Facts for Consumers About Health

Forms and Documents

Document Name	Status
0955-0002_FACTS FOR CONSUMER_PT B.docx Supporting Statement B	2012-10-31
Attachment C OMB 0955-0002.docx Supplementary Document	2012-10-31
0955-0002_Factfor Consumer.docx Supporting Statement A	2012-11-02

IC Document Collections

IC ID	Document Title	Status
189374	Participants selected Other-guide	Modified
189373	Individuals Screened/Coginitive testing Other-telephone script	Modified

ICR Details

OMB Control No: 0955-0002	ICR Reference No: 201211-0955-001
Status: Historical Active	Previous ICR Reference No: 201208-0955-002
Agency/Subagency: HHS/ONC	Agency Tracking No:
Title: Facts for Consumers About Health
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/08/2013
	Date Received in OIRA: 11/02/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2016	36 Months From Approved
Responses	156	0	0
Time Burden (Hours)	104	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Obama administration's domestic healthcare overhaul agenda and stimulus plan directly impacts and supports the mandate for The Office of the National Coordinator for Health Information Technology (ONC), a division of the Department of Health and Human Services (HHS). That mandate is to provide leadership for the strategic development and nationwide implementation for interoperable health information technology (health IT) by 2014.

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Authorizing Statute(s): PL: Pub.L. 111 - 5 0 Name of Law: American Recovery and Reinvestment Act of 2009
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 52033	08/28/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 64339	10/19/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Individuals Screened/Coginitive testing
Participants selected

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ICR Summary of Burden

	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	156	0	0	30	0	126
Annual Time Burden (Hours)	104	0	0	20	0	84
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The previous collections under this program were used to develop and analyze a model privacy notice for Personal Health Records (PHRs). The model privacy notice for PHRs that resulted was voluntarily adopted by several PHR vendors. Due to the success of this information collection, we are proposing to revise the program to use the same focus group and cognitive usability interview testing process for the development of an improved notice of privacy practices.

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Annual Cost to Federal Government: $140,560

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Yes

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 11/02/2012

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