Office of Minority Health: Performance Evaluation Measurement System (PEMS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-PEMS SS Clean 12.9.2024.docx	Supporting Statement A	Uploaded 2024-12-09	Repair queued
Appendix D GPRA Modernization Act.pdf	Supplementary Document	Uploaded 2024-12-09	Missing upstream
Appendix C Health Care and Education Reconciliation Act (1).pdf	Supplementary Document	Uploaded 2024-12-09	Missing upstream
Appendix B Patient Protection and Affordable Care Act (1).pdf	Supplementary Document	Uploaded 2024-12-09	Missing upstream
Appendix A Disadvantaged Minority Health Improvement Act (1).pdf	Supplementary Document	Uploaded 2024-12-09	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
272887	OMH Disparity Impact Statement	Other-Survey	New
272886	OMH Performance Progress Report	Other-Survey	New

ICR Details

OMB Control No:	ICR Reference No: 202412-0937-001
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/OASH	Agency Tracking No:
Title: Office of Minority Health: Performance Evaluation Measurement System (PEMS)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 12/09/2024

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	625	0
Time Burden (Hours)	875	0
Cost Burden (Dollars)	0	0

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Abstract: This request for Office of Management and Budget (OMB) clearance for a new information collection, Performance and Evaluation Measurement System (PEMS), to collect data from Office of Minority Health (OMH) grant recipients. This data is used to monitor performance and promote evaluation of intervention effectiveness throughout the course of a funding period/cycle to ‘grow the science’ regarding ‘what works’ in minority health improvement and health disparities reduction. This information collection includes two new web-based data collection tools: OMH Performance Progress Report and Disparity Impact Statement. Recipients will submit responses for these tools through GrantSolutions, a web-based platform. GrantSolutions is password protected and access is limited to Authorized HHS Officials, and Grantee Principal Investigators and Project Directors.

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Authorizing Statute(s): PL: Pub.L. 42 - 241 301 Name of Law: Public Health Service 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
60-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 61488	07/31/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 88787	11/08/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
OMH Disparity Impact Statement
OMH Performance Progress Report

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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	625	0	0	625	0	0
Annual Time Burden (Hours)	875	0	0	875	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: New Collection

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Annual Cost to Federal Government: $250,000

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: 12/09/2024

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