0920-0820 Rev. _SS_9_16_2009

Communities Putting Prevention to Work

Supporting Statement

For an Emergency Clearance Request

(revised 9/16/2009)

The revised Information Collection Request includes a new information collection form to be used exclusively by Pacific Islands jurisdictions. The new form reduces the estimated burden per response for these respondents. The revised ICR also includes a reduction in the estimated number of respondents for a previously approved from. There is an overall decrease in the total estimated burden from 12,780 hours to 12,640 hours.

A. Justification

1. Circumstances Making the Collection of Information Necessary

The American Recovery and Reinvestment Act of 2009 (Recovery Act), signed into law February 17, 2009, is designed to stimulate economic recovery in various ways, including preserving and creating jobs and promoting economic recovery, assisting those most impacted by the recession, stabilizing State and local government budgets in order to minimize and avoid reductions in essential services and counterproductive state and local tax increases, and strengthening the Nation’s healthcare infrastructure and reducing healthcare costs through prevention activities. The Recovery Act includes $650 million for evidence-based clinical and community-based prevention and wellness strategies that support specific, measurable health outcomes to reduce chronic disease rates. The legislation provides an important opportunity for states, cities, rural areas, and tribes to advance public health across the lifespan and to reduce health disparities. The Centers for Disease Control and Prevention (CDC) will support intensive community approaches to chronic disease prevention and control in selected communities (urban and rural), to achieve the following prevention outcomes:

• Increased levels of physical activity;

• Improved nutrition (e.g. increased fruit/vegetable consumption, reduced salt and transfats);

• Decreased overweight/obesity prevalence

• Decreased smoking prevalence and decreased teen smoking initiation; and

• Decreased exposure to secondhand smoke.

Health departments representing States, territories, the District of Columbia, the Pacific Islands and Tribal communities may apply to the CDC for Recovery Act funds to reduce risk factors, prevent and/or delay chronic disease, and promote wellness. The initiative will be managed by the National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).

CDC requests OMB approval to collect information that will assist CDC in determining which applicant entities meet the requirements for award. Emergency clearance is requested due to the time-sensitive nature of activities to be funded through the ARRA.

2. Purpose and Use of Information Collection

The information submitted by applicants to CDC will be used to assure eligibility and to determine which applicants receive funding under the following programs:

1. State Supplemental Funding for Healthy Communities, Tobacco Control, Diabetes Prevention and Control, and Behavioral Risk Factor Surveillance.

2. Pacific Islands Supplemental Funding for Tobacco Control, Diabetes Prevention and Control, and Behavioral Risk Factor Surveillance.

3. Community Approaches to Chronic Disease Prevention and Control.

3. Use of Improved Information Technology and Burden Reduction

Applications will be submitted electronically using grants.gov. The Letter of Intent will be submitted in paper form.

4. Efforts to Identify Duplication and Use of Similar Information

This is a new program. Information has not been previously collected for this purpose.

5. Impact on Small Businesses or Other Small Entities

There will be no impact on small business.

6. Consequences of Collecting the Information Less Frequent Collection

This is a one-time data collection.

7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5

There are no special circumstances.

8. Comments in Response to the Federal Register Notice/Outside Consultation

Due to the emergency nature of the program announce, OMB has waived the FRN requirements for this collection.

9. Explanation of any Payment/Gift to Respondents

Not applicable.

10. Assurance of Confidentiality Provided to Respondents

No personal information will be collected other than general contact information. All grant information will be maintained in a secure manner.

11. Justification for Sensitive Questions

No sensitive information will be collected.

12. Estimates of Annualized Burden Hours (Total Hours & Wages)

An estimated 235 respondents are expected to submit a Letter of Intent (Attachment 1) and an application (Attachment 2) under the “Community Approaches to Chronic Disease Prevention and Control” program. The focal points for implementation of plans for this effort are state health departments, local health departments, and tribes. Local health departments will coordinate applications for large cities and urban areas. State health departments will coordinate applications for small cities and rural areas.

An estimated 53 respondents will submit applications (see Attachment 3) for supplemental funding for “Healthy Communities, Tobacco Control, Diabetes Prevention and Control, and Behavioral Risk Factor Surveillance” (reference FOA DP09-901). Respondents will be health departments in States, territories, and the District of Columbia. Pacific Islands will submit a modified form of the application (see Attachment 4) for supplemental funding for Tobacco Control, Diabetes Prevention and Control, and Behavioral Risk Factor Surveillance (reference DP09-902).

The total estimated burden hours are 12,640.

12A. Estimated Annualized Burden Hours

Type of Respondent	Form Name	No. of Respondents	No. Responses per Respondent	Average Burden per Response (in hours)	Total Burden Hours
State and Local Health Departments	LOI for Community Approaches to Chronic Disease Prevention and Control	235	1	4	940
	Application for Community Approaches to Chronic Disease Prevention and Control	235	1	40	9,400
	Application for Supplemental Funding for Healthy Communities, Tobacco Control, Diabetes Prevention and Control and Behavioral Risk Factor Surveillance	53	1	40	2,120
Pacific Islands	Application for Pacific Islands, Supplemental Funding for Tobacco Control, Diabetes Prevention and Control and Behavioral Risk Factor Surveillance	6	1	30	180
		Total			12,640

12B. Cost estimates for a single respondent that has to complete the preliminary application

Form Name	Total Burden Hours	Hourly Wage Rate	Total Respondent Costs
LOI for Community Approaches to Chronic Disease Prevention and Control	940	$45.00	$42,300
Application for Community Approaches to Chronic Disease Prevention and Control	9,400	$45.00	$423,000
Supplemental Funding for States and Pacific Islands for Healthy Communities, Tobacco Control, Diabetes Prevention and Control and Behavioral Risk Factor Surveillance	2,440	$45.00	$109,800
	Total		$575,100

13. Estimates of other Total Annual Cost Burden to Respondents or Record Keepers/Capital Costs

There are no additional recordkeeping/capital costs.

14. Annualized Cost to Federal Government

Federal reviewers will be responsible for conducting an objective review of applications submitted under the programs described in this information collection request.

Type of Federal employee support	Total Burden Hours	Hourly Wage Rate	Total Federal Costs
Federal Reviewers	5,640	$39.48	$222,667

The average hourly wage rate for a federal reviewer is estimated at the GS-13, step 6 level.

15. Explanation for Program Changes or Adjustments

This is a new data collection.

16. Plans for Tabulation and Publication and Project Time Schedule

Data collection will begin as soon as clearance is received.

17. Reason(s) Display of OMB Expiration Date is Inappropriate

Not applicable.

18. Exceptions to Certification for Paperwork Reduction Act Submissions

There are no exceptions to the certification.

B. Collection of Information Employing Statistical Methods If statistical methods will not be used to select respondents and item 17 on Form 83-I is checked “No” use this section to describe data collection procedures.

The applications will be reviewed but the data will not be analyzed using statistical methods.

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