Information Collection

Services and Value of Immunization Info Systems and Public Health Emergency Preparedness Capabilities

IC 213123 under ICR 201402-0920-018 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Services and Value of Immunization Info Systems and Public Health Emergency Preparedness Capabilities	Form
SVIS - Immunization Info Systems Assessment IIS_F-Online Instrument Web.docx	Form
SVIS - Immunization Info Systems Interview IIS_H-Interview Instrument.docx	Form
Public Health Preparedness Capabilities Assessment PDRA_O_PHEP Assessment_Web Version.docx	Form
IIS-ESV-SSA_revised.docx SVIS - Statement A	IC Document
IIS-ESV-SSB_revised.docx SVIS - Statement B	IC Document
IIS_A-CDC Grantee List.pdf SVIS - A:Grantee List	IC Document
IIS_B-IIS Functional Standards.pdf SVIS - B:Functional Standards	IC Document
IIS_C-Healthy People 2020.pdf SVIS - C:Healthy People Brochure	IC Document
IIS_D-Bartlett Study.pdf SVIS - D:Bartlett Study	IC Document
IIS_E-BRP Summary.pdf SVIS - E:BRP Summary	IC Document
IIS_G-Online Instrument Word.docx SVIS - G:Online Assessment - word	IC Document
IIS_I-Introductory Email.docx SVIS - I:Intro Email	IC Document
IIS_J-Interview Request.docx SVIS - J:Interview request	IC Document
IIS_K-Confirmation Interview.docx SVIS - K:Interview confirmation	IC Document
IIS_L - Reminder Email.docx SVIS - L:Reminder email	IC Document
SIART-PDRA-SSA_revised.docx PRDA - Statement A	IC Document
SIART-PDRA-SSB_revised.docx PRDA - Statement B	IC Document
PDRA_A_PH Services.pdf PRDA - A:Essential PH Services	IC Document
PDRA_B_PHAB Standards_Measures.pdf PRDA - B:Standards and Measures	IC Document
PDRA_C_ESF 08.pdf PRDA - C:Emergency Support Function	IC Document
PDRA_D_2013 PHEP Funding.pdf PRDA - D:Preparedness funding	IC Document
PDRA_E_CDC PHPR Capabilities.pdf PRDA - E:Preparedness Summary	IC Document
PDRA_F_Research Priorities.pdf PRDA - F:Research Priorities in Preparedness	IC Document
PDRA_G_PERRC Fact Sheet.pdf PRDA - G:Response Research Centers	IC Document
PDRA_H_PERLC Fact Sheet.pdf PRDA - H:Response Learning Centers	IC Document
PDRA_I_PERRC Updates.pdf PRDA - I:Program updates	IC Document
PDRA_J_APC Products.pdf PRDA - J:APC Products	IC Document
PDRA_K_RWJF PBRN Report.pdf PRDA - K:Progress report	IC Document
PDRA_L_Evidence Report Mass Casualty Event.pdf PRDA - L:Evidence report	IC Document
PDRA_M_PHEP Legal Checklist.pdf PRDA - M:Legal Coordination for Preparedness	IC Document
PDRA_N_PHEP Assessment_Word Version.docx PRDA - N:Assessment - word	IC Document
PDRA_P_ASTHO Advance Email.docx PRDA -P:Advance email	IC Document
PDRA_Q_NACCHO Advance Email.docx PRDA - Q:NACCHO Advance Email	IC Document
PDRA_R_Notification Email_States.docx PRDA -R:State Notification	IC Document
PDRA_S_Notification Email_Locals.docx PRDA - S:Local Director Notification	IC Document
PDRA_T_Reminder Email_Non-response.docx PRDA - T:Reminder	IC Document
PDRA_U_Reminder Email_Partial Response.docx PRDA -U:Reminder	IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:

Services and Value of Immunization Info Systems and Public Health Emergency Preparedness Capabilities

Agency IC Tracking Number:

14AXS/14AXR

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	SVIS - Immunization Info Systems Assessment	IIS_F-Online Instrument Web.docx	Yes	Yes	Fillable Fileable
Form	none	SVIS - Immunization Info Systems Interview	IIS_H-Interview Instrument.docx	Yes	Yes	Fillable Fileable
Form	none	Public Health Preparedness Capabilities Assessment	PDRA_O_PHEP Assessment_Web Version.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 454

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 80 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	454	454
Annual IC Time Burden (Hours)	435	435
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SVIS - Statement A	IIS-ESV-SSA_revised.docx	09/15/2014
SVIS - Statement B	IIS-ESV-SSB_revised.docx	09/15/2014
SVIS - A:Grantee List	IIS_A-CDC Grantee List.pdf	09/15/2014
SVIS - B:Functional Standards	IIS_B-IIS Functional Standards.pdf	09/15/2014
SVIS - C:Healthy People Brochure	IIS_C-Healthy People 2020.pdf	09/15/2014
SVIS - D:Bartlett Study	IIS_D-Bartlett Study.pdf	09/15/2014
SVIS - E:BRP Summary	IIS_E-BRP Summary.pdf	09/15/2014
SVIS - G:Online Assessment - word	IIS_G-Online Instrument Word.docx	09/15/2014
SVIS - I:Intro Email	IIS_I-Introductory Email.docx	09/15/2014
SVIS - J:Interview request	IIS_J-Interview Request.docx	09/15/2014
SVIS - K:Interview confirmation	IIS_K-Confirmation Interview.docx	09/15/2014
SVIS - L:Reminder email	IIS_L - Reminder Email.docx	09/15/2014
PRDA - Statement A	SIART-PDRA-SSA_revised.docx	09/15/2014
PRDA - Statement B	SIART-PDRA-SSB_revised.docx	09/15/2014
PRDA - A:Essential PH Services	PDRA_A_PH Services.pdf	09/15/2014
PRDA - B:Standards and Measures	PDRA_B_PHAB Standards_Measures.pdf	09/15/2014
PRDA - C:Emergency Support Function	PDRA_C_ESF 08.pdf	09/15/2014
PRDA - D:Preparedness funding	PDRA_D_2013 PHEP Funding.pdf	09/15/2014
PRDA - E:Preparedness Summary	PDRA_E_CDC PHPR Capabilities.pdf	09/15/2014
PRDA - F:Research Priorities in Preparedness	PDRA_F_Research Priorities.pdf	09/15/2014
PRDA - G:Response Research Centers	PDRA_G_PERRC Fact Sheet.pdf	09/15/2014
PRDA - H:Response Learning Centers	PDRA_H_PERLC Fact Sheet.pdf	09/15/2014
PRDA - I:Program updates	PDRA_I_PERRC Updates.pdf	09/15/2014
PRDA - J:APC Products	PDRA_J_APC Products.pdf	09/15/2014
PRDA - K:Progress report	PDRA_K_RWJF PBRN Report.pdf	09/15/2014
PRDA - L:Evidence report	PDRA_L_Evidence Report Mass Casualty Event.pdf	09/15/2014
PRDA - M:Legal Coordination for Preparedness	PDRA_M_PHEP Legal Checklist.pdf	09/15/2014
PRDA - N:Assessment - word	PDRA_N_PHEP Assessment_Word Version.docx	09/15/2014
PRDA -P:Advance email	PDRA_P_ASTHO Advance Email.docx	09/15/2014
PRDA - Q:NACCHO Advance Email	PDRA_Q_NACCHO Advance Email.docx	09/15/2014
PRDA -R:State Notification	PDRA_R_Notification Email_States.docx	09/15/2014
PRDA - S:Local Director Notification	PDRA_S_Notification Email_Locals.docx	09/15/2014
PRDA - T:Reminder	PDRA_T_Reminder Email_Non-response.docx	09/15/2014
PRDA -U:Reminder	PDRA_U_Reminder Email_Partial Response.docx	09/15/2014

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.