BHPr Performance Report for Grants and Cooperative Agreements

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form B BHPr Performance Measures Forms	Form and Instruction	Modified	Available
HHS Priority Questions.docx	Supplementary Document	Uploaded 2019-03-12	Available
AppendixD60dayFRNdocx.docx	Supplementary Document	Uploaded 2019-02-06	Available
Pipeline and Diversity Programs Mapping.pdf	Supplementary Document	Uploaded 2019-02-06	Available
Nursing, Behavioral Health and Public Health Programs Mapping.pdf	Supplementary Document	Uploaded 2019-02-06	Available
Medicine, Dentistry and Geriatrics Programs Mapping.pdf	Supplementary Document	Uploaded 2019-02-06	Available
AppendixABHWfunded.docx	Supplementary Document	Uploaded 2019-02-06	Available
Feb6FINALSupporting Statement A_clean.docx	Supporting Statement A	Uploaded 2019-02-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206385	BHPr Performance Measures Forms	Form and Instruction	Modified

ICR Details

OMB Control No: 0915-0061	ICR Reference No: 201902-0915-001
Status: Active	Previous ICR Reference No: 201804-0915-001
Agency/Subagency: HHS/HSA	Agency Tracking No: 19184
Title: BHPr Performance Report for Grants and Cooperative Agreements
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: 03/14/2019
	Date Received in OIRA: 02/07/2019
Terms of Clearance: OMB is approving this information collection request for a period of three years during which time HRSA will request approval to extend or revise the collection if it seeks to continue the information collection activity beyond the period approved under this action.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	36 Months From Approved	06/30/2019
Responses	1,500	0	1,557
Time Burden (Hours)	5,710	0	5,992
Cost Burden (Dollars)	0	0	0

---

Abstract: .The BHW Performance Report for Grants and Cooperative Agreements (PRGCA) is an annual performance and progress report required from each health professions and nursing education grantee that has an approved, funded project with a project period of one year or more. The report is required to determine the extent to which objectives of the project have been met so that a decision regarding continuation funding can be made.

---

Authorizing Statute(s): US Code: 42 USC 292 Name of Law: Health Research and Training Facilities and Training of Professional Health Personnel
   US Code: 42 USC 201 Name of Law: Health Professions Education and Partnership Act of 1998
   US Code: 42 USC 296 Name of Law: Nurse Education
   PL: Pub.L. 105 - 392 101 Name of Law: Health Professions Education and Financial Assistance Program
   PL: Pub.L. 109 - 307 2 Name of Law: CHGME Support Reauthorization Act of 2006
  

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:
	83 FR 52840	10/18/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 756	01/31/2019
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
BHPr Performance Measures Forms	C, B	Appendix B Progress Report ,   Appendix C Performance Measures

---

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	1,500	1,557	0	-57	0	0
Annual Time Burden (Hours)	5,710	5,992	0	-282	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: Using Information Technology

Short Statement: The decrease in burden is primarily due to 1) an increase in efficiency of the electronic reporting system and 2) decreases in specific form requirements for multipurpose grant programs.

---

Annual Cost to Federal Government: $193,940

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]? 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: 02/07/2019

---