OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Indian Health Service Medical Staff Credentials and Privileges Files

ICR 200611-0917-002 · OMB 0917-0009 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
0917-0009supporting st06.doc Supporting Statement A Uploaded 2006-11-28 Available
IC Document Collections
IC IDCollectionTypeStatusForm
6568 Indian Health Service Medical Staff Credentials and Privileges Files Modified
46256 Pathology New
46255 Radiology New
46254 Podiatry New
46253 Audiology New
46252 Psychology New
46251 Optometry New
46250 Dental Privileges New
46249 Anesthesis New
46248 Psychiatry New
46247 Surgery New
46246 OB-GYN New
46245 Internal Medicine/Family Practice Privilege New
46244 Reaapointment Request New
46243 Reference Letter New
ICR Details
0917-0009 200611-0917-002
Historical Active 200306-0917-001
HHS/IHS
Indian Health Service Medical Staff Credentials and Privileges Files
Extension without change of a currently approved collection   No
Regular
Approved without change 01/26/2007
Retrieve Notice of Action (NOA) 11/30/2006
  Inventory as of this Action Requested Previously Approved
01/31/2010 36 Months From Approved 01/31/2007
3,265 0 3,709
1,929 0 2,371
0 0 0
Information is needed and used by the Indian Health Service Medical Staff to meet JCAHO accreditation requirements and to review, evaluate and verify the credentials, training, and experience of applicants applying for medical staff privileges at IHS health care facilities.
US Code: 25 USC 13 Name of Law: Synder Act
   US Code: 42 USC 2001-2004 Name of Law: IHS Transfer Act
   US Code: 25 USC 450 Name of Law: Indian Self-Determination and Education Act
  
None
Not associated with rulemaking
  71 FR 35921 06/22/2006
71 FR 53106 09/08/2006
No
  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 3,265 3,709 0 -444 0 0
Annual Time Burden (Hours) 1,929 2,371 0 -442 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Cutting Redundancy
The forms were made more streamline.
$182
No
Yes
Uncollected
Uncollected
Uncollected
Uncollected
Saleda Perryman
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/29/2006