Information Collection

Tribal Continuous Quality Improvement Collaboratives

IC 245093 under ICR 202012-0970-013 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Instrument 1 - PDSA Planning Tool Instructions_FINAL 02.06.20.docx	Instruction
Instrument 1 - PDSA Planning Tool Instructions_FINAL 02.06.20.docx	Instruction
Instrument 1 - PDSA Planning Tool_FINAL.docx	Other-Planning Tool
Instrument 1 - PDSA Planning Tool_FINAL.docx	Other-Planning Tool
INSTRU~1.XLS	Other-Template
INSTRU~1.XLS	Other-Template
INSTRU~2.XLS	Other-Template
INSTRU~2.XLS	Other-Template
Generics Supporting Statement A - Tribal CQIC Revised. 02-07-20. clean.docx Supporting Statement A - Formative Generic Program Support: Tribal CQIC	IC Document
Generics Supporting Statement A - Tribal CQIC Revised. 02-07-20. clean.docx Supporting Statement A - Formative Generic Program Support: Tribal CQIC	IC Document
NOA - Formative Generic Program Support_Tribal CQI Collabs_0970-0531_2.19.20.pdf NOA - Tribal Continuous Quality Improvement Collaboratives	IC Document
NOA - Formative Generic Program Support_Tribal CQI Collabs_0970-0531_2.19.20.pdf NOA - Tribal Continuous Quality Improvement Collaboratives	IC Document

IC Title:

Tribal Continuous Quality Improvement Collaboratives

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction	Instrument 1 - PDSA Planning Tool Instructions_FINAL 02.06.20.docx	Yes	No	Printable Only
Other-Planning Tool	Instrument 1 - PDSA Planning Tool_FINAL.docx	Yes	Yes	Fillable Fileable
Other-Template	INSTRU~1.XLS	Yes	Yes	Fillable Fileable
Other-Template	INSTRU~2.XLS	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 19

Number of Respondents for Small Entity: 0

Affected Public: Private Sector

Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	380	380
Annual IC Time Burden (Hours)	950	950
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
Supporting Statement A - Formative Generic Program Support: Tribal CQIC	Generics Supporting Statement A - Tribal CQIC Revised. 02-07-20. clean.docx	12/23/2020
NOA - Tribal Continuous Quality Improvement Collaboratives	NOA - Formative Generic Program Support_Tribal CQI Collabs_0970-0531_2.19.20.pdf	12/23/2020

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.