportunities offered by improved health care provision to attract and keep residents in rural areas, provide employment, and improve the quality of life.

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Annual Cost to Federal Government: $242,975

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 07/17/2012

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