Indicators of the Performance of Local and State Education Agencies in HIV Prevention and Coordinated School Health Program Activities for Adolescent and School Health Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 4 D-1-Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007)	Form and Instruction	Modified	Available
Form 7 Indicators for School Health Programs: Asthma Management (LEA)	Form and Instruction	New	Available
Form 5 Indicators for School Health Programs: Coordinated School Health Programs	Form and Instruction	New	Available
Form 1 Indicators for School Health Programs: HIV Prevention (for State Education Agencies)	Form and Instruction	New	Available
Attachment I (Description of Changes to Revised Questionnaires).doc	Supplementary Document	Uploaded 2008-03-11	Available
Attachment H (FY2008-FY2010 grantee list).doc	Supplementary Document	Uploaded 2008-03-11	Repair queued
Attachment G (FY2007 grantee list).doc	Supplementary Document	Uploaded 2008-03-11	Available
60 day FRN-E7-14389.pdf	Supplementary Document	Uploaded 2008-03-11	Available
Attachment 1- Regulation authorizing data collection.doc	Supplementary Document	Uploaded 2008-03-11	Available
SS Part A 03-06-08.doc	Supporting Statement A	Uploaded 2008-03-13	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7140	D-1-Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007)	Form and Instruction	Modified
184578	Indicators for School Health Programs: Asthma Management (LEA)	Form and Instruction	New
184577	Indicators for School Health Programs: Coordinated School Health Programs	Form and Instruction	New
184576	Indicators for School Health Programs: HIV Prevention (for State Education Agencies)	Form and Instruction	New

ICR Details

OMB Control No: 0920-0672	ICR Reference No: 200804-0920-002
Status: Historical Active	Previous ICR Reference No: 200410-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Indicators of the Performance of Local and State Education Agencies in HIV Prevention and Coordinated School Health Program Activities for Adolescent and School Health Programs
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/12/2008
	Date Received in OIRA: 04/23/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2011	36 Months From Approved
Responses	102	0	0
Time Burden (Hours)	783	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC requests OMB clearance for a 3-year reinstatement with change of Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV Prevention, Coordinated School Health Program, and Asthma Management Activities for Adolescent and School Health Programs. This clearance involves a set of web-based questionnaires that assess programmatic activities for HIV prevention, Coordinated School Health Program to address physical activity, nutrition, and tobacco use, and asthma management activities in local, state, territorial, and tribal education agencies.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 72363	12/20/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 15526	03/24/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
D-1-Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007)	4, 3	D-2-Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2008-2010) ,   D-1-Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007)
Indicators for School Health Programs: HIV Prevention (for State Education Agencies)	1, 2	C-1 Indicators for School Health Programs: HIV Prevention, State Education Agencies (FY2007) ,   C-2 Indicators for School Health Programs: HIV Prevention, State Education Agencies (FY2008-2010)
Indicators for School Health Programs: Coordinated School Health Programs	5, 6	E-1 Indicators for School Health Programs: Coordinated School Health Programs (FY2007) ,   E-2 Indicators for School Health Programs: to support (CSHP) and to address , (PANT), State Education Agencies (FY2008-FY2010)
Indicators for School Health Programs: Asthma Management (LEA)	7	F - Indicators for School Health Programs: Asthma Management, Local Education Agencies (FY2008-FY2010)

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ICR Summary of Burden

table that charts list 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	102	0	0	102	0	0
Annual Time Burden (Hours)	783	0	0	783	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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 request for a reinstatement with change of a current activity. In years 2 and 3 of this clearance request, original questionnaires will be updated to match the most recent Funding Opportunity Announcement. In addition, a new survey on Asthma Management activities will be implemented in years 2 and 3.

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Annual Cost to Federal Government: $125,554

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: 04/23/2008

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