CDC Oral Health Management Information System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form No number New MIS Modules: Success Stories & Environmental Assessment	Form	Removed	Available
CDC Oral Health Management Information System - MIS Data Collection Instrument	Form	Modified	Available
Attachment 2b. Public Comments and CDC Response.docx	Supplementary Document	Uploaded 2010-02-24	Available
Attachment 2a. 60 day FRN.pdf	Supplementary Document	Uploaded 2010-02-24	Available
Attachment 1. Authorizing Legislation.doc	Supplementary Document	Uploaded 2010-02-24	Repair queued
684 human subj MIS.pdf	Supplementary Document	Uploaded 2010-02-24	Available
0920-0739 SS_A_02.16.2010.doc	Supporting Statement A	Uploaded 2010-04-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
184680	New MIS Modules: Success Stories & Environmental Assessment	Form	Removed
178975	CDC Oral Health Management Information System - MIS Data Collection Instrument	Form	Modified

ICR Details

OMB Control No: 0920-0739	ICR Reference No: 201004-0920-005
Status: Historical Active	Previous ICR Reference No: 200804-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: CDC Oral Health Management Information System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/20/2010
	Date Received in OIRA: 04/14/2010
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	06/30/2010
Responses	42	0	30
Time Burden (Hours)	462	0	330
Cost Burden (Dollars)	0	0	0

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Abstract: CDC provides funds to oral health programs in states and territories to support oral health infrastructure and develop programs. Progress and performance information is collected from awardees to monitor and improve program performance. Information is collected through a web-based MIS.

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Authorizing Statute(s): US Code: 42 USC 241(a) Name of Law: Research and Investigation in General
   US Code: 42 USC 247(b)(k)(2) Name of Law: null
  

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:
	74 FR 66969	12/17/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 18846	04/13/2010
Did the Agency receive public comments on this ICR? Yes

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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
CDC Oral Health Management Information System - MIS Data Collection Instrument	none	MOLAR MIS
New MIS Modules: Success Stories & Environmental Assessment	No number	Attachment A - New MIS Modules

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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	42	30	0	12	0	0
Annual Time Burden (Hours)	462	330	0	132	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The total estimated burden hours will increase due to an increase in the number of funded programs from 15 to 21. The two previous information collections have been combined into one. There is no change in the estimated burden per response.

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Annual Cost to Federal Government: $33,040

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: 04/14/2010

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