[PHIC] Preventive Health and Health Services Block Grant

Forms and Documents

Document Name	Status
Annual Progress Report (subset of Final Progress questions) Form and Instruction	Unchanged
Annual Progress Report (subset of Final Progress questions) Form and Instruction	Unchanged
Annual Progress Report (subset of Interim Progress questions) Form and Instruction	Unchanged
Annual Progress Report (subset of Interim Progress questions) Form and Instruction	Unchanged
Work Plan Program Questions Form and Instruction	Unchanged
Work Plan Program Questions Form and Instruction	Unchanged
Workplan Start and Advisory Committee Questions Form and Instruction	Unchanged
Workplan Start and Advisory Committee Questions Form and Instruction	Unchanged
BGIS PHIVE CR 06092025.docx Justification for No Material/Nonsubstantive Change	2025-06-10
BGIS PHIVE CR 06092025.docx Justification for No Material/Nonsubstantive Change	2025-06-10
Att M_PHIVE Scr.docx Supplementary Document	2025-06-10
Att M_PHIVE Scr.docx Supplementary Document	2025-06-10
Att R_ELC CAMP PIA.pdf Supplementary Document	2025-06-10
Att R_ELC CAMP PIA.pdf Supplementary Document	2025-06-10
Att P_ELC CAMP Auth.pdf Supplementary Document	2025-06-10
Att P_ELC CAMP Auth.pdf Supplementary Document	2025-06-10
0920-0106 Change Request_EO 14168.docx Justification for No Material/Nonsubstantive Change	2025-03-31
0920-0106 Change Request_EO 14168.docx Justification for No Material/Nonsubstantive Change	2025-03-31
OCIO_Azure_GSS_AO_Decision_Letter_(High)_09152023.pdf Supplementary Document	2024-01-29
OCIO_Azure_GSS_AO_Decision_Letter_(High)_09152023.pdf Supplementary Document	2024-01-29
Copy_of_Privacy_Impact_Assessment_PIA_bl.pdf Supplementary Document	2024-01-29
Copy_of_Privacy_Impact_Assessment_PIA_bl.pdf Supplementary Document	2024-01-29
Att N_BGIS_2023 OMB pkg Crosswalk of changes_011024.xlsx Supplementary Document	2024-01-29
Att N_BGIS_2023 OMB pkg Crosswalk of changes_011024.xlsx Supplementary Document	2024-01-29
Att M_Announcements on BGIS Landing Page_Screenshot.docx Supplementary Document	2024-01-29
Att M_Announcements on BGIS Landing Page_Screenshot.docx Supplementary Document	2024-01-29
Att L_STARS Project Determination.docx Supplementary Document	2024-01-29
Att L_STARS Project Determination.docx Supplementary Document	2024-01-29
Att K_Privacy Act Checklist_BGIS 2023.docx Supplementary Document	2024-01-29
Att K_Privacy Act Checklist_BGIS 2023.docx Supplementary Document	2024-01-29
Att I_0920-0106_60dayFRN_05012023.pdf Supplementary Document	2024-01-29
Att I_0920-0106_60dayFRN_05012023.pdf Supplementary Document	2024-01-29
Statement B-Block Grant ICR_2023.docx Supporting Statement B	2024-01-29
Statement B-Block Grant ICR_2023.docx Supporting Statement B	2024-01-29
Statement A-Block Grant ICR_2023_final.docx Supporting Statement A	2024-01-12
Statement A-Block Grant ICR_2023_final.docx Supporting Statement A	2024-01-12
Att B_Block Grant Authorizing Legislation 1981 and 1992.docx Supplementary Document	2024-01-29
Att B_Block Grant Authorizing Legislation 1981 and 1992.docx Supplementary Document	2024-01-29
Att A_List of PHHS Block Grant Recipients.docx Supplementary Document	2024-01-29
Att A_List of PHHS Block Grant Recipients.docx Supplementary Document	2024-01-29

IC Document Collections

IC ID	Document Title	Status
264761	Annual Progress Report (subset of Final Progress questions) Form and Instruction	Unchanged
264761	Annual Progress Report (subset of Final Progress questions) Form and Instruction	Unchanged
264760	Annual Progress Report (subset of Interim Progress questions) Form and Instruction	Unchanged
264760	Annual Progress Report (subset of Interim Progress questions) Form and Instruction	Unchanged
264759	Work Plan Program Questions Form and Instruction	Unchanged
264759	Work Plan Program Questions Form and Instruction	Unchanged
264758	Workplan Start and Advisory Committee Questions Form and Instruction	Unchanged
264758	Workplan Start and Advisory Committee Questions Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-0106	ICR Reference No: 202506-0920-003
Status: Active	Previous ICR Reference No: 202503-0920-038
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0106-25-0131
Title: [PHIC] Preventive Health and Health Services Block Grant
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/27/2025
	Date Received in OIRA: 06/26/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2027	03/31/2027	03/31/2027
Responses	244	0	244
Time Burden (Hours)	1,403	0	1,403
Cost Burden (Dollars)	0	0	0

---

Abstract: The purpose of this colledtion is to ensure that the CDC PHHS Block Grant program managers and PHHS Block Grant recipients account for funds in accordance with legislative mandates by providing information on work through work plans and annual reports. CDC will use the Block Grant Information System to monitor awardees' progress, identify activities and personnel supported with Block Grant funding, and conduct compliance reviews of Block Grant awardees. This Non-Substantive Change Request is submitted to phase out BGIS and phase in a new web-based platform, PHIVE. The transition to PHIVE is designed to continue efficient data entry by recipients, ensure data quality, standardize the platforms implemented to support PHIC programs and streamline technical assistance / IT support. The information to be collected through PHIVE is the same information currently being collected through BGIS. This Change Request does not affect the content of any forms, the number of respondents, or total estimated annualized burden hours.

---

Authorizing Statute(s): PL: Pub.L. 102 - 531 101-104 Name of Law: Preventive Health and health Services Block Grant
   US Code: 42 USC 300w-300w-8 Name of Law: Preventive Health and Health Services Block Grants
   US Code: 45 USC 96.1-96.17 Name of Law: Block Grants
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 26549	05/01/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 5236	01/26/2024
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Annual Progress Report (subset of Final Progress questions)	n/a	Annual Progress Report Worksheet
Annual Progress Report (subset of Interim Progress questions)	n/a	Annual Progress Report Worksheet
Work Plan Program Questions	0920-0106, n/a	Workplan Program Quesions ,   WorkPlan Program Questions_REVISED 31MAR2025
Workplan Start and Advisory Committee Questions	n/a	Workplan Start and Advisory Committee Quesions

---

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	244	244	0	0	0	0
Annual Time Burden (Hours)	1,403	1,403	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Recipient Information Collection has been deleted from the burden table (-122 annualized burden hours). The BGIS will retain this information, however, the one-time burden of entering the Recipient Information was accounted for in the previous approval period.

---

Annual Cost to Federal Government: $288,219

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

---

Common Form ICR:  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:

(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: 06/26/2025

---