Data Collection Tool for Rural Health Community-Based Grant Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 6 rural Health Workforce Development	Form and Instruction	Removed	Available
Form 5 Rural Health Network Development Planning Performance Improvement and Measurement System Database	Form	Modified	Available
Form 5 Network Development Planning	Form and Instruction	Modified	Available
Form 4 Small Health Care Provider Quality Improvement Program Performance Improvement and Measurement System Database	Form	Modified	Available
Form 3 Delta States Rural Network Development Grant Program Performance Improvement Measurement System Measures	Form	Modified	Available
Form 2 Rural Health Network Development Program Performance Improvement and Measurement System Database	Form	Modified	Available
Form 1 Rural Health Care Services Outreach Program Performance Improvement and Measurement System Database	Form	Modified	Available
Supporting Statement 0319.docx	Supporting Statement A	Uploaded 2014-06-13	Available
Outreach authority (2002)_2010Submission.pdf	Supplementary Document	Uploaded 2011-03-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
197088	Rural Health Workforce Development Program	Form and Instruction	Removed	rural Health Workforce Development
184013	Rural Health Network Development Planning Performance Improvement and Measurement System Database	Form	Modified	Rural Health Network Development Planning Performance Improvement and Measurement System Database
184013	Rural Health Network Development Planning Performance Improvement and Measurement System Database	Form and Instruction	Modified	Network Development Planning
184012	Small Health Care Provider Quality Improvement Program Performance Improvement and Measurement System Database	Form	Modified	Small Health Care Provider Quality Improvement Program Performance Improvement and Measurement System Database
184011	Delta States Rural Network Development Grant Program Performance Improvement Measurement System Measures	Form	Modified	Delta States Rural Network Development Grant Program Performance Improvement Measurement System Measures
184010	Rural Health Network Development Program Performance Improvement and Measurement System Database	Form	Modified	Rural Health Network Development Program Performance Improvement and Measurement System Database
184009	Rural Health Care Services Outreach Program Performance Improvement and Measurement System Database	Form	Modified	Rural Health Care Services Outreach Program Performance Improvement and Measurement System Database

ICR Details

OMB Control No: 0915-0319	ICR Reference No: 201406-0915-001
Status: Historical Active	Previous ICR Reference No: 201103-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Data Collection Tool for Rural Health Community-Based Grant Programs
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/23/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	36 Months From Approved	08/31/2014
Responses	154	0	281
Time Burden (Hours)	575	0	1,095
Cost Burden (Dollars)	0	0	0

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Abstract: There are currently five rural health grant programs that operate under the authority of section 330A of the Public Health Service (PHS) Act. These programs include: (1) Rural Health Care Services Outreach Grant Program (Outreach); (2) Rural Health Network Development Grant Program (Network Development); (3) Small Healthcare Provider Quality Grant Program (Quality); (4) Delta States Rural Development Network Grant Program (Delta) and (5) Rural Health Network Development Planning Grant Program (Network Planning). These grants are to provide expanded delivery of health care services in rural areas, for the planning and implementation of integrated health care networks in rural areas, and for the planning and implementation of quality improvement and workforce activities. In general, the grants may be used to expand access, coordinate, and improve the quality of essential health care services and enhance the delivery of health care in rural areas. For these programs, performance measures were drafted to provide data useful to the programs and to enable HRSA to provide aggregate program data required by Congress under the Government Performance and Results Act (GPRA) of 1993. These measures cover the principal topic areas of interest to ORHP, including: (a) access to care; (b) the underinsured and uninsured; (c) workforce recruitment and retention; (d) sustainability; (e) health information technology; (f) network development; and (g) health related clinical measures. Several measures will be used for all six programs. All measures will speak to the Office's progress toward meeting the goals set.

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Authorizing Statute(s): US Code: 42 USC 254c Name of Law: Rural Health Outreach Grant Program
   US Code: 42 USC 254c Name of Law: Rural Health Network Development Program
   PL: Pub.L. 107 - 251 201 Name of Law: Health Care Safety Amendments of 2002
  

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:
	79 FR 13311	03/10/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 32301	06/04/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Delta States Rural Network Development Grant Program Performance Improvement Measurement System Measures	3	Delta States Rural Network Development Grant Program Performance Improvement Measurement System Measures
Rural Health Care Services Outreach Program Performance Improvement and Measurement System Database	1	Rural Health Care Services Outreach Program Performance Improvement and Measurement System Database
Rural Health Network Development Planning Performance Improvement and Measurement System Database	5, 5	Network Development Planning ,   Rural Health Network Development Planning Performance Improvement and Measurement System Database
Rural Health Network Development Program Performance Improvement and Measurement System Database	2	Rural Health Network Development Program Performance Improvement and Measurement System Database
Rural Health Workforce Development Program	6	rural Health Workforce Development
Small Health Care Provider Quality Improvement Program Performance Improvement and Measurement System Database	4	Small Health Care Provider Quality Improvement Program Performance Improvement and Measurement System Database

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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	154	281	0	-127	0	0
Annual Time Burden (Hours)	575	1,095	0	-520	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden has changed from the burden shown in the current inventory due to a number of reasons. There are minor changes in these data collection forms specifically around the instructions. Since the last approval, ORHP has received feedback from grantees during the grant cycles requesting revising the instructions on the data collection forms which we have incorporated in this submission. In addition, ORHP makes varying number of awards each grant cycle for the programs included in this package. Also, one of the programs (Rural Health Workforce Development Program) included in the previous OMB approval package was a one-time program that ended in 2013 and is not included in this submission.

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Annual Cost to Federal Government: $36,515

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: 06/23/2014

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