View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
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:
0920-0214
ICR Reference No:
201209-0920-004
Status:
Historical Active
Previous ICR Reference No:
201109-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
National Health Interview Survey
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
10/11/2012
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/10/2012
Terms of Clearance:
NHIS can continue to submit re-introduction of modules used in the past (and thus have gone through the public comment process in the past) as non-substantive changes. However, please remember that any new modules must be submitted as substantive changes.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2014
08/31/2014
08/31/2014
Responses
212,940
0
212,940
Time Burden (Hours)
55,343
0
55,343
Cost Burden (Dollars)
0
0
0
Abstract:
The annual NCHS National Health Interview Survey (NHIS) is a major source of general statistics on the health of the U.S. population and has been in the field every year since 1957. This household-based survey collects demographic and health-related information on a nationally representative sample of households throughout the country. This change request is to cycle topics in and out of the survey for the 2013 collection.
Authorizing Statute(s):
PL:
Pub.L. 101 - 445 301
Name of Law: The National Nutrition Monitoring and Related Research Act of 1990
PL:
Pub.L. 104 - 170 136
Name of Law: The Food Quality Protection Act of 1996
US Code:
42 USC 242
Name of Law: Public Health Service Act
US Code:
42 USC 306
Name of Law: Public Health Service Act
PL:
Pub.L. 111 - 148 1
Name of Law: The Patient Protection and Affordable Care Act
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
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
9
IC Title
Form No.
Form Name
Adult Core--line 3
3b
Adult Core
Child Core--line 4
3c
2011 NHIS Questionnaire--Sample Child
Child Record Check--Line 5
3d
Child Record Check--Immunization History Questionnaire
Family Core - line 2
3a
Family Core
National Health Interview Survey--Line 7
3g
Child Immunization Provider--NHIS Instrument Spec Report
Reinterview Survey--Line 9
3h
2011 NHIS Reinterview Instrument Screens
Screener Questionnaire--Line 1
1
OMB Statement and Screener Section of the
Supplements--Line 8
3f
Family Health Insurance--Health Care Reform
Teen Record Check--Line 6
3e
National Health Interview Provider Survey--Teen
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
212,940
212,940
0
0
0
0
Annual Time Burden (Hours)
55,343
55,343
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$31,000,000
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]?
Yes
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:
Shari Steinberg 404 639-4942 sxw2@cdc.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:
09/10/2012
An official website of the United States government
The .gov means it's official.
The site is secure.
