Resources and Services Database of the National Prevention Information Network

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0255 Att3B_initial_quest_tele_scriptClean	Form and Instruction	Modified	Available
Form 0920-0255 Att3A_Initial_Res_Org_Quest	Form and Instruction	Modified	Available
Form 0920-0255 Att5A_email_verification_instructionsTrack	Form and Instruction	Modified	Available
Form 0920-0255 Att5_email_verification_instructionsClean	Form and Instruction	Modified	Available
Form 0920-0255 Att4A_email_verification_messageTrack	Form and Instruction	Modified	Available
Form 0920-0255 Att4 Email_verification_message	Form and Instruction	Modified	Available
Form 0920-0255 Att5A_email_verification_instructionsTrack	Form and Instruction	Modified	Available
Form 0920-0255 Att5_email_verification_instructionsClean	Form and Instruction	Modified	Available
Form 0920-0255 Att4A_email_verification_messageTrack	Form and Instruction	Modified	Available
Form 0920-0255 Att3C_tele_verification_script	Form and Instruction	Modified	Available
Form 3 Telephone Verification Sript	Form	Removed	Available
Form 3 Telephone Verification Script	Form	Removed	Available
Form 0920-0255 Att3C_tele_verification_script	Form and Instruction	Modified	Available
Form 0920-0255 Att3B_initial_quest_tele_scriptClean	Form and Instruction	Modified	Available
Form 0920-0255 Att3A_Initial_Res_Org_Quest	Form and Instruction	Modified	Available
Appendix F: Annual update Request (E-Mail)	Form and Instruction	Modified	Available
Form 0920-0255 Att3B_initial_quest_tele_scriptClean	Form and Instruction	Modified	Available
Form 0920-0255 Att3A_Initial_Res_Org_Quest	Form and Instruction	Modified	Repair queued
Appendix E: Annual update request (Telephone)	Form and Instruction	Modified	Available
Form 0920-0255 Att3B_initial_quest_tele_scriptClean	Form and Instruction	Modified	Available
Form 0920-0255 Att3A_Initial_Res_Org_Quest	Form and Instruction	Modified	Available
Support B.docx	Supporting Statement B	Uploaded 2013-11-12	Available
Att6B_ScreenShotsUpdatingExistingRecord.docx	Supplementary Document	Uploaded 2013-11-20	Available
Att6A_ScreenShotsAddingNewRecord.docx	Supplementary Document	Uploaded 2013-11-20	Available
Final_0920_0255_2010_att6_sample_NPIN_res_serv_db_record.docx	Supplementary Document	Uploaded 2010-11-08	Available
Final_0920_0255_2010_att5_email_verification_instructions.docx	Supplementary Document	Uploaded 2010-11-08	Available
Final_0920_0255_2010_att4_email_verification_message.docx	Supplementary Document	Uploaded 2010-11-08	Available
Final_0920_0255_2010_att6_sample_NPIN_res_serv_db_record.docx	Supplementary Document	Uploaded 2010-11-08	Available
Final_0920_0255_2010_att5_email_verification_instructions.docx	Supplementary Document	Uploaded 2010-11-08	Available
Final_0920_0255_2010_att4_email_verification_message.docx	Supplementary Document	Uploaded 2010-11-08	Available
Supporting Stmt A.docx	Supporting Statement A	Uploaded 2013-11-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6708	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Registered Nurses	Form and Instruction	Modified	Att3B_initial_quest_tele_scriptClean
6708	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Registered Nurses	Form and Instruction	Modified	Att3A_Initial_Res_Org_Quest
195473	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Human Service Assistants		Removed
195472	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Health Educators		Modified
195471	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers	Form and Instruction	Modified	Att5A_email_verification_instructionsTrack
195471	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers	Form and Instruction	Modified	Att5_email_verification_instructionsClean
195471	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers	Form and Instruction	Modified	Att4A_email_verification_messageTrack
195471	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers	Form and Instruction	Modified	Att4 Email_verification_message
178811	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Registered Nurses, Health Educators, and Social and Human Service Assistants	Form and Instruction	Modified	Att5A_email_verification_instructionsTrack
178811	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Registered Nurses, Health Educators, and Social and Human Service Assistants	Form and Instruction	Modified	Att5_email_verification_instructionsClean
178811	Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Registered Nurses, Health Educators, and Social and Human Service Assistants	Form and Instruction	Modified	Att4A_email_verification_messageTrack
178810	Social and Human Service Assistants	Form and Instruction	Modified	Att3C_tele_verification_script
178809	Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Health Educators	Form	Removed	Telephone Verification Sript
178808	Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Social and Community Service Managers	Form	Removed	Telephone Verification Script
178807	Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Registered Nurses, Social and Community Service Managers, and Health Educators	Form and Instruction	Modified	Att3C_tele_verification_script
178806	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Human Service Assistants	Form and Instruction	Modified	Att3B_initial_quest_tele_scriptClean
178806	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Human Service Assistants	Form and Instruction	Modified	Att3A_Initial_Res_Org_Quest
178806	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Human Service Assistants	Form and Instruction	Modified	Appendix F: Annual update Request (E-Mail)
178805	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Community Service Managers	Form and Instruction	Modified	Att3B_initial_quest_tele_scriptClean
178805	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Community Service Managers	Form and Instruction	Modified	Att3A_Initial_Res_Org_Quest
178805	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Community Service Managers	Form and Instruction	Modified	Appendix E: Annual update request (Telephone)
178804	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Health Educators	Form and Instruction	Modified	Att3B_initial_quest_tele_scriptClean
178804	Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Health Educators	Form and Instruction	Modified	Att3A_Initial_Res_Org_Quest

ICR Details

OMB Control No: 0920-0255	ICR Reference No: 201311-0920-017
Status: Historical Active	Previous ICR Reference No: 201011-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 20939
Title: Resources and Services Database of the National Prevention Information Network
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/30/2013
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/26/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2016	36 Months From Approved	01/31/2014
Responses	11,700	0	15,887
Time Burden (Hours)	1,932	0	2,599
Cost Burden (Dollars)	0	0	0

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Abstract: The National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) requests a 3-year approval for revisions to the previously approved information collection entitled, "Resources and Services Database of the National Prevention Information Network", (formerly known as the National AIDS Clearinghouse) of the Centers for Disease Control and Prevention (CDC) (OMB Control No. 0920-0255).This information collection expires on January 31, 2014.

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Authorizing Statute(s): PL: Pub.L. 100 - 607 301 Name of Law: Public Law
   US Code: 42 USC 241 Name of Law: Public Health Service
  

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 40481	07/05/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 68846	11/15/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Health Educators
Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Registered Nurses, Health Educators, and Social and Human Service Assistants	0920-0255, 0920-0255, 0920-0255	Att4A_email_verification_messageTrack ,   Att5_email_verification_instructionsClean ,   Att5A_email_verification_instructionsTrack
Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Community Service Managers	0920-0255, 0920-0255, 0920-0255, 0920-0255	Att4 Email_verification_message ,   Att4A_email_verification_messageTrack ,   Att5_email_verification_instructionsClean ,   Att5A_email_verification_instructionsTrack
Resources and Services Database of the CDC National Prevention Information Network - Email Verification: Social and Human Service Assistants
Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Health Educators	0920-0255, 0920-0255	Att3A_Initial_Res_Org_Quest ,   Att3B_initial_quest_tele_scriptClean
Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Registered Nurses	0920-0255, 0920-0255	Att3A_Initial_Res_Org_Quest ,   Att3B_initial_quest_tele_scriptClean
Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Community Service Managers	None, 0920-0255, 0920-0255	Appendix E: Annual update request (Telephone) ,   Att3A_Initial_Res_Org_Quest ,   Att3B_initial_quest_tele_scriptClean
Resources and Services Database of the CDC National Prevention Information Network - Initial Questionnaire Telephone Script: Social and Human Service Assistants	None, 0920-0255, 0920-0255	Appendix F: Annual update Request (E-Mail) ,   Att3A_Initial_Res_Org_Quest ,   Att3B_initial_quest_tele_scriptClean
Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Health Educators	3	Telephone Verification Sript
Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Registered Nurses, Social and Community Service Managers, and Health Educators	0920-0255	Att3C_tele_verification_script
Resources and Services Database of the CDC National Prevention Information Network - Telephone Verification: Social and Community Service Managers	3	Telephone Verification Script
Social and Human Service Assistants	0920-0255	Att3C_tele_verification_script

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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	11,700	15,887	0	-3,800	-387	0
Annual Time Burden (Hours)	1,932	2,599	0	-634	-33	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: Changing Forms

Short Statement: The only changes to the survey involve the number of organizations surveyed and a reduction in the number of registered nurses that must be surveyed. Previously, 200 new organizations to be added were surveyed, 10,000 organizations were surveyed for updated information, and 60% of organizations required input from a registered nurse and another health professional. Under this request, the number of new organizations has increased to 500 (CDC programmatic change); while the number of updated organizations has dropped to 9,000 (elimination of organizations that no longer offer services)

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Annual Cost to Federal Government: $764,100

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: 11/26/2013

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