Billing Code: 4165-15-P
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Rural Health Care Coordination Program
Performance Improvement Measures
AGENCY: Health Resources and Services Administration (HRSA), Department of Health and
Human Services.
ACTION: Notice.
SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA submitted an
Information Collection Request (ICR) to the Office of Management and Budget (OMB) for
review and approval. Comments submitted during the first public review of this ICR will be
provided to OMB. OMB will accept further comments from the public during the review and
approval period. OMB may act on HRSA’s ICR only after the 30-day comment period for this
notice has closed.
DATES: Comments on this ICR should be received no later than [INSERT DATE 30 DAYS
AFTER DATE OF PUBLICATION IN THE FEDERAL REGISTER].
ADDRESSES: Written comments and recommendations for the proposed information
collection should be sent within 30 days of publication of this notice to
www.reginfo.gov/public/do/PRAMain. Find this particular information collection by selecting
"Currently under Review - Open for Public Comments" or by using the search function.
FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance requests
submitted to OMB for review, email Joella Roland, the HRSA Information Collection Clearance
Officer, at paperwork@hrsa.gov or call (301) 443-3983.
SUPPLEMENTARY INFORMATION:
Information Collection Request Title: Rural Health Care Coordination Program
Performance Improvement Measures, OMB No. 0906-0024  Revision

Abstract: The Rural Health Care Coordination (Care Coordination) Program is
authorized under 42 U.S.C. 254c(e) (section 330A(e) of the Public Health Service Act) to
promote rural health care services outreach by improving and expanding the delivery of health
care services through comprehensive care coordination strategies addressing a primary focus
area: (1) heart disease; (2) cancer; (3) chronic lower respiratory disease; (4) stroke; or (5)
maternal health. This authority permits the Federal Office of Rural Health Policy within HRSA
to award grants to eligible entities to promote rural health care services outreach by improving
and expanding the delivery of health care services to include new and enhanced services in rural
areas, through community engagement and evidence-based or innovative, evidence-informed
models. HRSA currently collects information about Care Coordination Program grants using an
OMB-approved set of performance measures and seeks to revise that approved collection. The
proposed changes to this information collection are a result of award recipient feedback and
information gathered from the previously approved Care Coordination Program measures.
A 60-day notice was published in the Federal Register on January 17, 2024, 89 FR 29602961. There were no public comments.
Need and Proposed Use of the Information: This program needs measures that will
enable HRSA to provide aggregate program data required by Congress under the Government
Performance and Results Act of 1993. These measures cover the principal topic areas of interest
to HRSA, including: (1) access to care; (2) population demographics and social determinants of
health; (3) care coordination and network infrastructure; (4) sustainability; (5) leadership and
workforce; (6) electronic health record; (7) telehealth; (8) utilization; and (9) clinical
measures/improved outcomes. All measures will evaluate HRSA’s progress toward achieving its
goals.
The proposed changes include additional components under “Access to Care” and
“Population Demographic” sections that seek information about the target population, counties
served, direct services, and social determinants of health such as transportation barriers, housing,

and food insecurity. Questions about Health Information Technology and Telehealth have been
modified to reflect an updated telehealth definition and to improve understanding of how these
important technologies are affecting HRSA award recipients. Sections previously titled “Care
Coordination” and “Quality Improvement” sections were consolidated into one section titled
“Care Coordination and Network Infrastructure” to improve clarity and ease of reporting for
respondents. Part of the previous “Care Coordination” section was revised to include a section
titled “Utilization” to improve clarity of instructions for related measures. Previously titled
“Staffing” section was revised to “Leadership and Workforce Composition” to improve measure
clarity and reduce overall burden for respondents by consolidating measures from previously
separate “Staffing”, “Quality Improvement” and “Care Coordination” sections. Revised
National Quality Forum and Centers for Medicare & Medicaid Services measures were also
included to allow uniform collection efforts throughout the Federal Office of Rural Health
Policy.
The total number of measures has increased from 40 total measures to 48 total measures
since the previous information collection request. Of the 48 measures, 11 measures are
designated as “optional” or “complete as applicable”. The measures within Section 6: Electronic
Health Record are noted as optional to grantees. In Section 9: “Clinical Measures/Improved
Health Outcomes”, grantees are only required to respond to Clinical Measure 1: Care
Coordination. Grantees can choose to provide data for Clinical Measures 2-10 if applicable to
their projects. The total number of responses has remained at 10 since the previous information
collection request. While the new Care Coordination Program grant cycle maintained the same
number of award recipients and number of respondents, in consideration of the new cohort of
awardees, HRSA has increased the estimated average burden per response. The increase in
burden is largely due to the amount of time it takes to build systems to capture and report data at
the start of a new project. Recent feedback from grantees indicated that larger networks with
multiple members and programs across different organizations also experienced higher burdens

due to the wait time in between responses. The increase in burden hours remains consistent with
the proposed changes that better reflect the program scope and intent of the notice of funding
opportunity announcement, HRSA-23-125, under which the new cohort of grants was awarded.
Likely Respondents: The respondents would be recipients of the Rural Health Care
Coordination Program grants.
Burden Statement: Burden in this context means the time expended by persons to generate,
maintain, retain, disclose, or provide the information requested. This includes the time needed to
review instructions; to develop, acquire, install, and utilize technology and systems for the
purpose of collecting, validating, and verifying information, processing and maintaining
information, and disclosing and providing information; to train personnel and to be able to
respond to a collection of information; to search data sources; to complete and review the
collection of information; and to transmit or otherwise disclose the information. The total annual
burden hours estimated for this ICR are summarized in the table below.
Total Estimated Annualized Burden Hours:

Form Name
Rural Health
Care
Coordination
Program
Performance
Improvement
Measures
Total

Number of
Respondents
10

Number of
Responses per
Respondent
Average
Burden per
Total
Response
Responses
(in hours)
10
48.67

Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2024-13624 Filed: 6/20/2024 8:45 am; Publication Date: 6/21/2024]

Total
Burden
Hours
486.70

486.70