Monitoring and Reporting System for the Division of Community Health's Cooperative Agreement Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Private Sector - Special Data Request	Form	Modified	Available
Private Sector - Semi-annual Reporting	Form	Modified	Available
Private Sector - Initial population	Form	Removed	Available
State/Local/Tribal Sector - Special Data Reporting	Form	Modified	Available
State/Local/Tribal - Semi-annual reporting	Form	Modified	Available
State/Local/Tribal Sector-Initial population	Form	Removed	Available
Att 6 NCCDPHP 684 Form.pdf	Supplementary Document	Uploaded 2018-02-08	Available
Att3b_DCH-PMD _User Guide_07 31 2017.docx	Supplementary Document	Uploaded 2018-02-08	Available
Att 5a 60-Day FRN Published.pdf	Supplementary Document	Uploaded 2018-02-08	Available
Att 2_Awardees.docx	Supplementary Document	Uploaded 2018-02-08	Available
Att 1b_ACA PPHF.pdf	Supplementary Document	Uploaded 2018-02-08	Available
Att 1a_PHSA.pdf	Supplementary Document	Uploaded 2018-02-08	Available
SS Part B.docx	Supporting Statement B	Uploaded 2018-02-05	Available
SS Part A.docx	Supporting Statement A	Uploaded 2018-02-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214570	Private Sector - Special Data Request	Form	Modified
214569	Private Sector - Semi-annual Reporting	Form	Modified
214568	Private Sector - Initial population	Form	Removed
214567	State/Local/Tribal Sector - Special Data Reporting	Form	Modified
214566	State/Local/Tribal - Semi-annual reporting	Form	Modified
214565	State/Local/Tribal Sector-Initial population	Form	Removed

ICR Details

OMB Control No: 0920-1053	ICR Reference No: 201802-0920-003
Status: Historical Active	Previous ICR Reference No: 201612-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1053
Title: Monitoring and Reporting System for the Division of Community Health's Cooperative Agreement 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: 04/11/2018
	Date Received in OIRA: 02/27/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2019	12 Months From Approved	04/30/2018
Responses	147	0	311
Time Burden (Hours)	588	0	1,596
Cost Burden (Dollars)	0	0	0

---

Abstract: Racial and Ethnic Approaches to Community Health (REACH; FOA DP14-1419PPHF14) awardees were provided supplemental funding for an additional year. CDC requests a revision to collect information from the 49 REACH awardees for an additional year via the same electronic management information system they use to provide semi-annual reports to CDC as required by the funding opportunity announcement. The information is used to monitor each awardee's progress, to provide oversight of the use of federal funds, to identify and disseminate awardee successes, to reduce duplication of effort, and to respond to inquires.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
   PL: Pub.L. 111 - 148 4002 Name of Law: Patient Protection and Affordable Care Act
  

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 44798	09/26/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 8277	02/26/2018
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Private Sector - Initial population	none	DCH screenshots
Private Sector - Semi-annual Reporting	none	DCH MIS
Private Sector - Special Data Request	none	Special Data Request
State/Local/Tribal - Semi-annual reporting	none	DCH MIS
State/Local/Tribal Sector - Special Data Reporting	none	Special Data Request
State/Local/Tribal Sector-Initial population	none	DCH screenshots

---

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	147	311	0	-164	0	0
Annual Time Burden (Hours)	588	1,596	0	-1,008	0	0
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden was reduced due to the cessation of funding for 44 previous awardees and the removal of the need for the initial population of the MIS database for continuing awardees.

---

Annual Cost to Federal Government: $117,655

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]? Yes

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: 02/27/2018

---