Rural Health Care Coordination Program Performance Improvement Measurement System;

Rural Health Care Coordination Network Partnership Program Performance Improvement Measurement System

Documents and Forms

Document Name Document Type
Form 1 Rural Health Care Coordination Program Performance Improvement Measurement System; Form and Instruction
1 Rural Health Care Coordination Program Performance Measu FY23 Rural Health Care Coordination Program Performance Measures 06182024.docx Form and Instruction
1 Rural Health Care Coordination Program Performance Measu FY23 Rural Health Care Coordination Program Performance Measures_Final 08162024.docx Form and Instruction

Information Collection (IC) Details

IC Title:	Rural Health Care Coordination Program Performance Improvement Measurement System;	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Required to Obtain or Retain Benefits

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	1	Rural Health Care Coordination Program Performance Measures	FY23 Rural Health Care Coordination Program Performance Measures_Final 08162024.docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 10	Number of Respondents for Small Entity: 10

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	10	0	10
Annual IC Time Burden (Hours)	487	452	35
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.