Million Hearts Hypertension Control Challenge

Forms and Documents

Document Name	Status
Data Verification Form Form	New
Nomination Form Form	New
MH SS_B_4 04 2013.docx Supporting Statement B	2013-05-07
Attachment 1c. OMB Guidance.pdf Supplementary Document	2013-05-07
Attachment 2b. Summary of Public Comments.docx Supplementary Document	2013-05-07
Attachment 2a. 60 day FRN.pdf Supplementary Document	2013-05-07
Attachment 1b. Authorizing Legislation.docx Supplementary Document	2013-05-07
Attachment 1a. Authorizing Legislation.docx Supplementary Document	2013-05-07
Attachment 3b. Confirmation email_4 4 2013.docx Supplementary Document	2013-05-08
MH SS_A_7 23 2013.docx Supporting Statement A	2013-07-23

IC Document Collections

IC ID	Document Title	Status
206922	Interview Guide Other-Interview Guide	New
206921	Data Verification Form Form	New
206920	Nomination Form Form	New

ICR Details

OMB Control No: 0920-0976	ICR Reference No: 201305-0920-008
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 19517
Title: Million Hearts Hypertension Control Challenge
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 07/31/2013
	Date Received in OIRA: 05/15/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2016	36 Months From Approved
Responses	1,795	0	0
Time Burden (Hours)	958	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Centers for Disease Control and Prevention (CDC) is offering a Challenge to identify and recognize clinical care providers, including healthcare systems, that have resulted in exemplary levels of blood pressure control in their patient populations.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 358 24 Name of Law: America COMPETES Reauthorization Act of 2010
  

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 75168	12/19/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 27390	05/10/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
Nomination Form	none, none	Nomination Form ,   Website Screenshots
Data Verification Form	none	Data Verification
Interview Guide

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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	1,795	0	0	1,795	0	0
Annual Time Burden (Hours)	958	0	0	958	0	0
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: This is a new data collection request.

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Annual Cost to Federal Government: $90,000

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)? No

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: 05/15/2013

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