Annual Performance Report for the State Grant for Assistive Technology Program

Forms and Documents

Document Name	Status
Statewide AT Annual Performance Measurements Report Form	Modified
Statewide AT Customer Satisfaction Survey Form and Instruction	Modified
Form 1 Record Keeping Burden Form	New
Form 1 Program Support Form	New
Form 1 Annual Report for the State Grant for Assistive Technology Program Form	Modified
RSA Response to 60Day 1820-0572.docx Supplementary Document	2014-08-28
Supporting Statement for AT APR (Clean) 9-26-17.docx Supporting Statement A	2017-10-12
60D_FRN_1820-0572.pdf Supplementary Document	2014-07-25
Control 14-003232-572 Report Revisions by Page Number 2014.docx Supplementary Document	2014-07-25

IC Document Collections

IC ID	Document Title	Status
46672	Statewide AT Annual Performance Measurements Report Form	Modified
46671	Statewide AT Customer Satisfaction Survey Form and Instruction	Modified
228667	Record Keeping Burden Form	New
228666	Program Support Form	New
21562	Annual Report for the State Grant for Assistive Technology Program Form	Modified

ICR Details

OMB Control No: 0985-0042	ICR Reference No: 201710-0985-003
Status: Historical Active	Previous ICR Reference No: 201505-0985-002
Agency/Subagency: HHS/ACL	Agency Tracking No: 1140.19
Title: Annual Performance Report for the State Grant for Assistive Technology Program
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: 11/20/2017
	Date Received in OIRA: 10/17/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved	11/30/2017
Responses	6,652	0	190,456
Time Burden (Hours)	22,624	0	23,772
Cost Burden (Dollars)	0	0	0

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Abstract: Section 4 of the Assistive Technology (AT) Act of 1998, as amended, requires states to submit annual data reports. This instrument helps the grantees report annual data related to the required activities implemented by the State under the AT Act. This data is used by Rehabilitation Services Administration (RSA) in order to prepare required annual reports to Congress. RSA calls this data collection an Annual Progress Report.

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Authorizing Statute(s): PL: Pub.L. 108 - 364 4 Name of Law: Assistive Technology Act of 1998, as amended
  

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 32710	07/17/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 46247	10/04/2017
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Program Support	1	State Grant for AT Annual Progres Report
Record Keeping Burden	1	State Grant for AT Progress Report
Annual Report for the State Grant for Assistive Technology Program	1	State Grant AT Annual Progress Report
Statewide AT Customer Satisfaction Survey	NA	SGAT Customer Survey
Statewide AT Annual Performance Measurements Report	N/A	State Assessment and Performance Measurement Form

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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	6,652	190,456	0	-183,804	0	0
Annual Time Burden (Hours)	22,624	23,772	0	-1,148	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 total estimated burden hour per respondent will decrease from 406 to 404 hours. The total burden hours will go from 23772 down to 22,264.

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Annual Cost to Federal Government: $175,500

Does this IC contain surveys, censuses, or employ statistical methods? No

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)? 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: 10/17/2017

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