Health Center Controlled Networks Progress Reports

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 Health Center Controlled Networks Progress Reports	Form and Instruction	Modified	Available
Summary of changes_EL 04302013v1.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2013-05-29	Available
Copy of hccnworkplan_EL 04302013v1_track changes.xls	Supplementary Document	Uploaded 2013-05-29	Available
Report Table.txt	Supplementary Document	Uploaded 2012-11-20	Available
Report Table 61.docx	Supplementary Document	Uploaded 2013-03-12	Available
Supporting Statement.docx	Supporting Statement A	Uploaded 2013-05-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
205055	Health Center Controlled Networks Progress Reports	Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0360	ICR Reference No: 201305-0915-006
Status: Historical Active	Previous ICR Reference No: 201212-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No: 19701
Title: Health Center Controlled Networks Progress Reports
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/31/2013
	Date Received in OIRA: 05/29/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	03/31/2016	03/31/2016
Responses	60	0	60
Time Burden (Hours)	1,662	0	1,662
Cost Burden (Dollars)	0	0	0

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Abstract: A priority for HRSA's Bureau of Primary Health Care is to provide grants to Health Ccenter Controlled Networks (HCCN) to support and advance the adoption, implementation, and meaningful use of Health Information Technology to improve the quality of care provided by existing Health Center Program grantees. HCCNs will support participating health centers through their participation in the current and future stages of meaningful use included in the Medicare and Medicaid EHR Incentive Programs. The CMS EHR Incentive Program provides incentive payments to the eligible health care providers as they adopt, implement, upgrade and demonstrate meaningful use of certified EHR technology. Stage 1 sets the baseline for electronic data capture and information sharing. Also, Stage 1 meaningful use criteria focus heavily on establishing the functionalities in certified EHR technology that will allow for continuous quality improvement and ease of information exchange. There are two progress report forms and both are designed to collect aggregate performance data from grantees funded. The Project Work Plan Update and Annual Progress/Interim Evaluation Progress Report forms have three parts: 1) Adoption and Implementation of HIT (including EHR); 2) Attainment of Meaningful Use Requirements; and 3) Quality improvement measures (e.g., Healthy People 2020 clinical quality measures, PCMH recognition status).

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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

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 Reports	2, 1	Repport Table Instructions ,   work plan

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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	60	60	0	0	0	0
Annual Time Burden (Hours)	1,662	1,662	0	0	0	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: $406,667

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: 05/29/2013

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