View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0915-0247
ICR Reference No:
202210-0915-007
Status:
Active
Previous ICR Reference No:
201910-0915-001
Agency/Subagency:
HHS/HSA
Agency Tracking No:
Title:
Children's Hospital Graduate Medical Education 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:
12/29/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/02/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2025
36 Months From Approved
01/31/2023
Responses
2,640
0
2,160
Time Burden (Hours)
9,880
0
8,200
Cost Burden (Dollars)
0
0
0
Abstract:
The Children’s Hospitals Graduate Medical Education (CHGME) Payment Program provides Federal support for graduate medical education to freestanding children’s hospitals. Eligible children’s hospitals receive payments for both direct and indirect medical education. Data are collected on the number of resident FTEs in applicant children’s hospitals’ training programs to determine the amount of direct and indirect medical education payments to be distributed to participating children’s hospitals. If this data is not collected, HRSA will have no means to monitor grantees, verify grantee reporting, or determine grantee eligibility for CHGME funding.
Authorizing Statute(s):
PL:
Pub.L. 115 - 241 340E
Name of Law: CHGME Support Reauthorization Act of 2013
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:
87 FR 48182
08/08/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 64061
10/21/2022
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
29
IC Title
Form No.
Form Name
Application Cover Letter (Reconciiation)
Application Cover Letter (initial and reconciliation)
CFO Cover Letter (Initial and Reconciliation)
Conversation Record (Resident FTE Assessment)
CR
Conversation Record (FTE Resident Assessment)
Exhibit 1 (Resident FTE Assessment)
Exhibit 2 (FTE Resident Assessment)
Exhibit 2 (Initial and Reconciliation)
Exhibit 3 (FTE Resident Assessment)
Exhibit 3 (Initial and Reconciliation)
Exhibit 4 (FTE Resident Assessment)
Exhibit 4 (Initial and Reconciliation)
Exhibit C (Resident FTE Assessment)
C
Exhibit C (FTE Resident Assessment)
Exhibit E (Fiscal Intermediary Introductory Request Letter)
Exhibit F (Resident FTE Assessment)
Exhibit N (Resident FTE Assessment)
N
Exhibit N (FTE Resident Assessment)
Exhibit O(1) (Resident FTE Assessment)
O(1)
Exhibit O(1) (FTE Resident Assessment)
Exhibit O(2) (Resident FTE Assessment)
O2
Exhibit O(2) (FTE Resident Assessment)
Exhibit P (Resident FTE Assessment)
P
Exhibit P (FTE Resident Assessment)
Exhibit P(2) (FTE Resident Assessment)
Exhibit S (Resident FTE Assessment)
S
Exhibit S (FTE Resident Assessment)
Exhibit T (Resident FTE Assessment)
Exhibit T(1) (Resident FTE Assessment)
FTE Assessment Letter (Resident FTE Assessment)
HRSA 99 (Initial and Reconcilation)
99 I and R
HRSA 99 (Initial and Reconciliation)
HRSA 99-1 (Initial)
99-1
HRSA 99-1 (Initial)
HRSA 99-1 (Reconcilliation)
99-1 R
HRSA 99-1 (Reconciliation)
HRSA 99-1 Supplemental (FTE Resident Assessment)
99-1 S
HRSA 99-1 (Supplemental FTE Resident Assessment)
HRSA 99-2 (Initial)
99-2 I
HRSA 99-2 (Initial)
HRSA 99-2 (Reconcilliation)
99-2 R
HRSA 99-2 (Reconciliation)
HRSA 99-4 (Reconciliation)
99-4 R
HRSA 99-4 (Reconciliation)
HRSA 99-5 (Initial and Reconciliation)
99-5 I & R
HRSA 99-5 (Initial and Reconciliation)
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
2,640
2,160
0
540
-60
0
Annual Time Burden (Hours)
9,880
8,200
0
1,830
-150
0
Annual Cost Burden (Dollars)
0
0
0
0
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
HRSA is proposing changes to the current CHGME Payment Program application and the FTE assessment forms and exhibits to be used for the CHGME Payment Program and THCGME Program. The changes are only proposed to the HRSA 99–1 form (also known as Exhibit O(2)), the HRSA 99–5 form, and the FTE resident assessment exhibits. Burden hours have been revised as appropriate based off program experiences working with the hospitals and discussions with the hospitals
Annual Cost to Federal Government:
$30,783
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?
No
Agency Contact:
Laura Cooper 301 443-2126 lcooper@hrsa.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:
11/02/2022
An official website of the United States government
The .gov means it's official.
The site is secure.
