OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Monitoring and Reporting System for the Division of Community Health's Cooperative Agreement Programs

ICR 201501-0920-011 · OMB 0920-1053 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Private Sector - Special Data Request Form New Repair queued
Private Sector - Semi-annual Reporting Form New Repair queued
Private Sector - Initial population Form New Available
State/Local/Tribal Sector - Special Data Reporting Form New Repair queued
State/Local/Tribal - Semi-annual reporting Form New Repair queued
State/Local/Tribal Sector-Initial population Form New Available
Att 3b_DCH-PMB Guidance_3 06 2015.docx Supplementary Document Uploaded 2015-03-10 Available
SS Part B_03 06 2015.docx Supporting Statement B Uploaded 2015-03-10 Available
SS Part A_03 06 2015.docx Supporting Statement A Uploaded 2015-03-10 Repair queued
Att 5_Federal Register Notice.pdf Supplementary Document Uploaded 2015-01-12 Available
Att 2_List of Awardees.docx Supplementary Document Uploaded 2015-01-12 Repair queued
Att 1b_ACA PPHF.pdf Supplementary Document Uploaded 2015-01-12 Available
Att 1a_PHSA.pdf Supplementary Document Uploaded 2015-01-12 Available
IC Document Collections
IC IDCollectionTypeStatusForm
214570 Private Sector - Special Data Request Form New
214569 Private Sector - Semi-annual Reporting Form New
214568 Private Sector - Initial population Form New
214567 State/Local/Tribal Sector - Special Data Reporting Form New
214566 State/Local/Tribal - Semi-annual reporting Form New
214565 State/Local/Tribal Sector-Initial population Form New
ICR Details
0920-1053 201501-0920-011
Historical Active
HHS/CDC 14AOO
Monitoring and Reporting System for the Division of Community Health's Cooperative Agreement Programs
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/10/2015
Retrieve Notice of Action (NOA) 01/16/2015
Non-substantive change requests will be approved only if the following conditions are met: the data requested is readily available to the awardee, the collection is low burden to the awardee (less than 30 minutes to compile and report the information), and it is related to existing data collected from awardees.
  Inventory as of this Action Requested Previously Approved
03/31/2018 36 Months From Approved
311 0 0
1,596 0 0
0 0 0
CDC plans to collection information from awardees funded under the Division of Community Health. Awardees will report progress and activity information to CDC using an electronic Management Information System. Reports are due twice per year but updates can be entered at any time. Approval is requested for three years.
PL: Pub.L. 111 - 148 4002 Name of Law: Patient Protection and Affordable Care Act
   US Code: 42 USC 241 Name of Law: PHSA
  
None
Not associated with rulemaking
  79 FR 41691 07/17/2014
80 FR 1636 01/13/2015
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 311 0 0 311 0 0
Annual Time Burden (Hours) 1,596 0 0 1,596 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new ICR.
$178,864
Yes Part B of Supporting Statement
No
Yes
No
No
Uncollected
Shari Steinberg 404 639-4942 [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.
01/16/2015