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:
0915-0247
ICR Reference No:
202509-0915-004
Status:
Active
Previous ICR Reference No:
202210-0915-007
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 without change
Conclusion Date:
12/22/2025
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/30/2025
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2028
36 Months From Approved
12/31/2025
Responses
2,640
0
2,640
Time Burden (Hours)
9,980
0
9,880
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 based on the number of FTE residents trained in applicant children’s hospital and teaching health center training programs is needed to determine the amount of graduate medical education payments to be distributed to participating children’s hospitals and teaching health centers. Children’s hospitals and teaching health centers applying for and receiving CHGME Payment Program and THCGME Program funds and fiscal intermediaries auditing data submitted by the participating children’s hospitals and teaching health centers are the anticipated respondents. 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:
90 FR 22496
05/28/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 46612
09/29/2025
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
29
IC Title
Form No.
Form Name
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)
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
2,640
0
0
0
0
Annual Time Burden (Hours)
9,980
9,880
0
100
0
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:
No
Burden Reduction Due to:
Short Statement:
The current burden in this collection is 9,880, and the burden in the last approved collection was 9,980. There was an increase in the burden for HRSA 99-2 (Initial) because the average burden per response went up from 9.67 hours to 11.33 hours. In June 2025, seven (7) CHGME Payment Program participating children’s hospitals and CHGME Payment Program and THCGME Program contracted fiscal intermediaries (auditors) reviewed the CHGME and THCGME materials for the burden estimate and for the clarity of instructions and forms. Based on their feedback, the total 9,980.40 burden hours for all forms and exhibits have not changed from the burden hours provided in the published 60-day FRN.
Annual Cost to Federal Government:
$698,577
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.
Yes
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.
Yes
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:
09/30/2025
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