Traumatic Brain Injury (TBI) State Partnership Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Traumatic Brain Injury (TBI) State Partnership Program	Form and Instruction	New	Available
TBI OMB Request to Publish and 60-day FRN Comment Summary.docx	Supplementary Document	Uploaded 2020-02-04	Repair queued
0985-New TBI Public Comment Crosswalk.xlsx	Supplementary Document	Uploaded 2020-02-04	Available
TBI_OMB_Sup State_FINAL 011020.docx	Supporting Statement A	Uploaded 2020-02-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
239261	Traumatic Brain Injury (TBI) State Partnership Program	Form and Instruction	New

ICR Details

OMB Control No: 0985-0066	ICR Reference No: 202001-0985-001
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACL	Agency Tracking No:
Title: Traumatic Brain Injury (TBI) State Partnership Program
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 without change	Conclusion Date: 03/10/2020
	Date Received in OIRA: 02/05/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	36 Months From Approved
Responses	54	0	0
Time Burden (Hours)	432	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of the federal Traumatic Brain Injury (TBI) State Partnership Program is to create and strengthen a system of services and supports that maximizes the independence, well-being, and health of people with TBIs across the lifespan and all other demographics, their family members, and support networks. The TBI State Partnership Program funds the development and implementation of statewide systems that ensure access to TBI related services, including transitional services, rehabilitation, education and employment, and long-term community support. To best monitor, guide, and support TBI State Partnership Program grantees, ACL needs regular information about the grantees’ activities and outcomes. The simplest, least burdensome, and most useful way to accomplish this goal is to require grantees to submit information as part of their required semiannual reports via the proposed electronic data submission instrument.

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Authorizing Statute(s): PL: Pub.L. 115 - 377 3657 Name of Law: Traumatic Brain Injury Reauthorization Act of 2018
  

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 52305	11/13/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 6198	02/04/2020
Did the Agency receive public comments on this ICR? Yes

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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
Traumatic Brain Injury (TBI) State Partnership Program	NA	TBI State Partnership Program Performance 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	54	0	0	54	0	0
Annual Time Burden (Hours)	432	0	0	432	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Changing Regulations

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The burden estimates presented here represent a significant reduction in estimated burden compared to the initial proposed IC in January 2018. At that time, ACL estimated there would could be as many as 45 grantees and each report would require 16 hours of grantee time to complete or 32 hours per year total. This submission to OMB includes our revised burden estimates based on how the proposed instrument has been shortened in length, narrowed in scope, and simplified in terms of the data requested. The specific changes to the data collection instrument that produce these reductions in burden are described under Question 8 in the supporting statement. This is a new information collection with a program change increase of 432 annual burden hours.

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Annual Cost to Federal Government: $157,108

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: 02/05/2020

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