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:
0920-1233
ICR Reference No:
201804-0920-010
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-17BAW
Title:
Paul Coverdell National Acute Stroke Program (2015-2020) Assessment
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 without change
Conclusion Date:
05/22/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/25/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
05/31/2021
36 Months From Approved
Responses
155
0
0
Time Burden (Hours)
292
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
The purpose of this data collection is to collect information from all nine funded Paul Coverdell National Acute Stroke Program (PCNASP) grantees and a sample of their partners to (1) assess the actual partner costs of establishing statewide comprehensive stroke systems of care; and (2) increase CDC’s understanding of funded programs’ implementation of effective state-based stroke systems of care and PCNASP specific contributions. The timing of the data collection request aligns with the term of the funding announcement. Information obtained from this data collection will be critical to improving immediate efforts and achieving the goals of spreading and replicating state-level strategies that are proven programmatically and are cost-effective in contributing to a higher quality of care for stroke patients.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: U.S. PHSA
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:
82 FR 46993
10/10/2017
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 17414
04/19/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Data Analyst/Program Evaluator - Telephone Interview Protocol
NA
Data Analyst/Program Evaluator - Telephone Interview Protocol
Grantee Program Manager - Telephone Interview Protocol
NA
Grantee Program Manager - Telephone Interview Protocol
Partner Program Manager - Cost Resource and Utilization Tool
NA
Cost Resource and Utilization Tool
Partner Support Staff - Telephone Interview Protocol
NA
Partner Support Staff - Telephone Interview Protocol
Principal Investigator - Telephone Interview Protocol
NA
Principal Investigator - Telephone Interview Protocol
Quality Improvement Specialist - Telephone Interview Protocol
NA
Quality Improvement Specialist - Telephone Interview Protocol
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
155
0
0
155
0
0
Annual Time Burden (Hours)
292
0
0
292
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:
Submission of 0920-17BAW is a request for a New Information Collection.
Annual Cost to Federal Government:
$97,905
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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:
Jeffrey Zirger 404 639-7118 wtj5@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:
04/25/2018
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