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:
0920-1289
ICR Reference No:
201910-0920-011
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-19ACI
Title:
Sealant Efficiency Assessment for Locals and States (SEALS)
Type of Information Collection:
Existing collection in use without an OMB Control Number
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/23/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/20/2019
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2023
36 Months From Approved
Responses
1,194
0
0
Time Burden (Hours)
463
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Approval of Sealant Efficiency Assessment for Locals and States (SEALS) is requested to lower caries rates among at-risk children by increasing the efficiency of local school sealant programs, which in turn will lead to more children receiving sealants to prevent oral health disease. Data will be used to generate school sealant program (SSP) efficiency performance measures (e.g., cost per averted cavity), and state oral health programs can use this information to monitor progress and increase efficiency, document return on investment, and increase their reach. CDC will use this information to identify feasible benchmarks for SSPs and identify best practices contributing to SSP efficiency to share with states and stakeholders.
Authorizing Statute(s):
US Code:
42 USC 301
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:
84 FR 13924
04/08/2019
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 61908
11/14/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Add Event - SSP Local Administrator
NA
Add Event
Add Program and Add User - State Sealant Administrator
NA
Add Program and Add User
Add User and Add School - SSP Local Administrator
NA
Add User and Add School
Program Options and Cost Options - SSP Local Administrator
NA
Program Options and Cost Options
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
1,194
0
0
0
0
1,194
Annual Time Burden (Hours)
463
0
0
0
0
463
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:
Annual Cost to Federal Government:
$62,810
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:
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:
11/20/2019
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