View Information Collection Request (ICR) Package
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View ICR - Agency Submission
COMMENT
Time Remaining
Days
HR
Min
Sec
OMB Control No:
0906-0029
ICR Reference No:
202512-0906-003
Status:
Received in OIRA
Previous ICR Reference No:
202303-0906-002
Agency/Subagency:
HHS/HRSA
Agency Tracking No:
Title:
Shortage Designation Management System
Type of Information Collection:
Extension without change of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
Date Submitted to OIRA:
12/18/2025
Requested
Previously Approved
Expiration Date
36 Months From Approved
04/30/2026
Responses
7,074
7,074
Time Burden (Hours)
38,664
38,664
Cost Burden (Dollars)
0
0
Abstract:
The need and purpose of this information collection is to obtain information from the State Primary Care Offices (PCO) via the Shortage Designation Management System (SDMS) for the review of geographic area, population, or facility Health Professional Shortage Area (HPSA) and Medically Underserved Area/Population (MUAP) designations. The application asks for national, state and local data required to determine the area, population, or facility’s eligibility for a shortage designation. The respondents for this information collection are State PCO who seek to improve primary care service delivery and workforce availability in the State or territory to meet the needs of underserved populations.
Authorizing Statute(s):
US Code:
42 USC 254b Title III Section 330(b)
Name of Law: Public Health Service Act as Amended by 42 USC
US Code:
42 USC 254e Title III Section 332
Name of Law: Public Health Service Act as Amended by 42 USC
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 21318
05/19/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 58569
12/17/2025
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Designation, Planning, and Preparation
E, F, G
PCO Provider Management User Guide - Attachment E.pdf
,
PCO Designation Management User Guide - Attachment F.pdf
,
Manual for Policies and Procedures - Attachment G.pdf
SDMS Application
D
SDMS Supplemental Information - Attachment D.docx
ICR Summary of Burden
Total Request
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
7,074
7,074
0
0
0
0
Annual Time Burden (Hours)
38,664
38,664
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:
Annual Cost to Federal Government:
$633,040
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:
12/18/2025
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