Black Lung Clinics Program Measures

ICR 201906-0915-002

OMB: 0915-0292

Federal Form Document

Forms and Documents
Document
Name
Status
Form
Modified
Supporting Statement A
2019-08-05
IC Document Collections
IC ID
Document
Title
Status
6545 Modified
ICR Details
0915-0292 201906-0915-002
Active 201607-0915-001
HHS/HSA 20203
Black Lung Clinics Program Measures
Extension without change of a currently approved collection   No
Regular
Approved with change 08/06/2019
Retrieve Notice of Action (NOA) 06/07/2019
OMB is approving this information collection request for a period of three years during which time the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action.
  Inventory as of this Action Requested Previously Approved
08/31/2022 36 Months From Approved 12/31/2019
15 0 15
150 0 150
0 0 0

The Federal Office of Rural Health Policy (FORHP), Health Resources and Services Administration (HRSA), conducts an annual data collection of user information for the Black Lung Program, which has been ongoing with OMB approval since 2004. The purpose of the Black Lung Clinics Program is to improve the health status of coal workers by providing services to minimize the effects of respiratory and pulmonary impairments of coal miners, including treatment required in the management of problems associated with black lung disease, which improves the miner’s quality of life and reduces economic costs associated with morbidity and mortality arising from pulmonary diseases. Collecting this data will provide HRSA information on how well each grantee is meeting the needs of active and retired miners in their communities.

US Code: 30 USC 937 Name of Law: Federal Mine Safety and Health Act of 1977, as amended
  
None

Not associated with rulemaking

  84 FR 8336 03/07/2019
84 FR 26689 06/07/2019
No

1
IC Title Form No. Form Name
Black Lung Clinics Program Database 1 Performance Measures

  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 15 15 0 0 0 0
Annual Time Burden (Hours) 150 150 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$1,980
No
    No
    No
No
No
No
Uncollected
Elyana Bowman 301 443-3983 enadjem@hrsa.gov

  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.
06/07/2019


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