Regional Extension Center Cooperative Agreement Program (CRM Tool)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
30-day Federal Register, Volume 82 Issue 101 (Friday, May 26, 2017).htm	Supplementary Document	Uploaded 2017-05-26	Available
60-dayFederal Register, Volume 82 Issue 54 (Wednesday, March 22, 2017).htm	Supplementary Document	Uploaded 2017-05-26	Available
0955-0009 CRM tool Statement B_final2017.docx	Supporting Statement B	Uploaded 2017-05-26	Repair queued
0955-0009_Non-substantive chg Workforce (3).docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-04-22	Available
0990-REC CRM Tool Screenshots.doc	Supplementary Document	Uploaded 2010-10-21	Available
0990-REC CRM Tool Screenshots.doc	Supplementary Document	Uploaded 2010-10-21	Available
0955-0009 CRM tool Statement A_final2017_2.doc	Supporting Statement A	Uploaded 2017-05-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
227019	CHP/Academy Health	Other-survey	New
195151	Community College Consortia	Other-ccc	Modified
195150	Regional Extenion Center	Other-crm tools	Modified

ICR Details

OMB Control No: 0955-0009	ICR Reference No: 201705-0955-001
Status: Historical Inactive	Previous ICR Reference No: 201604-0955-001
Agency/Subagency: HHS/ONC	Agency Tracking No: 21223
Title: Regional Extension Center Cooperative Agreement Program (CRM Tool)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 02/09/2018
	Date Received in OIRA: 05/26/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2017	36 Months From Approved	02/28/2018
Responses	2,400	0	2,400
Time Burden (Hours)	3,600	0	3,600
Cost Burden (Dollars)	0	0	0

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Abstract: The data collection will be used by ONC to evaluate program performance of each Regional Extension Center and track monetary draw downs for Core funding Direct Assistance allocation. Each Regional Center will have a proposed target number for priority primary care providers that they will help with EHR adoption and eventually meaningful use within their service area.

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Authorizing Statute(s): US Code: 13 USC 13301 Name of Law: Health Information Technology Regional Extension Centers Program
   PL: Pub.L. 111 - 12 3012 Name of Law: American Recovery and Reinvestment Act of 2009
  

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:
	82 FR 14734	03/22/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 24358	05/26/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
CHP/Academy Health
Regional Extenion Center
Community College Consortia

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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: There was an adjustment to the burden hours from the previous approval. The CRM is one tool that is used to collect data for multiple programs. The reporting requirements were adjusted resulting in 1405 decreased burden hours for this tool from 3600 to 2195.

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Annual Cost to Federal Government: $43,200

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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)? Yes

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: 05/26/2017

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