Rural Health Network Development Program Performance Improvement and Measurement System (PIMS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Rural Health Network Development Performance Improvement and Measurement System (PIMS)	Form and Instruction	Modified	Available
REVISIONS - Rural Health Network Development Program (0906-0010).docx	Supplementary Document	Uploaded 2018-04-12	Available
0010 RHND - Supporting Statement A Instructions CLEAN.docx	Supporting Statement A	Uploaded 2018-06-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215502	Rural Health Network Development Performance Improvement and Measurement System (PIMS)	Form and Instruction	Modified

ICR Details

OMB Control No: 0906-0010	ICR Reference No: 201804-0906-002
Status: Historical Active	Previous ICR Reference No: 201503-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Rural Health Network Development Program Performance Improvement and Measurement System (PIMS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/21/2018
	Date Received in OIRA: 04/13/2018
Terms of Clearance: Agency will display the OMB Control Number, Expiration Date, and PRA Burden Statement on EHB by 9/15/18 and will supply screenshots to OIRA demonstrating compliance by that date.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved	06/30/2018
Responses	51	0	54
Time Burden (Hours)	306	0	362
Cost Burden (Dollars)	0	0	0

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Abstract: Performance measures were drafted to provide data to the program and to enable HRSA to provide aggregate program data required by Congress under the Government Performance and Results Act (GPRA) of 1993 (Public Law 103-62). These measures cover the principal topic areas of interest to the Office of Rural Health Policy. Respondents are Rural Health Network Development Program grant recipients.

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Authorizing Statute(s): US Code: 42 USC 254c (f), Name of Law: Section 330A (f) of the Public Health Service Act
   PL: Pub.L. 107 - 251 201 Name of Law: Health Care Safety Net Amendments of 2002
  

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 56038	11/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 13761	03/30/2018
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Rural Health Network Development Performance Improvement and Measurement System (PIMS)	1	INSTRUMENT - RHND - 2017 PIMS.docx

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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	51	54	0	-3	0	0
Annual Time Burden (Hours)	306	362	0	-56	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: Reduction in respondents and burden per response led to decrease in overall burden.

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Annual Cost to Federal Government: $17,363

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: 04/13/2018

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