Million Hearts Hypertension Control Challenge

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-21FY Interview Guide	Form and Instruction	Modified	Repair queued
Form 0920-0976 Data Verification Form	Form and Instruction	Unchanged	Missing upstream
Form 0920-0976 Application Form	Form and Instruction	Unchanged	Repair queued
0920-0976_Change Request Justification_6_07_21.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-06-23	Missing upstream
Attachment 10. IRB determination 0920-0976.pdf	Supplementary Document	Uploaded 2019-08-14	Repair queued
Attachment 9. Example Business Associate Agreement 0920-0976.docx	Supplementary Document	Uploaded 2019-08-14	Missing upstream
Attachment 8. Proposed changes 0920-0976.docx	Supplementary Document	Uploaded 2019-08-14	Repair queued
Attachment 7. Revised Eligibility and Rules for Participation 0920-0976.docx	Supplementary Document	Uploaded 2019-08-14	Repair queued
Attachment 2 60 day FRN 12_12_2018 0920-0976.pdf	Supplementary Document	Uploaded 2019-08-09	Missing upstream
Attachment 1c. Office of Management and Budget Guidance on the Use of Challenges 0920-0976.pdf	Supplementary Document	Uploaded 2016-09-19	Missing upstream
Attachment 1b. Authorizing Legislation COMPETES.docx	Supplementary Document	Uploaded 2016-09-19	Repair queued
Attachment 1a. Authorizing Legislation PHSA.docx	Supplementary Document	Uploaded 2016-09-19	Repair queued
0920-0976 MH SS B.docx	Supporting Statement B	Uploaded 2019-07-25	Missing upstream
0920-0976 MH SS A.docx	Supporting Statement A	Uploaded 2019-07-25	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
206922	Interview Guide	Form and Instruction	Modified
206921	Data Verification Form	Form and Instruction	Unchanged
206920	Application Form	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-0976	ICR Reference No: 202106-0920-016
Status: Received in OIRA	Previous ICR Reference No: 201907-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0976
Title: Million Hearts Hypertension Control Challenge
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/23/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	11/30/2022	11/30/2022
Responses	275	275
Time Burden (Hours)	215	215
Cost Burden (Dollars)	0	0

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Abstract: CDC has been collecting information from applicants nominated for the Million Hearts ® Hypertension Control Challenge (OMB No. 0920-0976, exp. 12/31/2019) to identify medical practices and clinics achieving high rates of hypertension control. CDC uses this information to recognize exemplary clinical practices in hypertension control (at least 80% control) and identify and promote best practices for achieving high rates of control. Participation is voluntary.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 358 24 Name of Law: America COMPETES Reauthorization Act of 2010
  

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:
	83 FR 63890	12/12/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 40065	08/13/2019
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Application Form	0920-0976	Application Form
Data Verification Form	0920-0976	Data Verification Form
Interview Guide	0920-21FY	Attachment 5. Interview Guide 2013 0920-0976 (changed)

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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	275	275	0	0	0	0
Annual Time Burden (Hours)	215	215	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: $247,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     Yes

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? No

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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: 06/23/2021

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