FORHP 0915-0292 OMB NonSubstantive Change Request (BLCP) 6.4.25

5600 Fishers Lane

Rockville, MD 20857

DATE: June 4, 2025

TO: Dan Cline, Office of Management and Budget Desk Officer

FROM: Samantha Miller, Health Resources and Services Administration Information Collection Clearance Officer, Office of Planning, Analysis and Evaluation

______________________________________________________________________________

Request: The Health Resources and Services Administration (HRSA), Federal Office of Rural Health Policy (FORHP) requests approval for changes to the Black Lung Clinics Program Performance Measures (OMB 0915-0292 expiration date 12/31/2027).

Purpose: HRSA is requesting a change to revise response options to align with this Administration’s priorities and comply with Executive Order (E.O. 14168).

This memo explains the changes and supporting rationale.

Changes: This request involves deletion of response/selection options for certain questions within the form.

Changes are outlined in Table A (see below) and in the track changes version of the OMB approved measures (see Attachment).

Time Sensitivity: HRSA requests approval within the standard 10-day period (no later than June 18, 2025) to avoid any delay to data collection under 0915-0292.

Burden: The proposed changes are not expected to have any impact on burden.

PROPOSED CLARIFICATIONS AND NON-SUBSTANTIVE CHANGES:

Table A

Instrument	Type of Change	Question/Item	Change implemented	Rationale
Black Lung Clinics Program Performance Measures	Remove response option	Section I – 7 (Demographics – Sex Assign at Birth)	Change “Sex Assigned at Birth” to “Sex” Take out options for “Intersex”, “Other”, and “Chose not to Disclose”	Align with this Administration’s priorities, comply with E.O. 14168.

Attachments:

1. Black Lung Clinics Program Performance Measures instrument (See deletions in track-changes in the attached document).

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