HAvBed Assessment for 2009-H1N1 Influenza Serious Illness

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-OMB HAvBED v4.1.doc	Supporting Statement A	Uploaded 2009-08-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
190410	StateTerritory preparedness staff data collection	Instruction	New
190409	State Territory preparedness staff training	Instruction	New
190408	Hosptial Staff Data collection	Other-guide	New
190407	Hospital Staff	Other-survey	New

ICR Details

OMB Control No: 0990-0344	ICR Reference No: 200908-0990-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: HAvBed Assessment for 2009-H1N1 Influenza Serious Illness
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/28/2009
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/01/2009
	Date Received in OIRA: 08/21/2009
Terms of Clearance: OMB notes that HHS' supporting statement explains that “Additional data elements may need to be added to the system as the pandemic evolves to assure situational awareness so HHS can perform its duties under the National Response Framework.” HHS will obtain OMB approval for any additional data elements prior to fielding.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2010	6 Months From Approved
Responses	616,408	0	0
Time Burden (Hours)	652,120	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: As part of the National Framework for 2009-H1N1 Influenza Preparedness and Response, Surveillance pillar, HHS is tasked with mobilizing all national resources to develop and implement novel strategies to enhance domestic surveillance and clinical data sharing. A comprehensive assessment of public health and medical data streams has been undertaken by HHS, and information regarding health care system demands and stress has been determined to be woefully inadequate to meet HHS's mission to assist public health and local healthcare systems minimize suffering and maximize lives saved

Emergency Justfication: ASPR is requesting emergency processing procedures for this application because this information is needed immediately to help reduce morbidity and mortality from 2009-H1N1 by providing decision makers with timely, usable information regarding the status of the health care system.

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Authorizing Statute(s): US Code: 46 USC 391C2 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
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 42075	08/20/2009
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
Hospital Staff
Hosptial Staff Data collection
State Territory preparedness staff training
StateTerritory preparedness staff data collection

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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	616,408	0	0	616,408	0	0
Annual Time Burden (Hours)	652,120	0	0	652,120	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 new data collection.

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Annual Cost to Federal Government: $1,720,000

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)? No

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: 08/21/2009

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