View Information Collection Request (ICR) Package
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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:
3060-1271
ICR Reference No:
202012-3060-011
Status:
Historical Active
Previous ICR Reference No:
202008-3060-005
Agency/Subagency:
FCC
Agency Tracking No:
WCB
Title:
Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/29/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/28/2020
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2023
10/31/2023
10/31/2023
Responses
34,623
0
34,623
Time Burden (Hours)
198,347
0
198,347
Cost Burden (Dollars)
0
0
0
Abstract:
This submission is being made for a proposed non-substantive update to an existing information collection pursuant to 44 U.S.C. § 3507. The Commission submits the COVID-19 Telehealth Program Post-Program Report Template (Template) to be included as part of the existing information collection, which was approved by the Office of Management and Budget (OMB) on October 7, 2020. The FCC seeks approval to revise the existing collection 3060-1271 to also include information collection requirements for the Connected Care Pilot Program established by the Commission in the Report and Order entitled In the Matter of Promoting Telehealth for Low-Income Consumers; COVID-19 Telehealth Program (WC Docket No. 18-213, WC Docket No. 20-89, FCC 20-44). This collection is being revised to: (1) extend the existing information collection requirements for the COVID-19 Telehealth Program; (2) add new information collection requirements for the Connected Care Pilot Program; and (3) extend existing requirements applicable to both the COVID-19 Telehealth Program and the Connected Care Pilot Program. This information collection is necessary in order to facilitate the FCC’s and the Universal Administrative Company’s administration of the Programs, and to prevent waste, fraud, and abuse. The information will also allow the FCC to evaluate the extent to which the Programs are complying with the applicable rules and procedures for each program.
Authorizing Statute(s):
US Code:
47 USC 214, 254, 303(r), 403
Name of Law: Communications Act of 1934, as amended
US Code:
47 USC 1-4
Name of Law: Communications Act of 1934, as amended
PL:
Pub.L. 116 - 136 134 Stat. 281
Name of Law: Division B of the Coronavirus Aid, Relief, and Economic Security Act
US Code:
47 USC 151-154
Name of Law: Communications Act of 1934, as amended
US Code:
47 USC 201-205
Name of Law: Communications Act of 1934, as amended
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
3060-AK57
Final or interim final rulemaking
85 FR 19892
04/09/2020
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
85 FR 36406
06/16/2020
30-day Notice:
Federal Register Citation:
Citation Date:
85 FR 53001
08/27/2020
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
Business or other for-profit
N/A, N/A
COVID-19 Telehealth Program Application Form
,
COVID-19 Telehealth Request for Reimbursement Form
Federal Government
FCC Form 460
Description of Eligibility and Registration
State, Local or Tribal Governments
FCC Form 461, FCC Form 462, FCC Form 463
Request for Services
,
Request for Funding
,
Description of Request for Funding Disbursement
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
34,623
34,623
0
0
0
0
Annual Time Burden (Hours)
198,347
198,347
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
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:
No
Burden Reduction Due to:
Short Statement:
The Commission is reporting program changes/increases to this information collection. These program changes are a result of revising this collection to include the information collection requirements for the Connected Care Pilot Program, pursuant to the Report and Order. These program changes increase the total annual responses from 28,020 to 34,623 (+6,603) and total annual burden hours of 173,326 to 198,347 (+25,021). The number of unique respondents does not change. We conclude that the number of respondents under the Connected Care Pilot Program will be a subset of the number of unique respondents under the COVID-19 Telehealth Program. Although there may be applicants who apply to the Connected Care Pilot Program that did not participate in the COVID-19 Telehealth Program, we likewise expect that there will be respondents who applied for the COVID-19 but do not apply for the Connected Care Program. Therefore, we estimate that the number of respondents will not exceed the previously estimated number of unique respondents.
Annual Cost to Federal Government:
$0
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?
Yes
Agency Contact:
Regina Brown 202 418-0792 regina.brown@fcc.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:
12/28/2020
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