Public Health Systems, Mental Health and Community Recovery Project

Forms and Documents

Document Name	Status
Household Survey for General Public_Study Screener Form	Modified
Household Survey (Telephone) for General Public and Consent Form	Modified
OMB Control No 0920-0993 NonSubstantive Change Request Justification.docx Justification for No Material/Nonsubstantive Change	2014-03-04

IC Document Collections

IC ID	Document Title	Status
208429	Household Survey for General Public_Study Screener Form	Modified
208428	Household Survey (Telephone) for General Public and Consent Form	Modified
208427	Key Informant Interview Guide_Community Organization Respondents Other-Interview Guide	Modified
208426	Key Informant Interview Guide_PH/MH Agency Staff Other-Key Informant Interview Guide_PH/MH Agency Staff	Modified

ICR Details

OMB Control No: 0920-0993	ICR Reference No: 201403-0920-001
Status: Historical Active	Previous ICR Reference No: 201308-0920-012
Agency/Subagency: HHS/CDC	Agency Tracking No: 21533
Title: Public Health Systems, Mental Health and Community Recovery Project
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: 03/12/2014
	Date Received in OIRA: 03/05/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2015	09/30/2015	09/30/2015
Responses	8,790	0	8,790
Time Burden (Hours)	1,706	0	1,706
Cost Burden (Dollars)	0	0	0

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Abstract: The CDC is requesting minor changes to the household screener and household survey for this project. This project stems from, and aligns with, publication of the Office of Public Health Preparedness and Response's (OPHPR) "National Strategic Plan for Public Health Preparedness and Response" which provides overall direction for Centers for Disease Control and Prevention's (CDC) preparedness and response portfolio, including programmatic direction across OPHPR's four divisions. The focus of this project is to generate findings useful for future preparedness planning and response in order to develop strategies and interventions aimed at mitigating the impact of adverse events. In April 2011, one of the largest tornado outbreaks ever recorded, a "Super Outbreak," occurred in the southeastern United States, resulting in more than 300 deaths and an estimated $11 million in damages. CDC, in collaboration with ICF International, will conduct a mixed method evaluation utilizing key informant interviews of public health and mental health agency staff and other community representatives at the local, county and State levels and household survey data in each of the communities to assess community recovery and resilience. Specifically, the study design includes two main components (qualitative and quantitative) designed to comprehensively examine the PH/MH system response to and community recovery and resilience from disasters.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health and Welfare--Research and Investigations Generally
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Key Informant Interview Guide_PH/MH Agency Staff	None	Key Informant Interview Guide_Consent Form
Key Informant Interview Guide_Community Organization Respondents	None	Key Informant Interview Guide_Consent Form
Household Survey (Telephone) for General Public and Consent	none	Household Survey and Consent
Household Survey for General Public_Study Screener	none	Household Screener

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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	8,790	8,790	0	0	0	0
Annual Time Burden (Hours)	1,706	1,706	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: $457,384

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: 03/05/2014

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