Colorectal Cancer Screening Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0920-0745_SS Part B_2 25 2013.docx	Supporting Statement B	Uploaded 2013-03-14	Available
Attachment 6. Data Consultants.doc	Supplementary Document	Uploaded 2013-03-14	Available
Attachment 4abc. Sample Feedback.doc	Supplementary Document	Uploaded 2013-03-14	Available
Attachment 2b. Summary of Public Comments.pdf	Supplementary Document	Uploaded 2013-03-14	Available
Attachment 2a. Federal Register Notice.pdf	Supplementary Document	Uploaded 2013-03-14	Available
Attachment 1. Authorizing Legislation.docx	Supplementary Document	Uploaded 2013-03-14	Available
Attachment 3c. CCDE Data Users Manual.docx	Supplementary Document	Uploaded 2013-03-14	Available
0920-0745_SS Part A_2 25 2013.docx	Supporting Statement A	Uploaded 2013-03-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
179138	Cost Assessment Tool	Other-Cost Assessment Tool	Modified
179134	Clinical Data Elements (CCDE)	Other-Data Definition Table	Modified

ICR Details

OMB Control No: 0920-0745	ICR Reference No: 201304-0920-004
Status: Historical Active	Previous ICR Reference No: 201004-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 19143
Title: Colorectal Cancer Screening Program
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: 04/29/2013
	Date Received in OIRA: 04/04/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2016	36 Months From Approved	06/30/2013
Responses	10,904	0	9,776
Time Burden (Hours)	3,357	0	3,010
Cost Burden (Dollars)	0	0	0

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Abstract: CDC funds 29 cooperative agreement awardees to increase population-based colorectal cancer (CRC) screening and to reduce health disparities in CRC screening, incidence and mortality. CDC collects programmatic-level activity cost data and de-identified patient-level demographic, screening, diagnostic, treatment and outcome data. An Extension for three years is requested.

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Authorizing Statute(s): US Code: 42 USC 301 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:
	78 FR 3430	01/16/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 18595	03/27/2013
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Clinical Data Elements (CCDE)
Cost Assessment Tool

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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	10,904	9,776	0	0	1,128	0
Annual Time Burden (Hours)	3,357	3,010	0	0	347	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: No

Burden Reduction Due to:

Short Statement: This extension request shows an increase in burden due to an increase in the number of grantees.

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Annual Cost to Federal Government: $829,385

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: 04/04/2013

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