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View ICR - OIRA Conclusion

OMB Control No: 0920-1014	ICR Reference No: 201901-0920-009
Status: Historical Active	Previous ICR Reference No: 201709-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 14BE
Title: CDC Worksite Health Scorecard
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/29/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/21/2019
Terms of Clearance: OMB is approving this information collection request for a period of three years during which time CDC will request approval to extend or revise the collection if CDC seeks to continue the information collection activity beyond the period approved under this action.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2022	36 Months From Approved	03/31/2019
Responses	1,600	0	632
Time Burden (Hours)	667	0	306
Cost Burden (Dollars)	35,311	0	11,873

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion	Change Due to Adjustment in Estimate
Annual Number of Responses	1,600	632	1,600	-632
Annual Time Burden (Hours)	667	306	667	-306
Annual Cost Burden (Dollars)	35,311	11,873	35,311	-11,873

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: There has been a slight increase in the total number of burden hours from 303 to 667 estimated annualized burden hours due predominately to an increase in the number of employer respondents from 200 for the pilot test to 800 for broader implementation. We also found during the pilot test that respondents took slightly more time to complete the registration (Attachment C-1) from an estimated 2 minutes to 5 minutes but a significantly shorter time to complete the Scorecard assessment (Attachment C-2) from an hour and 15 minutes to 45 minutes. The cognitive interview and pilot evaluation instruments used in the pilot have been dropped and are no longer needed for broader implementation reducing burden for these instruments.

Annual Cost to Federal Government: $93,250

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]? 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: Kevin Joyce 404 639-1944 kdj7@cdc.gov