CDC Oral Health Management Information System

Forms and Documents

Document Name	Status
CDC Oral Health Management Information System - MOLAR MIS Form	Modified
0920-0739 SS_B_2_5_13.doc Supporting Statement B	2013-03-04
Attachment 2b. Summary of Public Comments.doc Supplementary Document	2013-03-04
Attachment 2a. Federal Register Notice.pdf Supplementary Document	2013-03-04
Attachment 1. Authorizing Legislation.doc Supplementary Document	2013-03-04
0920-0739 MOLAR_SS_A_2 6_13.doc Supporting Statement A	2013-03-04

IC Document Collections

IC ID	Document Title	Status
178975	CDC Oral Health Management Information System - MOLAR MIS Form	Modified

ICR Details

OMB Control No: 0920-0739	ICR Reference No: 201303-0920-008
Status: Historical Active	Previous ICR Reference No: 201004-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 19056
Title: CDC Oral Health Management Information System
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: 04/11/2013
	Date Received in OIRA: 03/15/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2014	7 Months From Approved	05/31/2013
Responses	20	0	42
Time Burden (Hours)	220	0	462
Cost Burden (Dollars)	0	0	0

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Abstract: CDC provides funds to oral health programs in states and territories to support oral health infrastructure and develop programs. Progress and performance information is collected from awardees to monitor and improve program performance. Information is collected through a web-based MIS.

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Authorizing Statute(s): US Code: 42 USC 241(a) Name of Law: Research and Investigation in General
   US Code: 42 USC 247(b)(k)(2) Name of Law: null
  

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:
	78 FR 305	01/03/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 15367	03/11/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
CDC Oral Health Management Information System - MOLAR MIS	none	MOLAR MIS

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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	20	42	0	0	-22	0
Annual Time Burden (Hours)	220	462	0	0	-242	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Information is routinely collected semi-annually. Only one collection will be conducted in the 7 month extension period. This will permit CDC to collect the final progress report from awardees, due 10/30/2013, including any reports submitted past the due date. This extension is based on 20 respondents, the actual number of awardees.

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Annual Cost to Federal Government: $13,200

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: 03/15/2013

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