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Agenda
Reg Review
ICR
View Information Collection (IC)
View Information Collection (IC)
IC Title:
Strengthening Public Health Incident Management Through Continuous Quality Improvement
Agency IC Tracking Number:
0920-1154-22BM
IC Status:
New
Obligation to Respond:
Voluntary
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
0920-1255
Incident Background Information
Attachment K - Incident Background Information_rev.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1255
Peer Assessor Protocol
Attachment J - SOP for Peer Assessor_rev.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1255
IM Team Survey
Attachment G - IM team survey.docx
Yes
Yes
Fillable Fileable
Form and Instruction
0920-1255
Interview Guide
Attachment H - Interview Guide.docx
Yes
Yes
Fillable Fileable
Federal Enterprise Architecture Business Reference Module
Line of Business:
Disaster Management
Subfunction:
Emergency Response
Privacy Act System of Records
Title:
FR Citation:
Number of Respondents:
1,272
Number of Respondents for Small Entity:
0
Affected Public:
State, Local, and Tribal Governments
Percentage of Respondents Reporting Electronically:
95 %
Approved
Program Change Due to New Statute
Program Change Due to Agency Discretion
Change Due to Adjustment in Agency Estimate
Change Due to Potential Violation of the PRA
Previously Approved
Annual Number of Responses for this IC
1,272
0
1,272
0
0
0
Annual IC Time Burden (Hours)
664
0
664
0
0
0
Annual IC Cost Burden (Dollars)
0
0
0
0
0
0
Documents for IC
Title
Document
Date Uploaded
SSA
SSA-CPR-Incident Management_final.docx
01/06/2022
SSB
SSB-CPR-IMSProject_final.docx
01/06/2022
GenIC Request Template
0920-1154GenICRequestTemplate-CPR-IMS Measures Testing_final.docx
01/06/2022
Construct List
Attachment A - Construct list.docx
01/06/2022
Draft Measures To Test
Attachment B - Measures to test.docx
01/06/2022
Authorizing Legislation
Attachment C - Authorizing legislation.docx
01/06/2022
Site Recruitment Letter
Attachment D - Site recruitment letter.docx
01/06/2022
Individual Recruitment Letter
Attachment E - Individual recruitment letter.docx
01/06/2022
IRB Exemption
Attachment F - IRB exemption.docx
01/06/2022
SOP for Site Level Coordinator
Attachment I - SOP for Site Level Coordinator_rev.docx
01/06/2022
Potential Sites
Attachment L - List of potential pilot sites.docx
01/06/2022
Sampling Frame
Attachment M - Sampling frame_final.docx
01/06/2022
Data Reporting Template
Attachment N - Data Reporting Template_rev.docx
01/06/2022
Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.