Developing a Responsive Plan for Building the Capacity of Community Based Organizations (CBOs) to Implement HIV Prevention Services

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Community-Based Organizations Capacity Building Assistance Needs Assessment--Dually Funded CBOs funded under both PS11-1113 and PS10-1003)	Form and Instruction	New	Available
Community-Based Organizations Capacity Building Assistance Needs Assessment--CBOs only funded under PS11-1113	Form and Instruction	New	Available
Supporting Statement B_KHM.docx	Supporting Statement B	Uploaded 2012-08-01	Available
Supporting Statement A_KHM.doc	Supporting Statement A	Uploaded 2012-08-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
203574	Community-Based Organizations Capacity Building Assistance Needs Assessment--Dually Funded CBOs funded under both PS11-1113 and PS10-1003)	Form and Instruction	New
203573	Community-Based Organizations Capacity Building Assistance Needs Assessment--CBOs only funded under PS11-1113	Form and Instruction	New

ICR Details

OMB Control No: 0920-0948	ICR Reference No: 201208-0920-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Developing a Responsive Plan for Building the Capacity of Community Based Organizations (CBOs) to Implement HIV Prevention Services
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: Approved without change	Conclusion Date: 10/15/2012
	Date Received in OIRA: 08/03/2012
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2013	36 Months From Approved
Responses	34	0	0
Time Burden (Hours)	75	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The purpose of this project is to assess the capacity building assistance (CBA) needs of CDC-funded community-based organizations (CBOs) and to develop a "Strategic Plan for Enhanced CBO Capacity" (a.k.a. "CBA Plan") to address those needs. The information will be used to inform the development of individualized CBA Plans to improve CDC grantees' program processes and operations in three critical areas: program implementation, monitoring and evaluation, and organizational infrastructure.

---

Authorizing Statute(s): US Code: 3 USC 301 Name of Law: Research and Investigations Generally
   US Code: 42 USC 241 Name of Law: The Public Health and Welfare/Public Health Service
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 25484	04/30/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 45616	08/01/2012
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Community-Based Organizations Capacity Building Assistance Needs Assessment--CBOs only funded under PS11-1113	None	Community-Based Organizations Capacity Building Assistance Needs Assessment
Community-Based Organizations Capacity Building Assistance Needs Assessment--Dually Funded CBOs funded under both PS11-1113 and PS10-1003)	None	Community-Based Organizations Capacity Building Assistance Needs Assessment

---

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	34	0	0	34	0	0
Annual Time Burden (Hours)	75	0	0	75	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: No

Burden Reduction Due to:

Short Statement: This is a new ICR

---

Annual Cost to Federal Government: $190,320

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

---

Common Form ICR:  No

---

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: 08/03/2012

---