School Dismissal Monitoring System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment 2 60d FRN_11 03 2009.pdf	Supplementary Document	Uploaded 2010-02-24	Available
Attachment 1 Public Health Service Act.pdf	Supplementary Document	Uploaded 2010-02-24	Available
Attachment 3 CDC School Guidance.pdf	Supplementary Document	Uploaded 2010-02-24	Available
School_Dismissal_Monitoring_Sup_Sta_03.10[1].doc	Supporting Statement A	Uploaded 2010-03-22	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
192337	School Dismissal Monitoring System (Reporting Form)	Other-WORD	New

ICR Details

OMB Control No: 0920-0849	ICR Reference No: 201003-0920-012
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: School Dismissal Monitoring System
Type of Information Collection: Existing collection in use without an OMB Control Number	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/04/2010
	Date Received in OIRA: 03/24/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2013	36 Months From Approved
Responses	500	0	0
Time Burden (Hours)	42	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: During the spring 2009 H1N1 outbreak, the U.S. Department of Education (ED) and the Centers for Disease Control and Prevention (CDC) received numerous daily requests about the overall number of school dismissals nationwide and the number of students and teachers impacted by the school dismissals. CDC and ED recognized the importance of having a mechanism in place to collect this information and gauge the impact of the outbreak. Thus, CDC and ED developed a standardized data collection instrument to obtain this data and have begun to collect data under OMB Control No. 0920-0008, Emergency Epidemic Investigations. Data collections under OMB Control No. 0920-0008 are permitted for a 90 days. Since CDC expects school closures to occur beyond the 90 day period and would like to collect this data over the long term, CDC is requesting OMB approval for this data collection under a separate OMB Control Number.

---

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:
	74 FR 56840	11/03/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 14163	03/24/2010
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
School Dismissal Monitoring System (Reporting Form)

---

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	500	0	0	0	0	500
Annual Time Burden (Hours)	42	0	0	0	0	42
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: $610,878

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

---

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: 03/24/2010

---