View Information Collection Request (ICR) Package
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View Information Collection (IC) List
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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 Generic ICR - OIRA Conclusion
OMB Control No:
0920-1036
ICR Reference No:
201709-0920-006
Status:
Historical Active
Previous ICR Reference No:
201609-0920-010
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-17NCJ
Title:
California Drought - Mariposa County, 2016 (Quarter 4)
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:
10/20/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/21/2017
Terms of Clearance:
Previous terms continue: The agency is reminded that If a 24- or 72-hour OMB approval is requested, an explanation must be provided as to why it is needed. Specifically, CDC must make a case as to why collection must begin within 24 to 72 hours, and it must be related to a public health need.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
12/31/2017
12/31/2017
12/31/2017
Responses
9,007
0
9,600
Time Burden (Hours)
4,439
0
4,731
Cost Burden (Dollars)
0
0
0
Abstract:
Community Assessment for Public Health Emergency Response (CASPER) is an effective public health tool designed to quickly provide low-cost, household-based information about a community's needs and health status in a simple, easy-to-understand format for decision-makers. CASPER uses well established, valid epidemiological methods to determine the health status and basic needs of the affected community, allowing officials to prioritize responses and make informed decisions regarding the distribution of resources. This change request contains the quarterly inventory of burden and instruments.
Authorizing Statute(s):
US Code:
42 USC 241
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:
79 FR 18553
04/02/2014
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 32959
06/09/2014
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Community Assessment for Public Health Emergency Response (CASPER) addressing the California Drought – Mariposa County, 2016
NA, NA
Questionnaire - Drought Community Assessment for Public Health Emergency Response -- 2016
,
Referral - Community Assessment for Public Health Emergency Response To Drought
Flood-Related Community Assessment for Public Health Emergency Response (CASPER) – WV, 2016
NA, NA
WV Flood 2016 CASPER Questionnaire
,
WV Flood 2016 CASPER Referral Form
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
9,007
9,600
0
-593
0
0
Annual Time Burden (Hours)
4,439
4,731
0
-292
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
This is a change request to report the actual burden hours used for CASPER - "California Drought -- Mariposa County, 2016 (Quarter 4)
Annual Cost to Federal Government:
$98,328
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
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:
Thelma Sims 4046394771
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:
09/21/2017
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