Implementation of an Internet & Paper-Based Uniform Data Set for OMH-funded Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Change Request 0990-0275 20200714.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-07-14	Available
Change Request 0990-0275 20200714.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-07-14	Repair queued
App B 0990-0275 Performance Data Reporting_Template_Monthly R.xlsx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-07-14	Available
App B 0990-0275 Performance Data Reporting_Template_Monthly R.xlsx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-07-14	Repair queued
App A 0990-0275 Performance Data Quarterly Report Template single quarter.xlsx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-07-14	Available
App A 0990-0275 Performance Data Quarterly Report Template single quarter.xlsx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-07-14	Repair queued
Supporting Statement B_PIMS-PDS-final.docx	Supporting Statement B	Uploaded 2022-08-19	Available
Supporting Statement B_PIMS-PDS-final.docx	Supporting Statement B	Uploaded 2022-08-19	Repair queued
0990-0275 Supporting Statement A_PIMS-PDS-final_08192022.docx	Supporting Statement A	Uploaded 2022-08-19	Available
0990-0275 Supporting Statement A_PIMS-PDS-final_08192022.docx	Supporting Statement A	Uploaded 2022-08-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234241	Performance Data: Quarterly Report Template	Other-report	Modified

ICR Details

OMB Control No: 0990-0275	ICR Reference No: 202208-0990-003
Status: Historical Active	Previous ICR Reference No: 202007-0990-003
Agency/Subagency: HHS/HHSDM	Agency Tracking No: 19226
Title: Implementation of an Internet & Paper-Based Uniform Data Set for OMH-funded Activities
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/13/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/19/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2026	36 Months From Approved	03/31/2023
Responses	400	0	520
Time Burden (Hours)	300	0	390
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Minority Health is seeking an approval on a revision to a currently approved collection OMB # 0990-0275. The revised data collection activities seeks to further streamline the current questions grantees are asked by reducing the number of questions, and reduce the cost of the data collection system by using a more cost efficient alternative to the Performance Data System, (PDS) web-based portal. The overall reduction in questions will reduce the number of burden hours on grantees. The movement from a customized web-based portal to reporting using commercial, off-the shelf software (i.e., a spreadsheet) significantly reduces the cost of performance data collection and reporting. To collect program management and performance data for all OMH-funded projects, grantee data collection via the Uniform Data Set, UDS (original data collection system) was first approved by OMB on June 7, 2004 (OMB No. 0990-275).

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Authorizing Statute(s): PL: Pub.L. 103 - 101 2d Name of Law: 527
  

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:
	87 FR 30967	05/20/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 50339	08/16/2022
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
Performance Data: Quarterly Report Template

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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	400	520	0	-120	0	0
Annual Time Burden (Hours)	300	390	0	-90	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The requested overall burden has been lowered as the estimated number of respondents was reduced from 130 to 100 in this request due to a program change. The program change is related to the change in number of organizations funded by OMH through the research and demonstration program that are asked to use this data collection form.

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Annual Cost to Federal Government: $32,768

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.     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]? Yes

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: 08/19/2022

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