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 Generic ICR - OIRA Conclusion
OMB Control No:
0920-0879
ICR Reference No:
202410-0920-015
Status:
Active
Previous ICR Reference No:
202306-0920-009
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-0879
Title:
[NCSTLTPHIW] Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery
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:
10/23/2024
Retrieve Notice of Action (NOA)
Date Received in OIRA:
10/16/2024
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2026
08/31/2026
08/31/2026
Responses
162,000
0
162,000
Time Burden (Hours)
162,000
0
162,000
Cost Burden (Dollars)
0
0
0
Abstract:
CDC requests an Extension to the Generic Clearance to continue to collect information related to domestic public health issues and services that affect state, tribal, local, and territorial STLT governmental entities. The Extension ICR includes a list of GENIC projects that were approved in the previous clearance period (January 2021-June 2023). Also noted [see ICR Summary of Burden, below]: There is a significant reduction in Total Cost Burden for this Extension. In the previous clearance period, CDC reported the figure calculated in SSA.12. In this Extension, per guidance from HHS, CDC is reporting the dollar amount ($0) calculated in SSA.13 This Non-Substantive Change Request is submitted to amend a previously approved GenIC (Use and Acceptability of the Model Aquatic Health Code 2024) to increase the number of focus groups from three to six and to keep the survey open for an additional two weeks..The objective, scope, and questions for the focus group will not change, and increasing the number of focus groups will not impact the overall burden approved for this generic information collection, as it would reallocate 17 burden hours from the MAHC Use and Acceptability Survey to the Focus Group.
Authorizing Statute(s):
US Code:
42 USC 301
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:
88 FR 3991
01/23/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 41626
06/27/2023
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
13
IC Title
Form No.
Form Name
[PHIC/NCEH] EPH Practice Repository: Piloting the Collection and Dissemination of Environmental Public Health Practices (2025-2026)
n/a
EPH Survey
[PHIC/NCEZID] Use and Acceptability of the Model Aquatic Health Code (2024)
0920-0879, 0920-0879, 0920-0879, 0920-0879, 0920-0879
MAHC Use and Acceptability Survey (EpiInfo Web Survey)
,
Focus Group Discussion Guide—Moderate MAHC Use and Implementation
,
Focus Group Discussion Guide—Moderate MAHC Use and Implementation
,
Focus Group Discussion Guide—Advanced MAHC Use and Implementation
,
Case Study In-Depth Interview Guide
[PHIC/NCHHSTP] 2024 TB Training and Education Needs Assessment – The U.S.-affiliated Pacific Islands – Online Survey
n/a
2024 Tuberculosis (TB) Training and Education Needs Assessment of the U.S.-affiliated Pacific Islands
[PHIC/NCIRD] Pediatric Hepatitis-Adenovirus Case Control Evaluation, United States 2022-2026 (24CN)
0920-0879, 0920-0879, 0920-0879, 0920-0879, 0920-0879
PEDIATRIC HEPATITIS OF UNKNOWN ETIOLOGY MEDICAL RECORD ABSTRACTION FORM
,
Pediatric Hepatitis of Unknown Etiology - Exposures Questionnaire (Parental Interview)
,
Pediatric Hepatitis of Unknown Etiology - Exposures Questionnaire CONTROL (Parental Interview)
,
Hepatitis pediátrica de etiología desconocida - Cuestionario sobre exposiciones (entrevista a los padres)
,
Hepatitis pediátrica de etiología desconocida. CONTROL del cuestionario sobre exposiciones (Entrevista a los padres)
[PHIC] 2025 Assessment of a Novel Funding Approach for Improving Health in Rural Communities
n/a, n/a, n/a
Rural Carveout Survey
,
Rural Carveout Interview - SHD
,
Rural Carveout Interview - SORH
[PHIC] 2025 Training Needs Assessment - U.S. Public Health Mycobacteriology Laboratories Online Questionnaire
n/a
2025 Training Needs Assessment – U.S. Public Health Mycobacteriology Laboratories Online Questionnaire
[PHIC] 2025 U.S. Pathogen and Genomics Centers for Excellence (PGCoE) Interim Assessment
n/a, n/a
PGCoE Interim Assessment Survey Data Collection Tool
,
PGCoE Interim Assessment Focus Group Script/ Discussion Guide
[PHIC] Assessing Funded Overdose Data to Action (OD2A) Grantee Implementation and Impacts of Stop Overdose Campaigns
0920-0879, 0920-0879
O2DA Partner Evaluation Survey: Screener and Annotated Questionnaire
,
O2DA Partner Evaluation Survey: Screener and Annotated Questionnaire
[PHIC] CDC Funded Recipient Experience Survey
n/a
CDC Funded Recipient Experience Survey
[PHIC] Developing Capacity to Decontaminate/Evacuate Vulnerable Persons During an Emergency (2025)
n/a, n/a
Call for Data
,
Semi-Structured Interview
[PHIC] Information Collections to Advance State, Tribal, Local and Territorial (STLT) Governmental Agency System Performance, Capacity, and Program Delivery
[PHIC] OT21-2103 Success Stories (2024-2026)
n/a
OT20-2103 Success Stories Form
[PHIC] State Dental Director and Key Oral Health Program Staff Survey (2025)
n/a
State Dental Director and Key Oral Health Program Staff Survey
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
162,000
162,000
0
0
0
0
Annual Time Burden (Hours)
162,000
162,000
0
0
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:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$92,950
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?
No
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:
10/16/2024
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