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:
0920-0214
ICR Reference No:
201407-0920-017
Status:
Historical Active
Previous ICR Reference No:
201312-0920-006
Agency/Subagency:
HHS/CDC
Agency Tracking No:
21178
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:
08/07/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/31/2014
Terms of Clearance:
CDC/NCHS may use the non-substantive change mechanism to modify existing questions, including those designed to add depth/additional detail and cycle in and out supplemental modules that have been used in the past years (with modest updates). A non-substantive change request is required before fielding the proposed incentive experiment. If new supplemental modules, new questionnaire instruments, or modifications to the sample are anticipated, a full revision of the ICR package must be submitted to OMB.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2016
12/31/2016
12/31/2016
Responses
179,000
0
179,000
Time Burden (Hours)
45,500
0
45,500
Cost Burden (Dollars)
0
0
0
Abstract:
The National Center for Health Statistics (NCHS), Division of Health Interview Statistics is conducting the National Health Interview Survey (OMB #0920-0214 exp. 12/31/16) on a sample of addresses from the 2012 American Community Survey (ACS) where a household member was identified as Native Hawaiian or Pacific Islander (NHPI) alone or in combination with one or more other races (the NHPI NHIS). This request is to increase the number of ACS addresses used in the NHPI NHIS sample.
Authorizing Statute(s):
US Code:
42 USC 242
Name of Law: Public Health Service 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
60-day Notice:
Federal Register Citation:
Citation Date:
78 FR 59036
09/25/2013
30-day Notice:
Federal Register Citation:
Citation Date:
78 FR 75920
12/13/2013
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 (sample adult)
Child / Teen Record Check (medical provider)
none
Child/Teen
Child Core (adult family member)
Family Core (adult family member)
NHCIS Multi-mode Study (adult family member)
none
NHCIS
Native Hawaiian / Pacific Islander Survey (adult family member)
none
Native Hawaiian Pacific Islander
Reinterview Survey
none
Reinterview
Screener Questionnaire
none
Screener
Supplements (adult family member)
none
Supplements
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
179,000
179,000
0
0
0
0
Annual Time Burden (Hours)
45,500
45,500
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:
This revision results in a burden decrease due to reduced screening efforts.
Annual Cost to Federal Government:
$42,000,000
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:
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:
07/31/2014
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