View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0938-0449	ICR Reference No: 199701-0938-004
Status: Historical Active	Previous ICR Reference No: 199602-0938-005
Agency/Subagency: HHS/CMS	Agency Tracking No:
Title: Home and Community-Based Services Waiver Requests
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/11/1997
	Date Received in OIRA: 01/23/1997
Terms of Clearance: This information collection is approved through 3-99 under the following condition: OMB commends HCFA for the agency's efforts to streamline the waiver application and renewal forms. Upon passage of the administration's health bill or similar effort to replace the waiver process with a State Plan amendment, HCFA eliminate this form and revise and submit the State Plan.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/1999	03/31/1999	04/30/1999
Responses	140	0	140
Time Burden (Hours)	8,200	0	12,600
Cost Burden (Dollars)	263,130,000	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	140	140	0
Annual Time Burden (Hours)	8,200	12,600	-4,400
Annual Cost Burden (Dollars)	263,130,000	0	263,130,000

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: Yes

Burden Reduction Due to:

Short Statement:

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.