Building Healthy Military Communities Pilot - Rapid Needs Assessment

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
BHMC Pilot RNA Outreach and Thank You Emails_08.docx	Supplementary Document	Uploaded 2017-12-28	Available
SR 113_85.pdf	Supplementary Document	Uploaded 2017-12-28	Available
BHMC Supporting Statement Part A_05.08.2018.docx	Supporting Statement A	Uploaded 2018-05-09	Available
BHMC Supporting_Statement_PartB_05.08.2018.doc	Supporting Statement B	Uploaded 2018-05-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229594	Building Healthy Military Communities Pilot - Rapid Needs Assessment	Other-Questionnaire Script	New

ICR Details

OMB Control No: 0704-0572	ICR Reference No: 201712-0704-003
Status: Active	Previous ICR Reference No:
Agency/Subagency: DOD/DODDEP	Agency Tracking No: 0704-AAKS
Title: Building Healthy Military Communities Pilot - Rapid Needs Assessment
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/10/2018
	Date Received in OIRA: 01/03/2018
Terms of Clearance: This collection is approved based on the revised materials provided by the Department.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2021	36 Months From Approved
Responses	280	0	0
Time Burden (Hours)	420	0	0
Cost Burden (Dollars)	13,062	0	0

---

Abstract: The Building Healthy Military Communities (BHMC) pilot is a multi-year initiative that aims to better understand unique challenges faced by geographically dispersed Service members and their families that may impact force readiness and well-being. The BHMC pilot derives guidance from Senate Report (S.R.) 113 – 85, which calls for the Department of Defense (DoD) to progress and expand well-being efforts utilizing the Total Force Fitness (TFF) framework by submitting “a plan for the comprehensive coordination and delivery of TFF onto the existing health and community programs”.

---

Authorizing Statute(s): None

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:
	82 FR 44395	09/22/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 61274	12/27/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Building Healthy Military Communities Pilot - Rapid Needs Assessment

---

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	280	0	0	280	0	0
Annual Time Burden (Hours)	420	0	0	420	0	0
Annual Cost Burden (Dollars)	13,062	0	0	13,062	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: No

Burden Reduction Due to:

Short Statement: This is a new collection with a new associated burden. The Building Healthy Military Communities (BHMC) pilot is a multi-year initiative that aims to better understand unique challenges faced by geographically dispersed Service members and their families that may impact force readiness and well-being. The BHMC pilot derives guidance from Senate Report (S.R.) 113 – 85, which calls for the Department of Defense (DoD) to progress and expand well-being efforts utilizing the Total Force Fitness (TFF) framework by submitting “a plan for the comprehensive coordination and delivery of TFF onto the existing health and community programs”.

---

Annual Cost to Federal Government: $1,032,015

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)? 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: 01/03/2018

---