Image-Assisted Cytology Workload Assessment and Measure

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Change Request 1-30-14.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2014-01-30	Available
Change Request 1-30-14.docx	Supplementary Document	Uploaded 2014-01-30	Available
Final Survey Reminder Email 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Second Survey Reminder Email 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Initial Survey Reminder Email 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Introductory Email Letter 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Survey Cover Letter 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Change Request 1-30-14.docx	Supplementary Document	Uploaded 2014-01-30	Available
Final Survey Reminder Email 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Repair queued
Second Survey Reminder Email 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Introductory Email Letter 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Initial Survey Reminder Email 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available
Survey Cover Letter 12-12-13.docx	Supplementary Document	Uploaded 2014-01-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
208767	Image-Assisted Cytology Workload Assessment Survey--Cytotechnologists	Other-PDF	Modified
208766	Image-Assisted Cytology Workload Practices Survey--Laboratory	Other-WORD	Modified

ICR Details

OMB Control No: 0920-1000	ICR Reference No: 201401-0920-010
Status: Historical Active	Previous ICR Reference No: 201309-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 21365
Title: Image-Assisted Cytology Workload Assessment and Measure
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/03/2014
	Date Received in OIRA: 01/31/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	12/31/2014	12/31/2014
Responses	5,577	0	5,577
Time Burden (Hours)	2,789	0	2,789
Cost Burden (Dollars)	0	0	0

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Abstract: The primary change request is to reformat the survey instrument forms to deliver the survey via Survey Monkey as a single online survey, rather than two paper surveys to be delivered by mail. There are corresponding changes in the format of the survey due to change in the delivery mode. The reason for the request to change to an online delivery format is to increase the efficiency of completing the survey. The online format also allows for skip logic patterns to be included in the survey which will assure that respondents are not asked questions that are not applicable based on their previous responses; this will be a benefit to respondents in reducing response errors.

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Authorizing Statute(s): PL: Pub.L. 42 - 493 1274 Name of Law: Clinical Laboratory Improvement Amendments of 1988
  

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 18983	03/28/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 55258	09/10/2013
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
Image-Assisted Cytology Workload Practices Survey--Laboratory
Image-Assisted Cytology Workload Assessment Survey--Cytotechnologists

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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	5,577	5,577	0	0	0	0
Annual Time Burden (Hours)	2,789	2,789	0	0	0	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:

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Annual Cost to Federal Government: $189,658

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: 01/31/2014

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