Office of Healthcare Information and Counseling (OHIC) Profiles at ACL

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
OHIC SMP Sub Recipient Report Template	Form and Instruction	New	Available
OHIC Profiles Template	Form and Instruction	New	Available
MIPPA Sub Recipients Report Template	Form and Instruction	New	Available
Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	Form and Instruction	New	Repair queued
0985-New OHIC Profiles Supporting Statement A__23.01.04 kr.docx	Supporting Statement A	Uploaded 2023-02-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
258450	Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	Form and Instruction	New	OHIC SMP Sub Recipient Report Template
258450	Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	Form and Instruction	New	OHIC Profiles Template
258450	Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	Form and Instruction	New	MIPPA Sub Recipients Report Template
258450	Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	Form and Instruction	New
258450	Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	Instruction	New

ICR Details

OMB Control No: 0985-0075	ICR Reference No: 202302-0985-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACL	Agency Tracking No:
Title: Office of Healthcare Information and Counseling (OHIC) Profiles at ACL
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/14/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/10/2023
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
Responses	125	0	0
Time Burden (Hours)	104	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Administration for Community Living’s (ACL’s) Office of Healthcare Information and Counseling (OHIC) seeks to collect data for grantees to develop standardized grantee profiles for three programs managed by OHIC: State Health Insurance Assistance Program (SHIP), Senior Medicare Patrol (SMP), and Medicare Improvements for Patients and Providers Act (MIPPA). SHIP was authorized by the Omnibus Budget Reconciliation Act of 1990, SMP by the Omnibus Consolidated Appropriation Act of 1997, and MIPPA was passed in 2008. For grantees in each program, there is a specific set of reporting requirements and associated reporting schedules outlined in the OHIC Program Reporting Guidelines. These include monthly, semiannual, and final reports that are either general or financial reports. Although reporting requirements are effective in obtaining specific grantees’ data, there is neither consistency nor uniformity in how individual grantees submit the data elements beyond a high-level agency overview. Profiles, or standardized documents summarizing grantee efforts, have been used by ACL for monitoring purposes and information sharing between grantees. However, profiles were only developed for SHIP grantees and were last updated in 2016. The goal of this data collection effort is to obtain consistent data elements for SHIP, SMP, and MIPPA program grantees. Data will allow ACL to develop an updated set of grantee profiles that are accessible, visually appealing, and uniform across programs. The profiles will be internal to ACL and will only be shared with OHIC grantees.

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Authorizing Statute(s): PL: Pub.L. 101 - 508 3209 Name of Law: Omnibus Budget Reconciliation Act of 1990
   PL: Pub.L. 104 - 208 3610 Name of Law: Omnibus Consolidated Appropriation Act of 1997
  

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 65068	10/27/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 8285	02/08/2023
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
Office of Healthcare Information and Counseling (OHIC) Profiles at ACL	NA, NA, NA	MIPPA Sub Recipients Report Template ,   OHIC Profiles Template ,   OHIC SMP Sub Recipient 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	125	0	0	125	0	0
Annual Time Burden (Hours)	104	0	0	104	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: This is a new data collection; there is a program change increase of 103.75 annual burden hours.

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Annual Cost to Federal Government: $27,600

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? 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: 02/10/2023

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