Rural Health Clinic COVID-19 (RHC COVID-19)Testing Program Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Rural Health Clinic COVID-19 (RHC COVID-19) Testing Program Data Collection	Form and Instruction	Modified	Missing upstream
Supporting Statement A - RHC COVID-19 Testing Program 12.23.2020.docx	Supporting Statement A	Uploaded 2021-02-24	Missing upstream
09292020 Memo to OIRA from HRSA ADM FINAL.pdf	Supplementary Document	Uploaded 2020-09-29	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
243770	Rural Health Clinic COVID-19 (RHC COVID-19) Testing Program Data Collection	Form and Instruction	Modified

ICR Details

OMB Control No: 0906-0056	ICR Reference No: 202102-0906-003
Status: Received in OIRA	Previous ICR Reference No: 202009-0906-002
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Rural Health Clinic COVID-19 (RHC COVID-19)Testing Program Data Collection
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/24/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2021
Responses	28,872	28,872
Time Burden (Hours)	7,218	7,218
Cost Burden (Dollars)	0	0

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Abstract: HRSA Federal Office of Rural Health Policy (FORHP) has requested approval to create a new monthly, aggregate data report to collect information on COVID-19 testing conducted by Rural Health Clinic (RHC) organizations. Respondents are RHC organizations who received funding for COVID-19 testing and related expenses. HRSA issued funding as one-time payments to 2,406 RHC organizations based on the number of certified clinic sites they operate, providing $49,461.42 per clinic site (4,549 RHC clinic sites total across the country). The organizations were identified by Tax ID number and an organization may operate one or more RHC sites which were identified by unique CMS Certification Numbers (CCN). Data report information is needed to comply with federal requirements to monitor funds distributed under The Paycheck Protection Program and Health Care Enhancement Act.

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Authorizing Statute(s): PL: Pub.L. 116 - 139 Division B, Title I Name of Law: Paycheck Protection Program and Health Care Enhancement Act, Public Health and Social Services Emerg
  

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:
	85 FR 79492	12/10/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 11304	02/24/2021
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 Clinic COVID-19 (RHC COVID-19) Testing Program Data Collection	1	HRSA FORHP COVID-19 Data Report 12.18.2020.docx

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	28,872	28,872	0	0	0	0
Annual Time Burden (Hours)	7,218	7,218	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: $55,840

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? Yes

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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: 02/24/2021

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