National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment C Work Group Members.doc	Supplementary Document	Uploaded 2010-07-27	Available
NPHPSP Denominator .xls	Supplementary Document	Uploaded 2010-07-27	Available
Attachment H NPHPSP Reporting System Website Screen Shots.doc	Supplementary Document	Uploaded 2010-07-27	Available
Attachment G NPHPSP Data Entry Instructions.doc	Supplementary Document	Uploaded 2010-07-27	Available
Attachment F Meeting Guide.doc	Supplementary Document	Uploaded 2010-07-27	Available
Governance Supp Stmt Part A.doc	Supporting Statement A	Uploaded 2010-07-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7041	National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool	Instruction	Modified

ICR Details

OMB Control No: 0920-0580	ICR Reference No: 201008-0920-006
Status: Historical Active	Previous ICR Reference No: 200706-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool
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: 09/16/2010
	Date Received in OIRA: 08/17/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2013	36 Months From Approved	09/30/2010
Responses	175	0	175
Time Burden (Hours)	875	0	875
Cost Burden (Dollars)	0	0	0

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Abstract: CDC proposes to extend the currently-approved data collection instrument related to the public health infrastructure and performance of local boards of health. The target audience for this instrument is the local public health governing entity that is ultimately accountable for public health governance at the local level. The data collection instrument solicits comprehensive data about the capacity of the local governing entity (generally the local board of health) in overseeing the delivery 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 boards of health and representatives from their local public health agencies) use this data collection instrument as both an educational and orientation tool for board members and as a self-assessment that identifies strengths and weaknesses upon which they can base strategic planning and performance improvement efforts. 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. 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 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
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 13134	03/18/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 44798	07/29/2010
Did the Agency receive public comments on this ICR? No

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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
National Public Health Performance Standards Program Local Public Health Governance Performance Assessment Tool

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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	175	175	0	0	0	0
Annual Time Burden (Hours)	875	875	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? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

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: 08/17/2010

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