Agency Information Collection Activities: Proposed Collection: Public Comment Request; Information Collection Request Title: Health Center Program Forms OMB No. 0915-0285 Revision, 62861-62863 [2022-22510]
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Federal Register / Vol. 87, No. 199 / Monday, October 17, 2022 / Notices
Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Scientific Integrity, Office of Science,
Centers for Disease Control and Prevention.
[FR Doc. 2022–22508 Filed 10–14–22; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Advisory Commission on Childhood
Vaccines Meeting
Health Resources and Services
Administration (HRSA), Department of
Health and Human Services (HHS).
ACTION: Notice.
AGENCY:
The Advisory Commission on
Childhood Vaccines (ACCV) provides
advice and recommendations to the
Secretary of HHS (Secretary) on policy,
program development, and other issues
related to the implementation of the
National Vaccine Injury Compensation
Program (VICP) and concerning other
matters as described under the Public
Health Service Act. To ensure
compliance with the statutory
requirement that the ACCV meet not
less than four times per year, this notice
announces that the ACCV meeting
originally scheduled for March 3, 2022,
has been rescheduled for December 2,
2022.
DATES: The ACCV meeting will be held
on December 2, 2022, from 1:00 p.m.–
4:00 p.m. Eastern Time.
ADDRESSES: This meeting will be held
by Zoom webinar.
• Webinar link: https://hrsagov.zoomgov.com/j/1603695024?
pwd=ZG4rUWw
0NUlTN2d0OWRZWVJjVmNIZz09.
• Conference call-in number: 833 568
8864, Meeting ID: 160 369 5024,
Passcode: 72471327.
FOR FURTHER INFORMATION CONTACT: Pita
Gomez, Principal Staff Liaison, ACCV,
5600 Fishers Lane, Rockville, Maryland
20857, telephone: (301) 945–9386 or
email: ACCV@HRSA.gov.
SUPPLEMENTARY INFORMATION: All 2022
ACCV meetings were originally
announced in the Federal Register, Vol.
87, No. 20 on Monday, January 31, 2022,
(FR Doc. 2022–01848 Filed 1–28–22),
and the notice canceling the March 3,
2022, meeting was published on
February 28, 2022 (FR Doc. 2022–04127
Filed 2–25–22).
Since priorities dictate ACCV meeting
times, be advised that start times, end
times, and agenda items are subject to
change. Agenda items may include but
lotter on DSK11XQN23PROD with NOTICES1
SUMMARY:
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17:35 Oct 14, 2022
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are not limited to, updates from the
Division of Injury Compensation
Programs (HRSA), Torts Branch
(Department of Justice), Office of
Infectious Disease and HIV/AIDS Policy
(HHS), Immunization Safety Office
(Centers for Disease Control and
Prevention), National Institute of
Allergy and Infectious Diseases
(National Institutes of Health) and
Center for Biologics, Evaluation and
Research (Food and Drug
Administration). Refer to the ACCV
website at https://www.hrsa.gov/
advisory-committees/vaccines/
index.html for all current and updated
information concerning the ACCV
meeting, including draft agendas and
meeting materials that will be posted 5
calendar days before the meeting.
The ACCV meeting will be public,
and members of the public will have the
opportunity to provide comments.
Public participants may submit written
statements in advance of the scheduled
meeting. Oral comments will be
honored in the order they are requested
and may be limited as time allows.
Requests to submit a written statement
or make oral comments to the ACCV
should be sent to Pita Gomez using the
contact information above at least 5
business days before the meeting date.
Individuals who need special
assistance or another reasonable
accommodation should notify Pita
Gomez using the contact information
listed above at least 10 business days
before the meeting they wish to attend.
Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2022–22486 Filed 10–14–22; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Agency Information Collection
Activities: Proposed Collection: Public
Comment Request; Information
Collection Request Title: Health Center
Program Forms OMB No. 0915–0285
Revision
Health Resources and Services
Administration (HRSA), Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
In compliance with the
requirement for opportunity for public
comment on proposed data collection
projects of the Paperwork Reduction Act
of 1995, HRSA announces plans to
submit an Information Collection
SUMMARY:
PO 00000
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62861
Request (ICR), described below, to the
Office of Management and Budget
(OMB). Prior to submitting the ICR to
OMB, HRSA seeks comments from the
public regarding the burden estimate,
below, or any other aspect of the ICR.
DATES: Comments on this ICR should be
received no later than December 16,
2022.
Submit your comments to
paperwork@hrsa.gov or mail the HRSA
Information Collection Clearance
Officer, Room 14N136B, 5600 Fishers
Lane, Rockville, MD 20857.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the data collection plans and draft
instruments, email paperwork@hrsa.gov
or call Samantha Miller, the acting
HRSA Information Collection Clearance
Officer at (301) 443–9094.
SUPPLEMENTARY INFORMATION: When
submitting comments or requesting
information, please include the
information request collection title for
reference.
Information Collection Request Title:
Health Center Program Forms, OMB No.
0915–0285 Revision.
Abstract: The Health Center Program,
administered by HRSA, is authorized
under section 330 of the Public Health
Service (PHS) Act (42 U.S.C. 254b).
Health centers are community-based
and patient-directed organizations that
deliver affordable, accessible, quality,
and cost-effective primary health care
services to patients regardless of their
ability to pay. Nearly 1,400 health
centers operate approximately 14,000
service delivery sites that provide
primary health care to more than 30
million people in every U.S. state, the
District of Columbia, Puerto Rico, the
U.S. Virgin Islands, and the Pacific
Basin. HRSA uses forms for new and
existing health centers and other entities
to apply for various grant and non-grant
opportunities, renew grant and nongrant designations, report progress, and
change their scopes of project.
Need and Proposed Use of the
Information: Health Center Programspecific forms are necessary for award
processes and oversight of the Health
Center Program and other relevant
programs. These forms provide HRSA
staff and objective review committee
panels with information essential for
application evaluation, funding
recommendation and approval,
designation, and monitoring. These
forms also provide HRSA staff with
information essential for evaluating
compliance with Health Center Program
statutory and regulatory requirements.
ADDRESSES:
E:\FR\FM\17OCN1.SGM
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Federal Register / Vol. 87, No. 199 / Monday, October 17, 2022 / Notices
HRSA intends to make several changes
to its forms:
• HRSA will modify the following
forms to streamline and clarify data
currently being collected: 1A, 1B, 1C, 2,
4, 6A, 8, Checklist for Adding a New
Service, Checklist for Adding a New
Service Delivery Site, Checklist for
Adding a New Target Population,
Checklist for Deleting Existing Service,
Checklist for Deleting Existing Service
Delivery Site, Expanded Services
Patient Impact, Health Center
Controlled Networks Progress Report,
Native Hawaiian Health Care
Improvement Act (NHHCIA) NonCompeting Continuation (NCC) Clinical
and Financial Performance Measures,
NHHCIA NCC Income Analysis Form,
NHHCIA NCC Project Work Plan
Progress Report, NHHCIA NCC Project
Work Plan Update, Operational Plan,
Project Narrative Update, Project
Overview Form, Project Work Plan, and
the Summary Page—Service Area
Competition.
• HRSA will add forms necessary for
funding applications and program
monitoring: Applicant Qualification
Criteria Form, Financial Performance
Indicators, Funding Request Summary
Form, fiscal year (FY) 2022 Accelerating
Cancer Screening Progress Report,
Patient Impact Form, Project Cover
Page, Progress Report—Non-Capital
Investments, School-Based Health
Center Location Form, Quality
Improvement Fund (QIF) Evaluative
Measures Report, QIF Project Plan Form
and QIF Progress Report.
• HRSA will remove forms to further
streamline information collected by
HRSA and reduce burden: Clinical
Performance Measures, Diabetes Action
Plan, Expanded Services, Financial
Performance Measures, FY 2018
Expanding Access to Quality Substance
Use Disorder—Mental Health Integrated
Behavioral Health Services Progress
Reporting, Health Center Program
Supplemental Information, HRSA
Electronic Handbooks Action Plan, and
the Program Specific Form Instructions.
Likely Respondents: Health Center
Program award recipients (those funded
under section 330 of the PHS Act) and
Number of
respondents
lotter on DSK11XQN23PROD with NOTICES1
Form name
Applicant Qualification Criteria Form ...................................
Capital Semi Annual Progress Report .................................
Checklist for Adding a New Service ....................................
Checklist for Adding a New Service Delivery Site ..............
Checklist for Adding a New Target Population ...................
Checklist for Deleting Existing Service ................................
Checklist for Deleting Existing Service Delivery Site ..........
Environmental Information and Documentation ..................
Equipment List .....................................................................
Expanded Services Patient Impact ......................................
Federal Object Class Categories Form ...............................
Financial Performance Indicators ........................................
Form 12: Organization Contacts ..........................................
Form 1A: General Information Worksheet ...........................
Form 1B: Funding Request Summary .................................
Form 1C: Documents on File ..............................................
Form 2: Staffing Profile ........................................................
Form 3: Income Analysis .....................................................
Form 3A: Look-Alike Budget Information ............................
Form 4: Community Characteristics ....................................
Form 5A: Services Provided ................................................
Form 5B: Service Sites ........................................................
Form 5C: Other Activities/Locations ....................................
Form 6A: Current Board Member Characteristics ...............
Form 6B: Request for Waiver of Board Member Requirements ................................................................................
Form 8: Health Center Agreements ....................................
Funding Request Summary Form School-Based Health
Center ...............................................................................
Funding Sources ..................................................................
FY2020 Ending the HIV Epidemic Primary Care HIV Prevention PCHP Progress Reporting ..................................
FY2022 Accelerating Cancer Screening Progress Report ..
Health Center Controlled Networks Progress Report .........
Health Center Program Progress Report ............................
HRSA Loan Guarantee Program Application ......................
NHHCIA NCC Clinical Performance Measures ...................
NHHCIA NCC Financial Performance Measures ................
NHHCIA NCC Income Analysis Form .................................
NHHCIA NCC Project Work Plan Progress Report ............
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17:35 Oct 14, 2022
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Frm 00081
Number of
responses per
respondent
Health Center Program look-alikes, state
and national technical assistance
organizations, and other organizations
seeking funding.
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose, or provide the information
requested. This includes the time
needed to review instructions; to
develop, acquire, install, and utilize
technology and systems for the purpose
of collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information; to train
personnel and to be able to respond to
a collection of information; to search
data sources; to complete and review
the collection of information; and to
transmit or otherwise disclose the
information. The total annual burden
hours estimated for this ICR are
summarized in the table below.
Total Estimated Annualized Burden—
Hours:
Total
responses
Average
burden per
response
(in hours)
Total burden
hours
500
1,317
450
1,480
100
500
750
750
1,375
996
735
20
1,058
1,058
1,000
1,058
1,058
1,058
50
1,058
1,058
1,058
1,058
1,058
1
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
500
2,634
450
1,480
100
500
750
750
1,375
996
735
20
1,058
1,058
1,000
1,058
1,058
1,058
50
1,058
1,058
1,058
1,058
1,058
1.00
1.00
2.00
2.00
2.00
2.00
2.00
0.50
0.50
1.00
0.25
1.00
1.00
1.00
0.75
0.50
1.00
1.00
1.00
1.00
1.00
1.00
1.00
1.00
500
2,634
900
2,960
200
1,000
1,500
375
688
996
184
20
1,058
1,058
750
529
1,058
1,058
50
1,058
1,058
1,058
1,058
1,058
1,058
1,058
1
1
1,058
1,058
1.00
1.00
1,058
1,058
500
735
1
1
500
735
0.50
0.50
250
368
182
10
90
735
20
6
6
6
6
1
1
1
1
1
1
1
1
1
182
10
90
735
20
6
6
6
6
1.00
1.50
1.00
1.00
1.00
1.50
0.50
0.15
0.15
182
15
90
735
20
9
3
1
1
Fmt 4703
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E:\FR\FM\17OCN1.SGM
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Federal Register / Vol. 87, No. 199 / Monday, October 17, 2022 / Notices
Number of
respondents
Form name
Total
responses
Average
burden per
response
(in hours)
Total burden
hours
NHHCIA NCC Project Work Plan Update ...........................
Operational Plan ..................................................................
Other Requirements for Sites ..............................................
Participating Health Centers List .........................................
Patient Impact Form ............................................................
Patient Target and Calculations ..........................................
Progress Report—Non-Capital Investments ........................
Project Cover Page ..............................................................
Project Narrative Update .....................................................
Project Overview Form ........................................................
Project Plan ..........................................................................
Project Qualification Criteria ................................................
Project Work Plan ................................................................
Proposal Cover Page ...........................................................
QIF Evaluative Measures Report ........................................
QIF Progress Report ............................................................
QIF Project Plan Form .........................................................
Summary Page (New Access Point-Funding Type) ............
Summary Page Service Area Competition ..........................
6
500
600
90
500
1,058
1,400
735
883
182
182
735
135
735
12
12
100
500
450
1
1
1
1
1
1
4
1
1
1
3
1
1
1
1
1
1
1
1
6
500
600
90
500
1,058
5,600
735
883
182
546
735
135
735
12
12
100
500
450
0.15
3.00
0.50
1.00
1.00
1.00
1.50
1.00
4.00
1.00
1.50
1.00
4.00
1.00
1.50
1.50
1.00
1.00
0.50
1
1,500
300
90
500
1,058
8,400
735
3,532
182
819
735
540
735
18
18
100
500
225
Total ..............................................................................
33,830
........................
39,711
........................
46,586
HRSA specifically requests comments
on (1) the necessity and utility of the
proposed information collection for the
proper performance of the agency’s
functions, (2) the accuracy of the
estimated burden, (3) ways to enhance
the quality, utility, and clarity of the
information to be collected, and (4) the
use of automated collection techniques
or other forms of information
technology to minimize the information
collection burden.
Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2022–22510 Filed 10–14–22; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Center for Scientific Review; Notice of
Closed Meetings
lotter on DSK11XQN23PROD with NOTICES1
Number of
responses per
respondent
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of the
following meetings.
The meetings will be closed to the
public in accordance with the
provisions set forth in sections
552b(c)(4) and 552b(c)(6), title 5 U.S.C.,
as amended. The grant applications and
the discussions could disclose
confidential trade secrets or commercial
property such as patentable material,
and personal information concerning
individuals associated with the grant
applications, the disclosure of which
would constitute a clearly unwarranted
invasion of personal privacy.
VerDate Sep<11>2014
17:35 Oct 14, 2022
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Name of Committee: Center for Scientific
Review Special Emphasis Panel; PAR 20–
103: Collaborative Program Grant for
Multidisciplinary Teams (RM1).
Date: October 31, 2022.
Time: 9 a.m. to 6 p.m.
Agenda: To review and evaluate grant
applications.
Place: National Institutes of Health,
Rockledge II, 6701 Rockledge Drive,
Bethesda, MD 20892 (Virtual Meeting).
Contact Person: Sergei Ruvinov, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 4158,
MSC 7806, Bethesda, MD 20892, 301–435–
1180, ruvinser@csr.nih.gov.
Name of Committee: Center for Scientific
Review Special Emphasis Panel; Special
Topics in Instrumentation and Systems
Development.
Date: November 2, 2022.
Time: 9:30 a.m. to 7:30 p.m.
Agenda: To review and evaluate grant
applications.
Place: National Institutes of Health,
Rockledge II, 6701 Rockledge Drive,
Bethesda, MD 20892 (Virtual Meeting).
Contact Person: Janice Patricia Dionisio
Duy, Ph.D., Scientific Review Officer, Center
for Scientific Review, 6701 Rockledge Drive,
Bethesda, MD 20892, 301–594–3139,
janice.duy@nih.gov.
Name of Committee: Center for Scientific
Review Special Emphasis Panel;
Fellowships: Chemistry, Biochemistry and
Biophysics A.
Date: November 2–3, 2022.
Time: 10 a.m. to 6 p.m.
Agenda: To review and evaluate grant
applications.
Place: National Institutes of Health,
Rockledge II, 6701 Rockledge Drive,
Bethesda, MD 20892 (Virtual Meeting).
Contact Person: Shan Wang, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
PO 00000
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Health, 6701 Rockledge Drive, Bethesda, MD
20892, (301) 496–4390, shan.wang@nih.gov.
Name of Committee: Integrative,
Functional and Cognitive Neuroscience
Integrated Review Group; Neurobiology of
Motivated Behavior Study Section.
Date: November 3–4, 2022.
Time: 8 a.m. to 6 p.m.
Agenda: To review and evaluate grant
applications.
Place: Embassy Suites at the Chevy Chase
Pavilion, 4300 Military Road NW,
Washington, DC 20015.
Contact Person: Janita N. Turchi, Ph.D.,
Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Bethesda, MD
20892, (301) 402–4005, turchij@mail.nih.gov.
Name of Committee: Molecular, Cellular
and Developmental Neuroscience Integrated
Review Group; Neural Oxidative Metabolism
and Death Study Section.
Date: November 3–4, 2022.
Time: 8 a.m. to 5 p.m.
Agenda: To review and evaluate grant
applications.
Place: Washington Marriott Georgetown,
1221 22nd Street NW, Washington, DC
20037.
Contact Person: Christine Jean DiDonato,
Ph.D., Scientific Review Officer, Center for
Scientific Review, National Institutes of
Health, 6701 Rockledge Drive, Room 1014J,
Bethesda, MD 20892, (301) 435–1042,
didonatocj@csr.nih.gov.
Name of Committee: Center for Scientific
Review Special Emphasis Panel;
Fellowships: Cell Biology, Developmental
Biology, and Bioengineering.
Date: November 3–4, 2022.
Time: 8:30 a.m. to 7:30 p.m.
Agenda: To review and evaluate grant
applications.
Place: Hyatt Regency Bethesda, 7400
Wisconsin Ave., Bethesda, MD 20814.
Contact Person: Mufeng Li, Ph.D.,
Scientific Review Officer, Center for
E:\FR\FM\17OCN1.SGM
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]]>Agencies
[Federal Register Volume 87, Number 199 (Monday, October 17, 2022)]
[Notices]
[Pages 62861-62863]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-22510]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection:
Public Comment Request; Information Collection Request Title: Health
Center Program Forms OMB No. 0915-0285 Revision
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with the requirement for opportunity for public
comment on proposed data collection projects of the Paperwork Reduction
Act of 1995, HRSA announces plans to submit an Information Collection
Request (ICR), described below, to the Office of Management and Budget
(OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the
public regarding the burden estimate, below, or any other aspect of the
ICR.
DATES: Comments on this ICR should be received no later than December
16, 2022.
ADDRESSES: Submit your comments to [email protected] or mail the HRSA
Information Collection Clearance Officer, Room 14N136B, 5600 Fishers
Lane, Rockville, MD 20857.
FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the data collection plans and
draft instruments, email [email protected] or call Samantha Miller,
the acting HRSA Information Collection Clearance Officer at (301) 443-
9094.
SUPPLEMENTARY INFORMATION: When submitting comments or requesting
information, please include the information request collection title
for reference.
Information Collection Request Title: Health Center Program Forms,
OMB No. 0915-0285 Revision.
Abstract: The Health Center Program, administered by HRSA, is
authorized under section 330 of the Public Health Service (PHS) Act (42
U.S.C. 254b). Health centers are community-based and patient-directed
organizations that deliver affordable, accessible, quality, and cost-
effective primary health care services to patients regardless of their
ability to pay. Nearly 1,400 health centers operate approximately
14,000 service delivery sites that provide primary health care to more
than 30 million people in every U.S. state, the District of Columbia,
Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin. HRSA uses
forms for new and existing health centers and other entities to apply
for various grant and non-grant opportunities, renew grant and non-
grant designations, report progress, and change their scopes of
project.
Need and Proposed Use of the Information: Health Center Program-
specific forms are necessary for award processes and oversight of the
Health Center Program and other relevant programs. These forms provide
HRSA staff and objective review committee panels with information
essential for application evaluation, funding recommendation and
approval, designation, and monitoring. These forms also provide HRSA
staff with information essential for evaluating compliance with Health
Center Program statutory and regulatory requirements.
[[Page 62862]]
HRSA intends to make several changes to its forms:
HRSA will modify the following forms to streamline and
clarify data currently being collected: 1A, 1B, 1C, 2, 4, 6A, 8,
Checklist for Adding a New Service, Checklist for Adding a New Service
Delivery Site, Checklist for Adding a New Target Population, Checklist
for Deleting Existing Service, Checklist for Deleting Existing Service
Delivery Site, Expanded Services Patient Impact, Health Center
Controlled Networks Progress Report, Native Hawaiian Health Care
Improvement Act (NHHCIA) Non-Competing Continuation (NCC) Clinical and
Financial Performance Measures, NHHCIA NCC Income Analysis Form, NHHCIA
NCC Project Work Plan Progress Report, NHHCIA NCC Project Work Plan
Update, Operational Plan, Project Narrative Update, Project Overview
Form, Project Work Plan, and the Summary Page--Service Area
Competition.
HRSA will add forms necessary for funding applications and
program monitoring: Applicant Qualification Criteria Form, Financial
Performance Indicators, Funding Request Summary Form, fiscal year (FY)
2022 Accelerating Cancer Screening Progress Report, Patient Impact
Form, Project Cover Page, Progress Report--Non-Capital Investments,
School-Based Health Center Location Form, Quality Improvement Fund
(QIF) Evaluative Measures Report, QIF Project Plan Form and QIF
Progress Report.
HRSA will remove forms to further streamline information
collected by HRSA and reduce burden: Clinical Performance Measures,
Diabetes Action Plan, Expanded Services, Financial Performance
Measures, FY 2018 Expanding Access to Quality Substance Use Disorder--
Mental Health Integrated Behavioral Health Services Progress Reporting,
Health Center Program Supplemental Information, HRSA Electronic
Handbooks Action Plan, and the Program Specific Form Instructions.
Likely Respondents: Health Center Program award recipients (those
funded under section 330 of the PHS Act) and Health Center Program
look-alikes, state and national technical assistance organizations, and
other organizations seeking funding.
Burden Statement: Burden in this context means the time expended by
persons to generate, maintain, retain, disclose, or provide the
information requested. This includes the time needed to review
instructions; to develop, acquire, install, and utilize technology and
systems for the purpose of collecting, validating and verifying
information, processing and maintaining information, and disclosing and
providing information; to train personnel and to be able to respond to
a collection of information; to search data sources; to complete and
review the collection of information; and to transmit or otherwise
disclose the information. The total annual burden hours estimated for
this ICR are summarized in the table below.
Total Estimated Annualized Burden--Hours:
----------------------------------------------------------------------------------------------------------------
Number of Average burden
Form name Number of responses per Total per response Total burden
respondents respondent responses (in hours) hours
----------------------------------------------------------------------------------------------------------------
Applicant Qualification Criteria 500 1 500 1.00 500
Form...........................
Capital Semi Annual Progress 1,317 2 2,634 1.00 2,634
Report.........................
Checklist for Adding a New 450 1 450 2.00 900
Service........................
Checklist for Adding a New 1,480 1 1,480 2.00 2,960
Service Delivery Site..........
Checklist for Adding a New 100 1 100 2.00 200
Target Population..............
Checklist for Deleting Existing 500 1 500 2.00 1,000
Service........................
Checklist for Deleting Existing 750 1 750 2.00 1,500
Service Delivery Site..........
Environmental Information and 750 1 750 0.50 375
Documentation..................
Equipment List.................. 1,375 1 1,375 0.50 688
Expanded Services Patient Impact 996 1 996 1.00 996
Federal Object Class Categories 735 1 735 0.25 184
Form...........................
Financial Performance Indicators 20 1 20 1.00 20
Form 12: Organization Contacts.. 1,058 1 1,058 1.00 1,058
Form 1A: General Information 1,058 1 1,058 1.00 1,058
Worksheet......................
Form 1B: Funding Request Summary 1,000 1 1,000 0.75 750
Form 1C: Documents on File...... 1,058 1 1,058 0.50 529
Form 2: Staffing Profile........ 1,058 1 1,058 1.00 1,058
Form 3: Income Analysis......... 1,058 1 1,058 1.00 1,058
Form 3A: Look-Alike Budget 50 1 50 1.00 50
Information....................
Form 4: Community 1,058 1 1,058 1.00 1,058
Characteristics................
Form 5A: Services Provided...... 1,058 1 1,058 1.00 1,058
Form 5B: Service Sites.......... 1,058 1 1,058 1.00 1,058
Form 5C: Other Activities/ 1,058 1 1,058 1.00 1,058
Locations......................
Form 6A: Current Board Member 1,058 1 1,058 1.00 1,058
Characteristics................
Form 6B: Request for Waiver of 1,058 1 1,058 1.00 1,058
Board Member Requirements......
Form 8: Health Center Agreements 1,058 1 1,058 1.00 1,058
Funding Request Summary Form 500 1 500 0.50 250
School-Based Health Center.....
Funding Sources................. 735 1 735 0.50 368
FY2020 Ending the HIV Epidemic 182 1 182 1.00 182
Primary Care HIV Prevention
PCHP Progress Reporting........
FY2022 Accelerating Cancer 10 1 10 1.50 15
Screening Progress Report......
Health Center Controlled 90 1 90 1.00 90
Networks Progress Report.......
Health Center Program Progress 735 1 735 1.00 735
Report.........................
HRSA Loan Guarantee Program 20 1 20 1.00 20
Application....................
NHHCIA NCC Clinical Performance 6 1 6 1.50 9
Measures.......................
NHHCIA NCC Financial Performance 6 1 6 0.50 3
Measures.......................
NHHCIA NCC Income Analysis Form. 6 1 6 0.15 1
NHHCIA NCC Project Work Plan 6 1 6 0.15 1
Progress Report................
[[Page 62863]]
NHHCIA NCC Project Work Plan 6 1 6 0.15 1
Update.........................
Operational Plan................ 500 1 500 3.00 1,500
Other Requirements for Sites.... 600 1 600 0.50 300
Participating Health Centers 90 1 90 1.00 90
List...........................
Patient Impact Form............. 500 1 500 1.00 500
Patient Target and Calculations. 1,058 1 1,058 1.00 1,058
Progress Report--Non-Capital 1,400 4 5,600 1.50 8,400
Investments....................
Project Cover Page.............. 735 1 735 1.00 735
Project Narrative Update........ 883 1 883 4.00 3,532
Project Overview Form........... 182 1 182 1.00 182
Project Plan.................... 182 3 546 1.50 819
Project Qualification Criteria.. 735 1 735 1.00 735
Project Work Plan............... 135 1 135 4.00 540
Proposal Cover Page............. 735 1 735 1.00 735
QIF Evaluative Measures Report.. 12 1 12 1.50 18
QIF Progress Report............. 12 1 12 1.50 18
QIF Project Plan Form........... 100 1 100 1.00 100
Summary Page (New Access Point- 500 1 500 1.00 500
Funding Type)..................
Summary Page Service Area 450 1 450 0.50 225
Competition....................
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Total....................... 33,830 .............. 39,711 .............. 46,586
----------------------------------------------------------------------------------------------------------------
HRSA specifically requests comments on (1) the necessity and
utility of the proposed information collection for the proper
performance of the agency's functions, (2) the accuracy of the
estimated burden, (3) ways to enhance the quality, utility, and clarity
of the information to be collected, and (4) the use of automated
collection techniques or other forms of information technology to
minimize the information collection burden.
Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2022-22510 Filed 10-14-22; 8:45 am]
BILLING CODE 4165-15-P
