Children's Hospital Graduate Medical Education Program Annual Report

Forms and Documents

Document Name	Status
Form 100-2 CHGME Payment Program HRSA 100-2 and HRSA 100-3 Annual Report Forms Form and Instruction	Modified
Form 1 Children's Hospital GME Annual Report Screeing Instrument Form and Instruction	Modified
Public Law 109-307.pdf Supplementary Document	2013-07-23
CHGME Supporting Statement.docx Supporting Statement A	2013-07-23

IC Document Collections

IC ID	Document Title	Status
182196	CHGME Payment Program HRSA 100-2 and HRSA 100-3 Annual Report Forms Form and Instruction	Modified
182195	Children's Hospital GME Annual Report Screeing Instrument Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0313	ICR Reference No: 201308-0915-001
Status: Historical Active	Previous ICR Reference No: 201008-0915-003
Agency/Subagency: HHS/HSA	Agency Tracking No: 20123
Title: Children's Hospital Graduate Medical Education Program Annual Report
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/16/2013
	Date Received in OIRA: 08/07/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	36 Months From Approved	11/30/2013
Responses	108	0	112
Time Burden (Hours)	4,558	0	4,922
Cost Burden (Dollars)	0	0	0

---

Abstract: The Children's Hospital BME Support Reauthorization Act of 2006 (P.L. 109-307) requires an annual report and a special Report to Congress for all hospitals participating in the CHGME Payment Program. The legislation requires an annual report that includes information for the residency training academic year completed immediately prior to each fiscal year for which the hospital applies for funds. The reauthorizing statute also requires a Report to Congress describing the results of the program and making recommendations for program improvement.

---

Authorizing Statute(s): PL: Pub.L. 109 - 307 2 Name of Law: Children's Hospital GME Support Reauthorization Act of 2006
   US Code: 42 USC 256e Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 31946	05/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 46592	08/01/2013
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Children's Hospital GME Annual Report Screeing Instrument	1	Hospital Fianance Staff HRSA 100-1
CHGME Payment Program HRSA 100-2 and HRSA 100-3 Annual Report Forms	100-2, 100-3	HRSA 100-2 FY13 - Redesign ,   HRSA 100-3_FY13

---

ICR Summary 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	108	112	0	0	-4	0
Annual Time Burden (Hours)	4,558	4,922	0	0	-364	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: The burden has changed with a reduction in total burden hours from 4,922.4 to 4,557.6. The reduction in total burden hours are due to fewer number of respondents from 56 to 54 per form and a reduction in respondent burden hour estimates secondary to experienced staff, increased efficiency and streamlining the reporting process over the years.

---

Annual Cost to Federal Government: $31,014

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

---

Common Form ICR:  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:

(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: 08/07/2013

---