Rural Health Care Services Outreach Performance Improvement and Measurement Systems (PIMS) Measures

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Rural Health Care Services Outreach Program Measures	Form	Modified	Available
30-day FRN 0009 FORHP OUTREACH.pdf	Supplementary Document	Uploaded 2018-10-24	Available
60-day FRN 0009 Rural Health Care Services Outreach Program PIMS.pdf	Supplementary Document	Uploaded 2018-10-24	Available
REVISIONS - Rural Health Care Services Outreach Program Measures - 0906-0009.docx	Supplementary Document	Uploaded 2018-04-12	Available
0009 Supporting Statement- RHCS Outreach Program PIMS Measures clean.docx	Supporting Statement A	Uploaded 2018-06-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215503	Rural Health Care Services Outreach Program Measures	Form	Modified

ICR Details

OMB Control No: 0906-0009	ICR Reference No: 201810-0906-001
Status: Active	Previous ICR Reference No: 201804-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Rural Health Care Services Outreach Performance Improvement and Measurement Systems (PIMS) Measures
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/02/2018
	Date Received in OIRA: 10/24/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	36 Months From Approved	06/30/2019
Responses	25	0	25
Time Burden (Hours)	88	0	88
Cost Burden (Dollars)	0	0	0

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Abstract: The Rural Health Care Services Outreach (Outreach) Program is authorized to “promote rural health care services outreach by expanding the delivery of health care services to include new and enhanced services in rural areas.” The goals for the Outreach Program are centered on the expansion of consortium-based, health care delivery in rural communities that ultimately improves population health and demonstrates health outcomes.

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Authorizing Statute(s): US Code: 42 USC 254c(e) Name of Law: Section 330A (e) of the Public Health Service (PHS) Act
  

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 56037	11/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 13763	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 Care Services Outreach Program Measures	1	Outreach Final PIMS Measures

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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	25	25	0	0	0	0
Annual Time Burden (Hours)	88	88	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $6,554

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: 10/24/2018

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