Health Center Program forms are
critical to the Program grant and non-grant award process, as well
as to Program oversight and monitoring activities. These forms are
used by health centers to request funding under Section 330 of the
Public Health Service (PHS) Act, change their scope of project and
become designated as Look-Alikes. Over 1,200 health centers deliver
comprehensive, high quality, cost-effective primary health care to
America's most vulnerable populations.
The OMB Inventory currently
contains 40,161 burden hours for this activity. This request is for
44,825 total burden hours, for an increase of 4,664 hours. The
increase is due to program adjustments resulting from an increase
in the number of health center organizations. In addition, the
number of programs using forms has increased due to Congressional
direction and the needs of health centers nationally. For this
clearance request, each form is being submitted separately to
accurately reflect the number of respondents per form. This results
in a large total number of responses as each form is submitted as a
single entity. OMB currently approves 23,976 annual responses for
1,138 respondents. This request includes an increase in the number
of respondents to 1,500 respondents with a total number of
responses of 32,450.
$138,000
No
No
Yes
No
No
Uncollected
Jodi Duckhorn 301
443-1984
No
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:
(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;
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.