Rural Health Care Coordination Network Partnership Program Performance Improvement Measurement System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Rural Health Care Coordination Program Performance Measures	Form and Instruction	Modified	Available
Form 1 Rural Health Care Coordination Program Performance Measures	Form and Instruction	Modified	Available
Form 1 Rural Health Care Coordination Program Performance Improvement Measurement System;	Form and Instruction	Modified	Repair queued
FORHP OMB NonSubstantive Change Request (RHCC) FINAL 07232025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-23	Repair queued
FORHP OMB NonSubstantive Change Request (RHCC) FINAL 07232025.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-07-23	Repair queued
2024 30-Day FRN Care Coordination Supporting Statement A_Revised 07292024.docx	Supporting Statement A	Uploaded 2024-08-16	Available
2024 30-Day FRN Care Coordination Supporting Statement A_Revised 07292024.docx	Supporting Statement A	Uploaded 2024-08-16	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222525	Rural Health Care Coordination Program Performance Improvement Measurement System;	Form and Instruction	Modified	Rural Health Care Coordination Program Performance Measures
222525	Rural Health Care Coordination Program Performance Improvement Measurement System;	Form and Instruction	Modified	Rural Health Care Coordination Program Performance Measures
222525	Rural Health Care Coordination Program Performance Improvement Measurement System;	Form and Instruction	Modified

ICR Details

OMB Control No: 0906-0024	ICR Reference No: 202507-0906-003
Status: Active	Previous ICR Reference No: 202406-0906-002
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Rural Health Care Coordination Network Partnership Program Performance Improvement Measurement System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/28/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/23/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	08/31/2026	08/31/2026
Responses	10	0	10
Time Burden (Hours)	487	0	487
Cost Burden (Dollars)	0	0	0

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Abstract: The Rural Health Care Coordination (Care Coordination) program is authorized under Section 330A(e) of the Public Health Service (PHS) Act (42 U.S.C. 254(e)), as amended, to “improve access and quality of care through the application of care coordination strategies with the focus areas of collaboration, leadership and workforce, improved outcomes, and sustainability in rural communities.” This authority permits the Federal Office of Rural Health Policy to support rural health consortiums/networks aiming to achieving the overall goals of improving access, delivery, and quality of care through the application of care coordination strategies in rural communities..

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Authorizing Statute(s): US Code: 42 USC 254c(e) Section 330A (e) Name of Law: Public Health Service Act (PHS)
  

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 2960	01/17/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 52068	06/21/2024
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 Care Coordination Program Performance Improvement Measurement System;	1, 1	Rural Health Care Coordination Program Performance Measures ,   Rural Health Care Coordination Program Performance Measures

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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	10	10	0	0	0	0
Annual Time Burden (Hours)	487	487	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $6,104

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: 07/23/2025

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