National Public Health Performance Standards Program Local Public Health System Performance Assessment

Forms and Documents

Document Name	Status
Form 1 Local Public Health System Performance Assessment Instrument Form and Instruction	Modified
SS_Part_B_5-28-2010.docx Supporting Statement B	2010-07-15
Att D_PossibleResp for use of NPHPSP Instr.xls Supplementary Document	2010-07-15
Att C_Work Group Members.doc Supplementary Document	2010-07-15
Att B 60 dy FRN-Local.pdf Supplementary Document	2010-07-15
Att A.pdf Supplementary Document	2010-07-15
Att H_Screen Shots_Web Based System.docx Supplementary Document	2010-07-15
Att G_ Data Entry Instructions_1007.docx Supplementary Document	2010-07-15
Att F_Mtg Guide.doc Supplementary Document	2010-07-15
Att E.4_Local Agency Contribution.pdf Supplementary Document	2010-07-15
Att E.3_Local Priority.pdf Supplementary Document	2010-07-15
Att E.2_Local RIF.pdf Supplementary Document	2010-07-15
Supp Stmt Part_A (Revised-2).docx Supporting Statement A	2010-07-16

IC Document Collections

IC ID	Document Title	Status
7006	Local Public Health System Performance Assessment Instrument Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0555	ICR Reference No: 201007-0920-008
Status: Historical Active	Previous ICR Reference No: 200706-0920-001
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Public Health Performance Standards Program Local Public Health System Performance Assessment
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/27/2010
	Date Received in OIRA: 07/28/2010
Terms of Clearance: Previous terms of clearance apply.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2013	36 Months From Approved	08/31/2010
Responses	350	0	350
Time Burden (Hours)	5,600	0	5,600
Cost Burden (Dollars)	0	0	0

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Abstract: CDC proposes to extend without changes the currently approved data collection instrument related to the public health infrastructure and performance of local public health systems. The target audience for this instrument is local public health systems; the "system" includes the local public health agency and other local-level partners that contribute to public health. The data collection instrument solicits comprehensive data about how well local public health systems are meeting optimal standards established for each of the ten Essential Public Health Services. This data collection is used by responding local jurisdictions as well as by CDC and national partners. Respondents (local public health agencies and their system partners) use this data collection instrument to inform strategic planning and performance improvement efforts, as the information provides critical input regarding its strengths and weaknesses. CDC and other national partners use the aggregate national data to monitor progress toward the accomplishment of national infrastructure objectives included in Healthy People 2010 and to strengthen our understanding of strengths and weaknesses in state and local public health practice. A similar objective is slated for inclusion in Healthy People 2020. Such information is critical for making better and more effective policy and resource decisions that will improve the nation's public health as a whole.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Services 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:
	75 FR 13132	03/18/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 41206	07/15/2010
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Local Public Health System Performance Assessment Instrument	1	Local Public Health System Performance Assessment Instrument

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ICR Summary 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	350	350	0	0	0	0
Annual Time Burden (Hours)	5,600	5,600	0	0	0	0
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:

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Annual Cost to Federal Government: $375,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? No

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: 07/28/2010

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