Sharing What Works - Best Practice, Promising Practice, and Local Effort (BPPPLE)

Forms and Documents

Document Name	Status
Form 0917-0034 0917-0034, Sharing What Works - Best Practice, Promising Practice, and Local Efforts (BPPPLE) Form and Instruction	Modified
2015-31534 Correction Notice 12-15-2015.pdf Supplementary Document	2015-12-21
FR Publication 11-17-15 (002).pdf Supplementary Document	2015-12-21
2015-25733.pdf Supplementary Document	2015-12-21
0917-0034 Supporting Statement FINAL 12-17-2015 TClay.doc Supplementary Document	2015-12-21
0917-0034 Supporting Statement FINAL 08-22-2016.doc Supporting Statement A	2016-08-22

IC Document Collections

IC ID	Document Title	Status
189459	0917-0034, Sharing What Works - Best Practice, Promising Practice, and Local Efforts (BPPPLE) Form and Instruction	Modified

ICR Details

OMB Control No: 0917-0034	ICR Reference No: 201512-0917-001
Status: Historical Active	Previous ICR Reference No: 201211-0917-001
Agency/Subagency: HHS/IHS	Agency Tracking No:
Title: Sharing What Works - Best Practice, Promising Practice, and Local Effort (BPPPLE)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/22/2016
	Date Received in OIRA: 12/22/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved	08/31/2016
Responses	100	0	100
Time Burden (Hours)	33	0	33
Cost Burden (Dollars)	0	0	0

---

Abstract: The Indian Health Service (IHS) goal is to raise the health status of the American Indian and Alaska Native (AI/AN) people to the highest possible level by providing comprehensive health care and preventive health services. To support the IHS mission and to provide the product/service to IHS, Tribal, and Urban (I/T/U) programs, the Office of Clinical and Preventive Services (OCPS) program divisions (i.e., Behavioral Health (BH), Health Promotion/Disease Prevention (HP/DP), Nursing, and Dental) have developed a centralized program database consisting of Best and Promising Practices and Local Efforts (BPPPLE), resources, and policies. The purpose of this collection is to further the development of a database of BPPPLE, resources, and policies which are available to the public on the IHS.gov website. This database will be a resource for program evaluation and for modeling examples of various health care projects occurring in AI/AN communities.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 61215	10/09/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 71813	11/17/2015
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
0917-0034, Sharing What Works - Best Practice, Promising Practice, and Local Efforts (BPPPLE)	0917-0034	IHS BPPPLE Form

---

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	100	100	0	0	0	0
Annual Time Burden (Hours)	33	33	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $17,640

Does this IC contain surveys, censuses, or employ statistical methods? No

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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  Yes

Description/Changes for Common Form Usage:  This is a request for approval of an extension without program or burden changes for a previously approved collection (OMB Form No. 0917-0034). However, there were a number of changes to the form to make it easier for the user to complete the submission.

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

---

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: 12/22/2015

---