Survey of SCHIP Enrollees and Disenrollees for the Congressionally Mandated Evaluation of the State Children's Health Insurance Program

ICR 200202-0990-001

OMB: 0990-0256

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0990-0256 200202-0990-001
Historical Active
HHS/HHSDM
Survey of SCHIP Enrollees and Disenrollees for the Congressionally Mandated Evaluation of the State Children's Health Insurance Program
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 02/22/2002
Retrieve Notice of Action (NOA) 02/07/2002
This information collection request is approved consistent with HHS's memos of 1/23/02, 2/7/02 & 2/12/02. HHS will conduct an experiment on the effect of incentives on response rates as was agreed upon in 2/12 memo. HHS will also examine response rate variations due to field follow-up process. HHS will report back to OMB the results of their incentive experiment and examination of field follow up procedures. Also, OMB notes that HHS engaged in significant data collection efforts during State site visits without first obtaining OMB approval, in violation of the PRA. This violation will be recorded in OMB's annual Information Collection Budget.
  Inventory as of this Action Requested Previously Approved
02/28/2005 02/28/2005
21,600 0 0
12,744 0 0
0 0 0

This information collection, part of the Congressionally mandated Evaluation of the SCHIP program, will collect data about children currently and previously covered by the program by conducting surveys in 10 States. A supplemental survey about Medicaid children will be conducted in two states.

None
None


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 21,600 0 0 21,600 0 0
Annual Time Burden (Hours) 12,744 0 0 12,744 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
02/07/2002


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