View Information Collection Request (ICR) Package
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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 ICR - OIRA Conclusion
OMB Control No:
2700-0171
ICR Reference No:
201905-2700-001
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
NASA
Agency Tracking No:
Title:
NASA TREAT Astronauts Act
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:
06/13/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/13/2019
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2022
36 Months From Approved
Responses
175
0
0
Time Burden (Hours)
88
0
0
Cost Burden (Dollars)
4,375
0
0
Abstract:
The National Aeronautics and Space Administration’s (NASA) Office of Chief Health and Medical Officer (OCHMO), in conjunction with Johnson Space Center (JSC), Flight Medicine Clinic (FMC) is implementing the National Aeronautics and Space Administration Transition Authorization Act of 2017 the TREAT Astronauts Act, noted in subsection 441. (https://www.congress.gov/115/plaws/publ10/PLAW-115publ10.pdf). Implementation of this act necessitates the collection of information from former astronauts and/ or former payload specialists at the JSC FMC in order to provide treatment. Additionally, the information collected will develop a knowledge base on the effects of spaceflight; and identify any gaps in services that support medical monitoring, diagnosis and treatment of conditions associated with human space flight. The purpose for this information collection is to support the approved TREAT Astronauts Act for former astronauts and/ or former payload specialists. This information is collected with electronic forms built into the Electronic Medical Records (EMR) software in operation at the JSC, FMC.
Authorizing Statute(s):
PL:
Pub.L. 115 - 10 442
Name of Law: National Aeronautics and Space Administration Transition Authorization Act of 2017
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:
83 FR 245
12/21/2018
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 58
03/26/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
NASA Treat Astronauts Act
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
175
0
0
175
0
0
Annual Time Burden (Hours)
88
0
0
88
0
0
Annual Cost Burden (Dollars)
4,375
0
0
4,375
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:
This is a new ICR authorized by Public Law 115-10 Sec 442
Annual Cost to Federal Government:
$10,325
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.
Yes
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.
Yes
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:
Gatrie Johnson 202 358-1013 gatrie.johnson@nasa.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:
05/13/2019
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