Rural Health Network Development Planning Program Performance Improvement and Measurement System (PIMS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Rural Health Network Development Planning Program Performance Measures	Form and Instruction	Modified	Available
Supporting Statement A Instructions (Network Planning) 04142026.docx	Supporting Statement A	Uploaded 2026-04-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
211181	Rural Health Network Development Planning Program Performance Improvement and Measurement System (PIMS) Form	Form and Instruction	Modified	Rural Health Network Development Planning Program Performance Measures

ICR Details

OMB Control No: 0915-0384	ICR Reference No: 202604-0915-002
Status: Received in OIRA	Previous ICR Reference No: 202506-0915-002
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Rural Health Network Development Planning Program Performance Improvement and Measurement System (PIMS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/20/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	04/30/2026
Responses	25	23
Time Burden (Hours)	281	23
Cost Burden (Dollars)	0	0

---

Abstract: Performance measures for the Rural Health Network Development Planning Program (Network Planning Program) serve the purpose of quantifying awardee-level data that conveys the successes and challenges associated with the grant award. These measures and aggregate data substantiate and inform the focus and objectives of the grant program. The approved measures encompass the following principal topic areas: network infrastructure, network collaboration, sustainability, and network assessment. The respondents for these measures are Rural Health Network Development Planning Program award recipients.

---

Authorizing Statute(s): US Code: 42 USC 330A(f) Name of Law: Public Health Service Act, Title III
   US Code: 42 USC 254(c)(g) Name of Law: Public Health Service Act, Title III
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 5773	02/09/2026
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 21005	04/20/2026
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Rural Health Network Development Planning Program Performance Improvement and Measurement System (PIMS) Form	1	Rural Health Network Development Planning Program Performance Measures

---

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	25	23	0	2	0	0
Annual Time Burden (Hours)	281	23	0	258	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: There are several contributing factors to the increase in estimated total burden. The increase in burden is to account for a new set of awardees who will be new to this data collection. The new set of awardees represent a group of organizations who are funded in the 1-year Network Planning Program. These organizations vary in data collection and reporting capacity as well as vary in the number of member organizations it must coordinate with to report this data to HRSA. The amount of time it takes to build processes to coordinate and collect data from network partners will vary. Larger networks with multiple partners across different organizations are expected to report higher burdens due to the wait time in between requests. Networks who already have established working relationships with its member organizations may already have existing processes in place to effectively collect data for this program.

---

Annual Cost to Federal Government: $96,212

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

---

Common Form ICR:  No

---

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: 04/20/2026

---