National Survey of Prison Healthcare

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
NSPHC Questionnaire	Form	New	Repair queued
NSPHC Supporting Statement Part B_v13 FINAL.doc	Supporting Statement B	Uploaded 2011-11-30	Repair queued
Attachment G ERB Exemption Approval Form.pdf	Supplementary Document	Uploaded 2011-11-30	Repair queued
Attachment D Public Comments for 60-day Notice.docx	Supplementary Document	Uploaded 2011-11-30	Repair queued
Attachment B Expert Meeting Attendees.docx	Supplementary Document	Uploaded 2011-11-30	Repair queued
Attachment C Copy of Official 60-day Notice.pdf	Supplementary Document	Uploaded 2011-11-30	Repair queued
Attachment A Legislative Authority FINAL.docx	Supplementary Document	Uploaded 2011-11-30	Repair queued
Attachment E NSPHC Introduction Letter.docx	Supplementary Document	Uploaded 2011-12-01	Repair queued
NSPHC Supporting Statement Part A_v16 FINAL.doc	Supporting Statement A	Uploaded 2011-11-30	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
200367	NSPHC Questionnaire	Form	New

ICR Details

OMB Control No:	ICR Reference No: 201112-0920-003
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Survey of Prison Healthcare
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 02/07/2012
	Date Received in OIRA: 12/08/2011
Terms of Clearance: This package is withdrawn consistent with CDC/NCHS's intent to improve the questionnaire instrument and better document in the supporting statement the relative priority associated with the different types of data sought, the precision needed, the developmental work, and the balance between the utility and the burden. As long as the scope of the collection does not change, it will not be necessary to publish another 60 or 30 day public notice in the Federal Register.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		12 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Survey of Prison Health Care (NSPHC) will be a mail survey to a prison official in the Department of Corrections within each of the 50 States and Federal Bureau of Prisons and will seek facility-level information on the types of healthcare services delivered and the mechanism used to deliver these services.

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Authorizing Statute(s): US Code: 42 USC 306 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:
	76 FR 17420	03/29/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 75885	12/05/2011
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
NSPHC Questionnaire	none	NSPHC Questionnaire

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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: No

Burden Reduction Due to:

Short Statement: This is a new data collection request.

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Annual Cost to Federal Government: $299,400

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]? No

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: 12/08/2011

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