Public Health Law Training and Technical Assistance Needs Assessment and Pandemic Influenza Nonpharmaceutical Interventions

Surveys of State, Tribal, Local and Territorial (STLT) Governmental Health Agencies

OMB: 0920-0879

IC ID: 202480

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Form 4 Public Health Law Training and Technical Assistance Needs Assessment and Pandemic Influenza Nonpharmaceutical Interventions Form and Instruction
1 PH Law Survey PH law_Attach-C_Word Survey.docx Form and Instruction
2 PH Law web survey PH Law _Attach-D_ Web_Survey.docx Form and Instruction
3 PanFlu Survey Attachment C_NonPharm PanFlu_WebSurvey.docx Form and Instruction
4 PanFlu Web Survey Attachment D_NonPharm PanFlu_SurveyWebScreenShots.docx Form and Instruction
PH Law Supporting_Statement_PART-A.docx PH Law Supporting_Statement_PART-A IC Document
PH LawSupporting_Statement_PART-B.docx PH LawSupporting_Statement_PART-B IC Document
PH Law_Attach-A_Public Health Law Program Brochure.pdf PH Law_Attach-A_Public Health Law Program Brochure IC Document
PH Law _Attach-E Survey Notification Email.docx PH Law _Attach-E Survey Notification Email IC Document
PH Law_Attach-F_Survey Reminder Email.docx PH Law_Attach-F_Survey Reminder Email IC Document
PHLaw_Attach-B_ Core Legal Competencies for PH Professionals.pdf PHLaw_Attach-B_ Core Legal Competencies for PH Professionals IC Document
Attachment A_NonPharm PanFlu Overview of Focus groups_2009_2011.docx Attachment A_NonPharm PanFlu Overview of Focus groups_2009_2011 IC Document
Attachment B_NonPharm PanFlu_STLT_NA_KII_ToplineReport.docx Attachment B_NonPharm PanFlu_STLT_NA_KII_ToplineReport IC Document
Attachment E_NonPharm PanFlu_AdvanceNotificationEmail.docx Attachment E_NonPharm PanFlu_AdvanceNotificationEmail IC Document
Attachment F_NonPharm PanFlu_SurveyRecruitmentEmail.docx Attachment F_NonPharm PanFlu_SurveyRecruitmentEmail IC Document
Attachment G_NonPharm PanFlu_SurveyReminderEmails.docx Attachment G_NonPharm PanFlu_SurveyReminderEmails IC Document
CIICU_STLT_NonPharm PanFlu_SupportingStatement A.docx CIICU_STLT_NonPharm PanFlu_SupportingStatement A IC Document
CIICU_STLT_NonPharm PanFlu_SupportingStatement B.docx CIICU_STLT_NonPharm PanFlu_SupportingStatement B IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Public Health Law Training and Technical Assistance Needs Assessment and Pandemic Influenza Nonpharmaceutical Interventions	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	4	PanFlu Web Survey	Attachment D_NonPharm PanFlu_SurveyWebScreenShots.docx	Yes	Yes	Fillable Fileable
Form and Instruction	1	PH Law Survey	PH law_Attach-C_Word Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	2	PH Law web survey	PH Law _Attach-D_ Web_Survey.docx	Yes	Yes	Fillable Fileable
Form and Instruction	3	PanFlu Survey	Attachment C_NonPharm PanFlu_WebSurvey.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 853	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	853	0	0	0	0	0
Annual IC Time Burden (Hours)	246	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
PH Law Supporting_Statement_PART-A	PH Law Supporting_Statement_PART-A.docx	05/24/2012
PH LawSupporting_Statement_PART-B	PH LawSupporting_Statement_PART-B.docx	05/24/2012
PH Law_Attach-A_Public Health Law Program Brochure	PH Law_Attach-A_Public Health Law Program Brochure.pdf	05/24/2012
PH Law _Attach-E Survey Notification Email	PH Law _Attach-E Survey Notification Email.docx	05/24/2012
PH Law_Attach-F_Survey Reminder Email	PH Law_Attach-F_Survey Reminder Email.docx	05/24/2012
PHLaw_Attach-B_ Core Legal Competencies for PH Professionals	PHLaw_Attach-B_ Core Legal Competencies for PH Professionals.pdf	05/24/2012
Attachment A_NonPharm PanFlu Overview of Focus groups_2009_2011	Attachment A_NonPharm PanFlu Overview of Focus groups_2009_2011.docx	05/24/2012
Attachment B_NonPharm PanFlu_STLT_NA_KII_ToplineReport	Attachment B_NonPharm PanFlu_STLT_NA_KII_ToplineReport.docx	05/24/2012
Attachment E_NonPharm PanFlu_AdvanceNotificationEmail	Attachment E_NonPharm PanFlu_AdvanceNotificationEmail.docx	05/24/2012
Attachment F_NonPharm PanFlu_SurveyRecruitmentEmail	Attachment F_NonPharm PanFlu_SurveyRecruitmentEmail.docx	05/24/2012
Attachment G_NonPharm PanFlu_SurveyReminderEmails	Attachment G_NonPharm PanFlu_SurveyReminderEmails.docx	05/24/2012
CIICU_STLT_NonPharm PanFlu_SupportingStatement A	CIICU_STLT_NonPharm PanFlu_SupportingStatement A.docx	05/24/2012
CIICU_STLT_NonPharm PanFlu_SupportingStatement B	CIICU_STLT_NonPharm PanFlu_SupportingStatement B.docx	05/24/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.