View Information Collection Request (ICR) Package
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Burden
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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:
0915-0343
ICR Reference No:
201107-0915-001
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/HSA
Agency Tracking No:
Title:
Poison Help General Population Survey
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
10/31/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/25/2011
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2014
36 Months From Approved
Responses
2,353
0
0
Time Burden (Hours)
370
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
The Poison Help campaign is the vehicle for introducing the national toll-free number for use in poisoning emergencies and providing poison prevention information to all age groups and audience segments. The overarching goals for the campaign are to raise awareness of the national toll-free number to levels on a par with 911 and 411 and to increase awareness of the availability of poison center services. Campaign messages and activities promote awareness of the national toll-free number, the role poison centers play and the services they provide in disseminating poison information and treatment advice in poisoning emergencies. The goal of HRSA's Poison Help General Population Telephone Survey is to evaluate the campaign's current performance. Assessment information will include awareness and use of the national toll-free number to access poison exposure or information services and awareness and knowledge of poison centers and the services they provide. The survey will allow for some comparisons with previous data, as well as comparisons with follow-up evaluation activities to be conducted in future years, and provide direction for future campaign initiatives.
Authorizing Statute(s):
None
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:
76 FR 23602
04/27/2011
30-day Notice:
Federal Register Citation:
Citation Date:
76 FR 37821
06/28/2011
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Poison Help General Population Survey
1, 2
Poison Help Survey Screener
,
Poison Help Survey Final
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
2,353
0
0
2,353
0
0
Annual Time Burden (Hours)
370
0
0
370
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:
This is a new collection. Therefore, there is a total annual increase of 370 burden hours due to agency discretion.
Annual Cost to Federal Government:
$109,200
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?
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?
Uncollected
Agency Contact:
Carla Haddad 301 443-0165 Carla.Haddad@hrsa.hhs.gov
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:
07/25/2011
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