View Information Collection Request (ICR) Package
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View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0740
ICR Reference No:
200904-0920-003
Status:
Historical Active
Previous ICR Reference No:
200701-0920-006
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
Medical Monitoring Project
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
05/29/2009
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/02/2009
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2012
36 Months From Approved
06/30/2010
Responses
22,334
0
20,894
Time Burden (Hours)
9,603
0
9,123
Cost Burden (Dollars)
0
0
0
Abstract:
The interview and medical record abstraction instruments have been updated since the last submission to OMB based on feedback from project areas participating in the 2007 data collection cycle. Data collection instruments were changed to ensure that interview questions will be easy for respondents to understand, and that data are collected on the medical record abstraction is consistent across all 26 project areas. Interview questions and medical record abstraction fields previously collected were deleted from the instruments. None of the changes to the data collection instruments altered the burdens estimated for the respondents. The Provider Survey is a new data collection and is incorporated as one of the paradigms in the Medical Monitoring Project.
Authorizing Statute(s):
US Code:
42 USC 301 (241.)a.
Name of Law: Research and investigations generally
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:
73 FR 32334
06/06/2008
30-day Notice:
Federal Register Citation:
Citation Date:
74 FR 10916
03/13/2009
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
7
IC Title
Form No.
Form Name
Facility staff providing patient lists
Facility Staff Medical Record Abstraction
Facility staff Providing Estimated Patient Loads
Patient Short interview
Patients Standard Interview
Patients approached by facility staff for enrollment
Physician/Nurse/Practitioner Provider Survey
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
22,334
20,894
0
1,440
0
0
Annual Time Burden (Hours)
9,603
9,123
0
480
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Data collection forms were edited- some questions were removed and others were added. Some questions were changed to make them easier for respondents to understand. An additional survey was added, the provider survey
Annual Cost to Federal Government:
$13,714,425
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
Yes
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Uncollected
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
Uncollected
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Catina Conner 4046394775
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:
04/02/2009
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