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<td colspan="6"><p><strong>Office of the Chief Information
Officer</strong></p>
<p><strong>Office of the Assistant Secretary for Budget, Technology and
Finance</strong></p>
<p><strong>Department of Health and Human Services</strong></p></td>
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<td colspan="6"><p>HHS Policy for</p>
<p>E-Gov Forms</p></td>
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<td colspan="7"><strong>June 7, 2006</strong></td>
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<td colspan="2"><strong>Project:</strong></td>
<td colspan="5">HHS OCIO Policy</td>
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<td colspan="2"><strong>Document Number:</strong></td>
<td colspan="5">HHS-OCIO-2006-0003</td>
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**Table of Contents**

[1. Purpose 1](#purpose)

[2. Background 1](#background)

[3. Scope 2](#scope)

[4. Policy 2](#policy)

[5. Roles and Responsibilities 4](#roles-and-responsibilities)

[5.1 The Agency Head (Department) 4](#the-agency-head-department)

[5.2 The OPDIV Director (or designee)
4](#the-opdiv-director-or-designee)

[5.3 The Department (HHS) Forms Management Officer
4](#the-department-hhs-forms-management-officer)

[5.4 The OPDIV Forms Management Officers
5](#the-opdiv-forms-management-officers)

[6. Applicable Policies and Guidance
5](#applicable-policies-and-guidance)

[6.1 Laws 5](#laws)

[6.2 Regulations 6](#regulations)

[6.3 OMB Guidance 6](#omb-guidance)

[7. Information and Assistance 6](#information-and-assistance)

[8. Effective Date/Implementation 6](#effective-dateimplementation)

[9. Approved 6](#approved)

[Glossary 7](#glossary)

# Purpose

This document establishes the Policy for the Department of Health and
Human Services (HHS) E-Gov Forms. The purpose is to ensure that HHS
maintains accurate form content for those HHS forms that are in the
E-Gov Forms Catalogue (FORMS.GOV), managed by the Small Business
Administration (SBA) and the General Services Administration (GSA) under
the Business Gateway (BG) initiative. The Business Gateway (BG)
initiative is part of the President's Management Agenda (PMA). The BG
will provide the Nation's businesses with a single, internet-based
access point to government services and information to help businesses
with their operations. E-Gov Forms are public-facing electronic forms
required to be included in the e-gov catalog.

This policy supplements HHS IRM Circular #20, Standard and Optional
Forms Management, dated February 25, 1993. It specifically applies to
HHS E-Gov forms that reside on the website: FORMS.GOV and provides
references, as appropriate, that govern and influence FORMS.GOV.

Requirement to establish, modify or delete E-Gov Forms and the
objectives, responsibilities, standards, guidelines and instructions for
forms management resides with the HHS Forms Management Officer for
promulgation to the OPDIVs/STAFFDIVs. This Policy specifically addresses
the roles and responsibilities throughout HHS, including procedures, to
mitigate any indiscretions.

# Background

The Department of Health and Human Services (HHS) established procedures
in 2005 to ensure HHS maintains accurate form content in the Forms
Catalog (FORMS.GOV), managed by the Small Business Administration (SBA)
and the General Services Administration (GSA) under the Business Gateway
initiative, as part of the President's Management Agenda. These
procedures apply to all public-facing forms. The HHS endeavor has been
and will continue to be managed by the HHS Forms Management Officer, who
is located within the Program Support Center (PSC) which is a part of
the Office of the Secretary (OS) Staff Division (STAFFDIV), Assistant
Secretary for Administration and Management (ASAM).

HHS is required to comply with the established rules and regulations
addressing the implementation of the E-Gov Forms Catalog for all
public-facing forms. All data elements associated with these forms must
be entered correctly into FORMS.GOV as specified by SBA and GSA.

Failure to create and/or maintain accurate form content data and
adequate web links is not the only concern for HHS. We also must ensure
that our forms content are properly maintained for public use. This
policy serves as the foundation and where applicable, more granular
Agency-specific policy may supplement but not diminish the intent of
this HHS Policy.

Further guidance is contained in GSA and National Archives and Records
Administration (NARA) bulletins, handbooks and other publications, as
well as their websites.

# Scope

This document applies to all Department Operating Divisions, including
the Office of the Secretary, and organizations conducting business for
and on behalf of the Department, whether owned and operated by HHS, or
operated on behalf of HHS.[^1] It applies to all HHS personnel, interns
and visitors who have access to HHS supported facilities or HHS
information. Within this Policy the term Operating Division (OPDIV) is
defined as an entity of Health and Human Services (HHS) that is an
independent agency; the term Office of the Secretary Operating Division
(OS OPDIV) is defined as including the Inspector General, the Offices of
the Regional Directors, STAFFDIVs as well as the immediate Office of the
Secretary as a combined, single entity.

This Policy applies to the management of content of all HHS E-Gov Forms
that are created, used, filed or retrieved (databases, file cabinets,
database management systems, etc.). It clearly establishes Form
Management Officer responsibilities, which include forms creation,
quality and Web link management.

Agencies/OPDIVs will use this Policy or may create a more restrictive
OPDIV policy, but not one that is less restrictive, comprehensive or
compliant with GSA, NARA and SBA requirements and HHS Department Policy
and Guidelines.

Further guidance is contained in GSA and NARA Bulletins, handbooks and
other publications, as well as their website(s):
[http://www.gsa.gov](http://www.gsa.gov/) and
[http://www.archives.gov](http://www.archives.gov/) .

# Policy

4.1 Each OPDIV will establish and maintain an active, continuing program
for E-Gov Forms that are on the FORMS.GOV website managed by SBA and GSA
under the Business Gateway, part of the President's Management Agenda
(PMA). Each OPDIV will:

4.1.1 Identify an OPDIV Forms Management Officer (FMO) and backup and
notify the HHS FMO of the contact information;

4.1.2 Monitor and maintain its E-Gov Form web site to ensure that there
are no oversights, linkage problems, etc.;

> 4.1.3 Identify any linkage problems via email to the HHS Forms
> Management Officer (FMO) and provide the "from" and "to" Web site
> locations;
>
> 4.1.4 Review their OPDIV web site quarterly for quality and
> completeness, and;
>
> 4.1.5 Keep the HHS FMO current on any changes to the OPDIV FMO contact
> information.

4.2 The OPDIVs will comply with applicable sections of Title 44 of the
U.S.C., the regulations published by NARA and GSA, and the supplementary
policies and guidance provided by the Department. Under the Federal
Records Act and NARA regulation 36 CFR 1226, a specific retention period
for completed forms will be required and the OPDIV should contact its
Records Management Officer for authorized retention periods that will
apply.

4.3 The OPDIVs will consider the guidance contained in GSA and NARA
handbooks and bulletins when establishing and implementing their forms
management programs. This will preserve record copies of substantive
forms developed by their respective organizations. Copies of completed
forms should be retained in accordance with NARA's General Records
Schedule 16, Administrative Management Records, Item 3: Forms Files.

4.  For any proposed changes of OPDIV forms (additions, revisions or
    deletions) added to or already residing on the OPDIV respective
    inventories on the website FORMS.GOV, send an e-mail notification to
    the HHS Forms Management Officer. This notification is for tracking
    purposes only. The email should include the name, number, etc. of
    the form and the effective date for the action.

4.5 Each OPDIV will ensure that all employees creating forms to enter
into the FORMS.GOV web site are adequately trained in the requirements
to establish forms, and should be reviewed annually to ensure compliance
to the established Forms Management Policies and Records Management
Policies regarding the sanctions provided for the unauthorized addition,
removal or destruction of Federal forms.

4.6 OPDIVs will issue any necessary internal directives and/or
regulatory supplements establishing policies and procedures for their
forms management programs.

4.7 OPDIVs will institute controls over:

> 4.7.1 The creation of E-Gov Forms, to ensure agency functions is
> adequately and properly documented;

2.  The maintenance and use of E-Gov Forms, to ensure that integrity,
    availability, and confidentiality requirements are met; and

3.  The disposition of E-Gov Forms, to ensure that permanent records are
    preserved and ultimately transferred to the Archives and that
    temporary records no longer of current use are promptly disposed of
    or retired in accordance with their disposition schedules.

4.8 Each OPDIV will report any violations in conformance with 36 CFR
Chapter XII, Subchapter G, "Damage to, Alienation, and Unauthorized
Destruction of Records", to the Department head via the HHS Forms
Management Officer.

# Roles and Responsibilities

## The Agency Head (Department)

The Secretary is responsible for ensuring the requirements of PMA are
satisfied and the Office of the HHS/CIO establishes a continuing E-Gov
Forms management program to align with the President's Management Agenda
(PMA).

## The OPDIV Director (or designee)

The Office of the Chief Information Officer (OCIO) advises the Secretary
and the Assistant Secretary Budget, Technology and Finance on matters
pertaining to the use of information and related technologies to
accomplish Departmental goals and program objectives. This process can
be designated to the OPDIV Director (or designee) for the development
and implementation of OPDIV-wide policy for forms management in
accordance with this Policy and other Department, SBA, NARA and GSA
guidance and requirements.

## The Department (HHS) Forms Management Officer

The Department (HHS) Forms Management Officer (FMO) is responsible for
reviewing OPDIV forms web sites for accuracy and currency of the
information contained and the interoperability of the OPDIV web site to
the E-Gov Forms Catalogue or FORMS.GOV. Specifically the HHS FMO will:

1.  Test OPDIV forms web sites monthly for linkage problems with and to
    FORMS.GOV and promptly notify the OPDIV FMO of any problems. A
    record of this contact shall be created and maintained by the HHS
    FMO for research and to identify any trends of dysfunction;

2.  Conduct a quality review monthly of all OPDIV forms web sites;

3.  Notify the OPDIV FMO immediately of the quality or linkage problem
    and request the OPDIV to take corrective action within 2 business
    days. Follow-up action may be needed if the problem persists;

4.  Maintain a current list of the HHS FMO and OPDIV FMOs and their
    back-ups;

5.  Establish HHS Forms Management Policy for E-Gov forms that are
    contained on the web site: FORMS.GOV.

6.  Coordinate the reporting of any and all violations of forms
    disposition to the Department's Chief Information Officer in
    accordance with the PMA objectives.

## The OPDIV Forms Management Officers

The OPDIVs are responsible for establishing the objectives,
responsibilities, standards, guidelines and instructions for their OPDIV
forms management programs, in accordance with this Policy and other
Department, SBA, NARA and GSA E-Gov and FORMS.GOV guidelines and
requirements. This includes reporting to the Department Forms Management
Officer any and all unauthorized additions, destruction, or
modifications of any kind.

The OPDIV Forms Management Officer is responsible for:

> 5.4.1 Monitoring its E-Gov Form web site to ensure that there are no
> oversights, linkage problems, etc., and that the OPDIV has taken into
> account its needs for the current business as well as the likelihood
> for potential future forms usage for legal, fiscal and administrative
> purposes; and adequate documentation via e-mail (including the "from"
> and the "to" web site locations) to the HHS FMO of any linkage
> problems supporting the proposed disposition and schedule of the
> correction/maintained,
>
> 5.4.2 Reviewing their OPDIV E-Gov forms web site weekly to ensure
> quality and completeness;
>
> 5.4.3 Ensuring that the HHS FMO has the latest list of OPDIV FMO and
> backup contact information;
>
> 5.4.4 Ensuring that the HHS FMO receives an immediate email to request
> that additions, revisions or deletions for their respective OPDIV
> inventory be made. This request includes the name, number, etc. of the
> form and the effective date for the action.

# Applicable Policies and Guidance

## Laws

6.1.1 Federal Property and Administrative Services Act of 1949, as
amended (40 U.S.C. 759 § 111).

6.1.2 Section 207 (f) (2) E-Government Act of 2002 (P.L. 107-347)

6.1.3 Section 508 Rehabilitation Act (29 U.S.C. 794d)

6.1.4 Paperwork Reduction Act of 1980, as amended (44 U.S.C. Chapter
35).

5.  Information Quality Act, Pub. L. No. 106-554, section 515

6.  5 U.S.C. 552a(e)(1)

7.  44 U.S.C. 3508

8.  Small Business Paperwork Relief Act of 2002

## Regulations

> 6.2.1 NARA-\"36\" CFR Parts 1220-1238
>
> 6.2.2 5 CFR Part 1320

## OMB Guidance

6.3.1 OMB Circular No. A-130

# Information and Assistance

Direct questions, comments, suggestions or requests for further
information to the Deputy Assistant Secretary for Information
Technology, who serves as the HHS CIO, (202) 690-6162.

# Effective Date/Implementation

The effective date of this policy is the date the policy is approved.

These policies and procedures will not be implemented in any recognized
bargaining unit until the union has been provided notice of the proposed
changes and given an opportunity to fully exercise its representational
rights.

The HHS policies contained in this issuance shall be exercised in
accordance with Public Law 93-638, the Indian Self-Determination and
Education Assistance Act, as amended, and the Secretary\'s policy
statement dated August 7, 1997, as amended, titled \"Department Policy
on Consultation with American Indian/Alaska Native Tribes and Indian
Organizations.\" It is HHS\' policy to consult with Indian people to the
greatest practicable extent and to the extent permitted by law before
taking actions that affect these governments and people; to assess the
impact of the Department\'s plans, projects, programs and activities on
tribal and other available

resources; and to remove any procedural impediments to working directly
with tribal governments or Indian people.

# Approved

[\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_/s/\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_]{.underline}
[\_\_June 7, 2006]{.underline}\_\_\_\_\_

Charles Havekost

HHS Chief Information Officer DATE

# Glossary {#glossary .Style-Heading-1-+-Left:--0\"-First-line:--0\"}

**Database --** A set of data, consisting of at least one data file,
that is sufficient for a given purpose.

**Disposal --** The action taken regarding temporary forms consisting
usually of destruction.

**E-Gov** **--'**electronic Government' means the use by the Government
of web-based Internet applications and other information technologies,
combined with processes that implement these technologies, to\--

\(A\) enhance the access to and delivery of Government information and
services to the public, other agencies, and other Government entities;
or

\(B\) bring about improvements in Government operations that may include
effectiveness, efficiency, service quality, or transformation.

**Electronic Mail (Email) --** A way to send messages between computer
users, either over a network or the Internet. E-mail is usually just
text, but can be pictures, diagrams, sounds or programs embedded in the
text or as attachments.

**Electronic Records --** Any information that is recorded in a form
that only a computer can process and that satisfies the definition of a
Federal record in 44 U.S.C. 3301.[^2] Electronic records include
numeric, graphic and text information, which may be recorded on any
medium capable of being read by a computer and which satisfies the
definition of a record.

This includes, but is not limited to, magnetic media, such as tapes and
disks, and optical disks. Unless otherwise noted, these requirements
apply to all electronic records systems, whether on microcomputers,
minicomputers, or mainframe computers, regardless of storage media, in
network or stand-alone configurations. (FIRMR Bulletin B-1).

**Electronic Records System --** Any system that produces, manipulates,
or stores Federal records by using a computer.

**Information System --** Is defined by the Office of Management and
Budget (OMB) in Circular No. A-130 "....the organized collection,
processing, transmission and dissemination of information in accordance
with defined procedures, whether automated or manual."

**Office of the Secretary (OS) --** includes the Offices of the Regional
Directors.

**OS OPDIV --** Includes the immediate Office of the Secretary, the
Regional Directors, the Inspector General and several STAFFDIVS.

**Operating Division (OPDIV) --** An entity of Health and Human Services
(HHS) that is an independent agency.

**OS Staff Division (OS) --** Includes the Inspector General, as well as
the immediate Office of the Secretary as a combined, single entity.

**Records --** includes all books, papers, maps, photographs, machine
readable materials, or other documentary materials, regardless of
physical form or characteristics, made or received by an agency of the
United States Government under Federal law or in connection with the
transaction of public business, and preserved or appropriate for
preservation by that agency or its legitimate successor as evidence of
the organization, functions, policies, decisions, procedures, operations
or other activities of the Government, or because of the information
value of the data in them. (44 U.S.C. 3301)

**Records Disposition** -- is any activity with respect to:

-   disposal of temporary records no longer needed for the conduct of
    business by destruction or donation to an eligible person or
    organization outside of Federal custody;

-   transfer of records to Federal agency storage facilities or records
    centers;

-   transfer to the national Archives of the United States of records
    determined to have sufficient historical or other value to warrant
    continued preservation; or

-   transfer of records from one Federal agency to any other Federal
    agency. (44 U.S.C. 2901 \[5\]).

**Records Management --** the planning, controlling, directing,
organizing, training, promoting, and other managerial activities
involved with respect to records creation, records maintenance and use,
and records disposition in order to achieve adequate and proper
documentation of the policies and transactions of the Federal Government
and effective and economical management of agency operations. (44 U.S.C.
2901 \[2\].

**Records Schedule** -- means:

-   an SF 115, "Request for Records Disposition Authority," that has
    been approved by NARA to authorize the disposition of Federal
    records;

-   a General Records Schedule (GRS) issued by NARA; or

-   a printed agency manual or directive containing the records
    descriptions and disposition instructions approved by NARA on one or
    more SF 115 or issued by NARA in the GRS. (36 CFR 1220.14).

**Records series --** file units or documents arranged according to a
filing system or kept together because they relate to a particular
subject or function, result from the same activity, document a specific
kind of transaction, take a particular physical form, or have some other
relationship arising out of their creation, receipt, or use, such as
restrictions on access and use. (NARA, "A Federal Records Management
Glossary").

**Web Sites** --

E-Gov Strategy <http://www.whitehouse.gov/omb/egov/2003egov_strat.pdf>

E-Gov Initiatives [http://www.egov.gov](http://www.egov.gov/)

OMB Communications [http://www.omb.gov](http://www.omb.gov/)

Interagency Committee

on Government Information
[http://www.webcontent.gov](http://www.webcontent.gov/)

Management of Federal

Information Resources
<http://www.whitehouse.gov/omb/circulars/a130/a130trans4.pdg>

Privacy Protection
<http://www.whitehouse.gov/omb/memorandum/m03-22.html>

Maintain Accessibility <http://www.access-board.gov/index.htm>

Records Management
<http://www.archives.gov/records_management/index.html>

NARA: PKI Digital

Signature Authenticated

& Secured Transaction

Records <http://www.archives.gov/records-mgmt/policy/pki.html>

[^1]: Since aspects of this E-Gov forms policy may pertain to HHS
    contractors, the Office of Acquisition Management & Policy
    (ASAM/OAMP) plans to work with the Office of the CIO (ASBTF/OCIO) to
    develop appropriate acquisition guidance under HHS\' Acquisition
    Regulation.

[^2]: This includes E-mail, sent or received, by all devices.