FORHP 0906-0102 OMB NonSubstantive Change Request_062725

5600 Fishers Lane

Rockville, MD 20857

DATE: June 27, 2025

TO: Dan Cline, Desk Officer, Office of Management and Budget

FROM: Samantha Miller, Information Collection Clearance Officer, Office of Planning, Analysis and Evaluation, Health Resources and Services Administration

______________________________________________________________________________

Request: The Health Resources and Services Administration’s (HRSA) Federal Office of Rural Health Policy requests approval for changes to the Small Health Care Provider Quality Improvement Performance Improvement and Measurement Systems Measures (OMB 0906-0102 expiration date August 31, 2027).

Purpose: HRSA is requesting a change to revise response options to align with this Administration’s priorities. This memo explains the changes and supporting rationale.

Changes: This request involves deletion of response/selection options for certain questions within the form.

Changes are outlined in Table A (see below) and in the track changes version of the Office of Management and Budget approved measures (see Attachment).

Time Sensitivity: HRSA requests approval within the standard 10-day period to avoid any delay to data collection under 0906-0102.

Burden: The proposed changes are not expected to have any impact on burden.

Total Estimated Annualized Burden Hours:

Form Name	Number of Respondents	Number of Responses per Respondent	Total Responses	Average Burden per Response (in hours)	Total Burden Hours
SHCPQI Performance Improvement and Measurement Systems	21	1	21	13.5	283.5
Total	21	1	21	13.5	283.5

PROPOSED CLARIFICATIONS AND NON-SUBSTANTIVE CHANGES:

Table A

Instrument	Type of Change	Question/Item	Change implemented	Rationale
Small Health Care Provider Quality Improvement Performance Improvement and Measurement Systems Measures	Remove response option	Section 4 – 9a (Number of Member Organizations in the Consortium/Network)	Remove “Migrant Health Center.”	These data are not being used to assess program performance.
	Remove response option	Section 5 – 10a (Approaches to Quality Improvement)	Remove “/cultural competency.”	These data are not being used to assess program performance.
	Remove response option	Appendix A	Remove “Cultural Competency” definition	These data are not being used to assess program performance.

Attachments:

• A: FORHP 0906-0102 SHCPQI Program Measures (Redline)

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