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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Shortage Designation Management System
Agency IC Tracking Number:
Is this a Common Form?
No
IC Status:
New
Obligation to Respond:
Mandatory
CFR Citation:
Information Collection Instruments:
Document Type
Form No.
Form Name
Instrument File
URL
Available Electronically?
Can Be Submitted Electronically?
Electronic Capability
Instruction
SDMS Supplemental Information - Attachment D.docx
Yes
Yes
Fillable Fileable
Instruction
SDMS Provider Management User Guide - Attachment E.pdf
Yes
Yes
Fillable Fileable
Instruction
SDMS Mapping Tool User Guide - Attachment F.pdf
Yes
Yes
Fillable Fileable
Instruction
SDMS Manual for Policies and Procedures - Attachment G.pdf
Yes
Yes
Fillable Fileable
Instruction
SDMS Primary Care Office Portal User Guide - Attachment H.pdf
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Health
Subfunction:
Health Care Services
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
54
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
100 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
3,078
0
3,078
0
0
0
Annual IC Time Burden (Hours)
106,899
0
106,899
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
Statute A
HPSA Statute - Attachment A.pdf
01/12/2016
Statute B
MUAP Statute - Attachment B.pdf
01/12/2016
Regulation C
HPSA Regulations - Attachment C.pdf
01/12/2016
FRN 60 day I
SDMS 60 Day FRN - Attachment I.pdf
01/12/2016
FOA K
HRSA FOA PCSRCD - Attachment K.pdf
01/12/2016
FRN Shortage Areas
HPSA FRN - Attachment L.pdf
01/12/2016
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.