Helping to End Lead Poisoning: A Study of Medicaid Providers' Self-Reported Attitudes, Practices, Beliefs, & Barriers to Childhood Blood Lead Testing

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Forms and supporting documents for this ICR

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IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7181	Helping to End Lead Poisoning: A Study of Medicaid Providers' Self-Reported Attitudes, Practices, Beliefs, & Barriers to Childhood Blood Lead Testing		Migrated

ICR Details

OMB Control No:	ICR Reference No: 200512-0920-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Helping to End Lead Poisoning: A Study of Medicaid Providers' Self-Reported Attitudes, Practices, Beliefs, & Barriers to Childhood Blood Lead Testing
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OIRA Conclusion Action: Withdrawn	Conclusion Date: 03/13/2006
	Date Received in OIRA: 12/16/2005
Terms of Clearance: Withdrawn per CDC request submitted to OMB 03/10/06, if CDC chooses to resubmit a revised version of the survey OMB will waive the 60 and 30 day comment periods under the PRA.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		02/28/2007
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC's National Center for Environmental Health is proposing a pilot study to obtain information that will be used to understand the barriers Medicaid providers face concerning childhood blood lead testing and to develop effective strategies that promote blood lead testing among Medicaid providers. This is a comparison study between two communities in Wisconsin - one has high blood lead testing rates; the other has low blood lead testing rates. Targeted Medicaid providers will be mailed a short questionnaire. The study will not request or maintain personal identifiers of the....

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Helping to End Lead Poisoning: A Study of Medicaid Providers' Self-Reported Attitudes, Practices, Beliefs, & Barriers to Childhood Blood Lead Testing

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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:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 12/16/2005

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