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View ICR - OIRA Conclusion

OMB Control No: 0915-0293	ICR Reference No: 201408-0915-001
Status: Historical Active	Previous ICR Reference No: 201108-0915-003
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Free Clinics FTCA Program Application
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: 10/07/2014
	Date Received in OIRA: 08/28/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	36 Months From Approved	12/31/2014
Responses	227	0	200
Time Burden (Hours)	454	0	2,800
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	227	200	27
Annual Time Burden (Hours)	454	2,800	-2,346
Annual Cost Burden (Dollars)	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: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: There is a change to the estimate of burden. The number of hours per Free Clinic application has been reduced from fourteen (14) to two (2) hours due to the Free Clinic deeming application module, which is the new electronic application submitted to HRSA through the Electronic Handbooks. The number of respondents has also increased to 227. As a result the total number of burden hours has decreased to 454.

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