Black Lung Clinic Program Guidelines -- 42 CFR 55a

ICR 199703-0915-003

OMB: 0915-0081

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
6350
Migrated
ICR Details
0915-0081 199703-0915-003
Historical Active 199402-0915-001
HHS/HSA
Black Lung Clinic Program Guidelines -- 42 CFR 55a
Extension without change of a currently approved collection   No
Regular
Approved without change 05/27/1997
Retrieve Notice of Action (NOA) 03/17/1997
OMB commends HRSA for submitting the Black Lung Clinic Guidelines for review under the PRA. This information collection is approved for three years subject to the following terms of clearance: 1. DHHS shall review the status of similar guidance documents associated with the PHS 5161 (OMB No. 0937-0189) and shall ensure that they are properly accounted for under the PRA upon sub- mission of the 5161, which is due to expire 07/98. 2. The agency shall indicate in the burden disclosure statement associated with this information collection the actual number of hourse required to complete the application in accordance with the guidance and shall submit a correction worksheet, if necessary, for the 5161.
  Inventory as of this Action Requested Previously Approved
07/31/2000 07/31/2000 05/31/1997
14 0 14
1 0 42,000
0 0 0

The program and application guidance further elaborates the program requirements contained in the regulations for the Black Lung Clinic Program. It establishes the level of services to be provided to Black Lung patients and gives the standard operating procedures for all grantee organizations.

None
None


No

1
IC Title Form No. Form Name
Black Lung Clinic Program Guidelines -- 42 CFR 55a

  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 14 14 0 0 0 0
Annual Time Burden (Hours) 1 42,000 0 0 -41,999 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$0
No
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.
03/17/1997


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