School Associated Violent Deaths Surveillance System

Forms and Documents

Document Name	Status
Supporting Statement B.doc Supporting Statement B	2013-02-13
Attachment 8 - Telephone Script.doc Supplementary Document	2013-02-14
Attachment 9 - Parental Consent Form.doc Supplementary Document	2013-02-13
Attachment 12 - Cross Walk for SAVD Survey Tools - School Staff.xlsx Supplementary Document	2013-02-13
Attachment 11 - Cross Walk for SAVD Survey Tools - Law Enforcement.xlsx Supplementary Document	2013-02-13
Attachment 7 - CDC IRB Approval.doc Supplementary Document	2013-02-13
Attachment 6 - AoC.doc Supplementary Document	2013-02-13
Attachment 4 - Publications.doc Supplementary Document	2013-02-13
Attachment 3 Law Enforcement Participation Letter.docx Supplementary Document	2013-02-13
Attachment 2 - Published 60-Day Notice.pdf Supplementary Document	2013-02-13
Attachment 1 - Authorizing Legislation.doc Supplementary Document	2013-02-13
Supporting Statement A.doc Supporting Statement A	2013-02-13

IC Document Collections

IC ID	Document Title	Status
7069	Interview - School Officials Other-CATI Interview	Modified
191865	Interview - Law Enforcement Officials Other-CATI Interview	Modified

ICR Details

OMB Control No: 0920-0604	ICR Reference No: 201302-0920-018
Status: Historical Active	Previous ICR Reference No: 201001-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 18810
Title: School Associated Violent Deaths Surveillance System
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/23/2013
	Date Received in OIRA: 02/28/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2016	36 Months From Approved
Responses	70	0	0
Time Burden (Hours)	70	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC is requesting reinstatement of this surveillance system which remains the only systematic effort to document school-associated violent deaths on a national basis. Despite the important role of schools as a setting for violence research and prevention interventions, relatively little scientific or systematic work has been done to describe the nature and level of fatal violence associated with schools. The surveillance system will continue to contribute to the understanding of fatal violence associated with schools, guide further research in the area, and help direct ongoing and future prevention programs.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act`
   US Code: 42 USC 391 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:
	77 FR 74484	12/14/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 12320	02/22/2013
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Interview - School Officials
Interview - Law Enforcement Officials

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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	70	0	0	70	0	0
Annual Time Burden (Hours)	70	0	0	70	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 reinstatement with change that involves changes to the data collection instruments and the adding of an additional security measure. Changes made to data collection instruments do not increase nor decrease the burden.

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Annual Cost to Federal Government: $172,194

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: 02/28/2013

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