OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

National Ambulatory Medical Care Survey Supplement on Culturally and Linguistically Appropriate Services (NAMCS CLAS)

ICR 201605-0920-014 · OMB 0920-1119 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Att G - IRB Approval Letter.docx Supplementary Document Uploaded 2016-05-23 Available
Att F -Letters 061616.docx Supplementary Document Uploaded 2016-06-16 Available
Att E - Consultants.docx Supplementary Document Uploaded 2016-05-23 Available
Att B - 60dy Federal Register Notice.pdf Supplementary Document Uploaded 2016-05-23 Available
Att A - Public Health Service Act.docx Supplementary Document Uploaded 2016-05-23 Available
2016 NAMCS CLAS OMB SS-B 061516.docx Supporting Statement B Uploaded 2016-06-16 Available
2016 NAMCS CLAS OMB SS-A 061516.docx Supporting Statement A Uploaded 2016-06-16 Available
IC Document Collections
IC IDCollectionTypeStatusForm
221652 Att D_Phone Script Other-WORD New
221651 Att C_NAMCS CLAS Questionnaire Other-WORD New
ICR Details
0920-1119 201605-0920-014
Historical Active
HHS/CDC 15BCU
National Ambulatory Medical Care Survey Supplement on Culturally and Linguistically Appropriate Services (NAMCS CLAS)
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 06/27/2016
Retrieve Notice of Action (NOA) 05/27/2016
  Inventory as of this Action Requested Previously Approved
06/30/2017 12 Months From Approved
3,312 0 0
676 0 0
0 0 0
The general purpose of this study is to describe cultural and linguistic competency and the provision of the National Standards for Culturally and Linguistically Appropriate Services in Health and Health Care (the National CLAS Standards) among office-based physicians regionally and nationally in the United States.
US Code: 42 USC 242k Name of Law: Public Health Service Act
   US Code: 42 USC 242M(d) Name of Law: Public Health Service Act
   PL: Pub.L. 107 - 347 Title 5 Name of Law: Confidential Information Protection and Statistical Efficiency Act
  
None
Not associated with rulemaking
  80 FR 52291 08/28/2015
81 FR 32758 05/24/2016
No
2
IC Title Form No. Form Name
Att C_NAMCS CLAS Questionnaire
Att D_Phone Script
  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 3,312 0 0 3,312 0 0
Annual Time Burden (Hours) 676 0 0 676 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new information collection request.
$300,000
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Thelma Sims 4046394771
  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.
05/27/2016