The Hospital Preparedness Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-0391 Section B - Methodology (Statistical Methods).docx	Supporting Statement B	Uploaded 2015-04-16	Available
0990-HospitalPrepardnessAPPENDIX C.DOCX	Supplementary Document	Uploaded 2012-03-13	Available
0990-0391HospitalPreparednessProgram-1-30-15FINALCYS (3edit4_13) (2).doc	Supporting Statement A	Uploaded 2015-04-16	Source copy available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
231479	Health Center Survey and Interviews	Other-survey	New
231115	Hospital Preparedness Program (HPP) Ebola / OSP Preparedness Measures	Other-survey	New
229531	Hospital Preparedness Program (HPP) Trauma Center Association of America (TCAA) Member Survey	Other-survey	New
228505	Hospital Preparedness Program (HPP) Impact Survey	Other-survey	New
227990	Urgent Care Center Interviews	Other-interview	New
227119	Hospital Preparedness Program (HPP) –PHEP 2017 FOA and Aligned Application Process "Hotwash"	Other-questionnaire	New
226735	Hospital Preparedness Program (HPP) Coalition Assessment Tool (CAT)	Other-form	New
220886	ASPR Medical Supply Chain Interviews	Other-interview	New
220760	Crisis Re-Entry Questionnaire Survey	Other-questionnaire	New
220006	HPP BP2 Data Display Survey	Other-survey	New
219019	Partnership Meeting Questionnaire	Other-questionnaire	New
218648	Healthcare System Stress Pulse Query	Other-survey	New
217165	HEALTHCARE PREPAREDNESS PROGRAM (HPP) NEEDS ASSESSMENT QUESTIONNAIRE	Other-questionnaire	New
216769	TRACIE Technical Assistance User Feedback Survey	Other-survey	New
216149	BP3 HPP EOY	Other-Template	New

ICR Details

OMB Control No: 0990-0391	ICR Reference No: 201504-0990-001
Status: Historical Active	Previous ICR Reference No: 201203-0990-001
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: The Hospital Preparedness Program
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/27/2015
	Date Received in OIRA: 04/16/2015
Terms of Clearance: Approved with the understanding that the Program will submit individual GenIC requests to OMB review and approval before initiating data collection activities for those instruments.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2018	36 Months From Approved
Responses	186	0	0
Time Burden (Hours)	14,973	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: GenIC approved under this generic clearance will be used to monitor awardees' compliance with program requirements and for the development of selected healthcare preparedness capabilities.

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Authorizing Statute(s): PL: Pub.L. 109 - 417 2802 (b) Name of Law: Public Health Services 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
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 6518	02/05/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 19675	04/13/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 15

table that charts list of burden

IC Title	Form No.	Form Name
TRACIE Technical Assistance User Feedback Survey
Hospital Preparedness Program (HPP) Ebola / OSP Preparedness Measures
Hospital Preparedness Program (HPP) –PHEP 2017 FOA and Aligned Application Process "Hotwash"
BP3 HPP EOY
Healthcare System Stress Pulse Query
Hospital Preparedness Program (HPP) Trauma Center Association of America (TCAA) Member Survey
Hospital Preparedness Program (HPP) Impact Survey
Urgent Care Center Interviews
Hospital Preparedness Program (HPP) Coalition Assessment Tool (CAT)
HPP BP2 Data Display Survey
Partnership Meeting Questionnaire
HEALTHCARE PREPAREDNESS PROGRAM (HPP) NEEDS ASSESSMENT QUESTIONNAIRE
Crisis Re-Entry Questionnaire Survey
Health Center Survey and Interviews
ASPR Medical Supply Chain Interviews

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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	186	0	0	0	0	186
Annual Time Burden (Hours)	14,973	0	0	0	0	14,973
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: $172,625

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: 04/16/2015

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