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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:
0970-0394
ICR Reference No:
201206-0970-010
Status:
Historical Active
Previous ICR Reference No:
201106-0970-008
Agency/Subagency:
HHS/ACF
Agency Tracking No:
Title:
Health Profession Opportunity Grants (HPOG) program
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
10/19/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/25/2012
Terms of Clearance:
Approved as revised by ACF.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2014
24 Months From Approved
09/30/2014
Responses
10,314
0
64
Time Burden (Hours)
4,559
0
1,997
Cost Burden (Dollars)
0
0
59,531
Abstract:
ACF is implementing a multi-pronged research and evaluation approach for the HPOG program to better understand and assess the activities conducted and their results. The current submission is in support of the HPOG Impact Study (HPOG-Impact). Currently, we request a revision to OMB clearance number 0970-0394 to add baseline questions to the PRS, which is currently in use by all HPOG grantees. These added questions will be administered to HPOG-Impact study participants only, including both those in the treatment group(s) and control group, at baseline (i.e., prior to random assignment and prior to intake into the programs studied for the treatment group) in conjunction with the currently approved PRS. These Supplemental Baseline Questions will complement baseline data already being collected about the universe of HPOG program participants through the PRS.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 5507
Name of Law: Patient Protection and Affordable Care Act
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:
77 FR 6126
02/07/2012
30-day Notice:
Federal Register Citation:
Citation Date:
77 FR 36276
06/18/2012
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
#1. Semi-annual HPOG Program Performance Report
Supplemental Baseline Questions (grantees)
Supplemental Baseline Questions (program participants and control group members)
ICR Summary 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
10,314
64
0
10,250
0
0
Annual Time Burden (Hours)
4,559
1,997
0
2,562
0
0
Annual Cost Burden (Dollars)
0
59,531
0
-59,531
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:
New survey.
Annual Cost to Federal Government:
$339,430
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
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?
Uncollected
Agency Contact:
Steve Hanmer 202 401-5651 Steven.Hanmer@ACF.hhs.gov
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:
06/25/2012
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