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	Available
Form 1 Rural Health Clinic COVID-19 (RHC COVID-19) Testing Program Data Collection	Form and Instruction	Modified	Repair queued
OMB _0906-0056 Memo to OIRA - Clean 09.28.21.pdf	Supplementary Document	Uploaded 2021-09-29	Available
OMB _0906-0056 Memo to OIRA - Clean 09.28.21.pdf	Supplementary Document	Uploaded 2021-09-29	Missing upstream
Supporting Statement A - RHC COVID-19 Testing Program - 9.28.2021 Clean.docx	Supporting Statement A	Uploaded 2021-09-29	Available
Supporting Statement A - RHC COVID-19 Testing Program - 9.28.2021 Clean.docx	Supporting Statement A	Uploaded 2021-09-29	Repair queued
09292020 Memo to OIRA from HRSA ADM FINAL.pdf	Supplementary Document	Uploaded 2020-09-29	Available
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
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: 202109-0906-001
Status: Active	Previous ICR Reference No: 202102-0906-003
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Rural Health Clinic COVID-19 (RHC COVID-19)Testing Program Data Collection
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 10/06/2021
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/01/2021
	Date Received in OIRA: 09/30/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	6 Months From Approved	04/30/2024
Responses	43,719	0	28,872
Time Burden (Hours)	14,427	0	7,218
Cost Burden (Dollars)	0	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.

Emergency Justfication: Approval of the RHC COVID-19 Reporting Portal is time-sensitive to meet federal reporting requirements as outlined in the American Rescue Plan Act legislation. Because of the urgent nature of the COVID-19 pandemic response, combined with the quick disbursement of and the short-term duration of this funding (one time disbursement in June 2021 of 2-year funds), it is important for HRSA to obtain data as quickly as possible.

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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
   PL: Pub.L. 117 - 2 Division B, Title I Name of Law: American Rescue Plan Act
  

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

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 9.2021_CLEAN.docx

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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	43,719	28,872	0	14,847	0	0
Annual Time Burden (Hours)	14,427	7,218	0	7,209	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: Decrease in burden is due to a decrease in respondents.

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Annual Cost to Federal Government: $60,903

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: 09/30/2021

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