OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

IHS Urban Indian Health Program Common Reporting Requirements

ICR 201108-0917-001 · OMB 0917-0007 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0917-0007 IHS Urban Indian Health Program Common Reporting Requirements Form and Instruction Modified Available
60_Day_FR_Notice_OUIHP_11-18-09[1].pdf Supplementary Document Uploaded 2010-11-16 Repair queued
30_DAY_NOTICE_OUIHP_5-23-2011-_final.doc Supplementary Document Uploaded 2011-05-23 Repair queued
30_DAY_NOTICE_OUIHP_6-29-2011-_final.doc Supplementary Document Uploaded 2011-06-29 Available
Urban_Programs_Manual_Supporting_Statement_6-29-11final1.docx Supplementary Document Uploaded 2011-06-29 Available
Urban_Programs_Manual_Supporting_Statement_8-5-11final.docx Supporting Statement A Uploaded 2011-08-05 Available
IC Document Collections
IC IDCollectionTypeStatusForm
6565 IHS Urban Indian Health Program Common Reporting Requirements Form and Instruction Modified
ICR Details
0917-0007 201108-0917-001
Historical Active 200408-0917-001
HHS/IHS
IHS Urban Indian Health Program Common Reporting Requirements
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 10/23/2011
Retrieve Notice of Action (NOA) 08/08/2011
  Inventory as of this Action Requested Previously Approved
10/31/2014 36 Months From Approved
33 0 0
792 0 0
0 0 0
Information required to assess the quality of healthcare services, and are likely already familiar to, and may already be in use by UIHP grantees.
PL: Pub.L. 94 - 437 507 Name of Law: Indian Health Care Improvement Act
  
None
Not associated with rulemaking
  74 FR 59544 11/18/2009
75 FR 65357 10/22/2010
No
1
IC Title Form No. Form Name
IHS Urban Indian Health Program Common Reporting Requirements 0917-0007 UDS Reporting Instructions for OUIHP Programs
  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 33 0 0 33 0 0
Annual Time Burden (Hours) 792 0 0 792 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The former estimated burden was 515 hours for the UCRR reporting. The UDS will increase the burden to approximately 792 hours, for an overall increase of 177 hours. The change is due to the following: 1) the majority for the programs have not used the UDS reporting and will require training to complete the UDS report; and 2) tables in the UDS report were not reported on the UCRR.
$274,729
No
No
No
No
No
Uncollected
Tamara Clay 301 443-4750 [email protected]
  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.
08/08/2011