Enhanced STD Surveillance Network

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Gonnorhea Case Surveillance	Form and Instruction	New	Available
Gonorrhea Patient Interview	Form and Instruction	New	Available
STD Clinic-based Surveillance	Form and Instruction	New	Available
Program responses.docx	Supplementary Document	Uploaded 2015-06-15	Available
Attachment 4_List of Cycle 3 collaborators.docx	Supplementary Document	Uploaded 2014-12-17	Available
att3A_IntegratedProtocol_FinalDraft_December2014.pdf	Supplementary Document	Uploaded 2014-12-17	Available
Att 2B- Non Substantive Comment.docx	Supplementary Document	Uploaded 2014-12-17	Available
Att 2A_ 60 DayFRN.pdf	Supplementary Document	Uploaded 2014-12-17	Available
Att 1 Legis.pdf	Supplementary Document	Uploaded 2014-12-17	Available
SSB_12092014.doc	Supporting Statement B	Uploaded 2014-12-17	Available
SSA_12092014.docx	Supporting Statement A	Uploaded 2014-12-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
214282	Gonnorhea Case Surveillance	Form and Instruction	New
214281	Gonorrhea Patient Interview	Form and Instruction	New
214279	STD Clinic-based Surveillance	Form and Instruction	New

ICR Details

OMB Control No: 0920-1072	ICR Reference No: 201412-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 14AQA
Title: Enhanced STD Surveillance Network
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/22/2015
	Date Received in OIRA: 12/23/2014
Terms of Clearance: Before this ICR is renewed, efforts must be taken and explained in the Supporting Statement to increase internal coordination of CDC activities to reduce burden on the states from multiple STD reporting systems.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2018	36 Months From Approved
Responses	3,477	0	0
Time Burden (Hours)	2,854	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Enhanced STD Surveillance Network (eSSuN) is a network of local and state health departments (10) who perform active surveillance and provide detailed information on demographic characteristics, behavioral risk factors, and clinical history 1) on persons who attend participating STD clinics and Family planning/ Reproductive health clinics in one of the 10 cities around the US and 2) on a random sample of persons diagnosed with gonorrhea within the participating SSuN jurisdictions. This information will enable public health officials to understand important characteristics of persons tested, diagnosed, and treated for STDs, inform and guide state/local and national programs and policies for STD control, and identify and evaluate the effectiveness of public health interventions to reduce STD morbidity.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: PHSA
  

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:
	79 FR 46825	08/11/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 75813	12/19/2014
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Gonnorhea Case Surveillance	none	Case Surveillance by Health Department Manager
STD Clinic-based Surveillance	none	Facility Surveillance Data Elements
Gonorrhea Patient Interview	none	Patient Interview 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	3,477	0	0	3,477	0	0
Annual Time Burden (Hours)	2,854	0	0	2,854	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR.

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Annual Cost to Federal Government: $2,695,020

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: 12/23/2014

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