Healthy People User Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-Attachment 3_Cover letter to healthy people coordinators_Final_1 26 15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Attachment 4_Cover letter to local and tribal health officials_Final_1 26_15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Attachment 5_Cover letter to senior deputy directors_Final_1 26 15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Attachment 6_Cover letter to healthy people consortium members_Final_1 26 15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Attachment 7_Cover letter to healthy people webinar attendees_Final_1 26 15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Attachment 8_Cover letter to tribal area health board officials_Final_1 26_15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Attachment 9_Cover letter to tribal leader_Final_1 26 15.doc	Supplementary Document	Uploaded 2015-06-12	Available
0990-Healthy People User Study Section B.docx	Supporting Statement B	Uploaded 2015-06-12	Available
0990-HPUS 2014 FINAL OMB package_Revised 6.10.15.docx	Supporting Statement A	Uploaded 2015-06-12	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217013	Healthy People Webinar Attendees	Other-webinar survey	New
217011	Healthy People Consortium Organizations	Other-survey	New
217010	Tribal Area Health Boards	Other-survey	New
217006	Tribal Health Organizations	Other-survey	New
217005	Local Health Organizations	Other-survey	New
217004	Senior Deputy Directors	Other-survey	New
216973	Healthy People State Coordinators	Other-survey	New

ICR Details

OMB Control No: 0990-0437	ICR Reference No: 201503-0990-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Healthy People User Study
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 without change	Conclusion Date: 08/31/2015
	Date Received in OIRA: 06/17/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2018	36 Months From Approved
Responses	1,102	0	0
Time Burden (Hours)	331	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Healthy People initiative has provided a comprehensive set of data-driven, national disease prevention and health promotion objectives with 10-year targets aimed at improving the health of all Americans since 1979. Healthy People 2020 (HP2020) is the fourth iteration of the Healthy People initiative. Its overarching goals are: to attain high-quality, longer lives free of preventable disease, disability, injury, and premature death; to achieve health equity, eliminate disparities, and improve the health of all groups; to create social and physical environments that promote good health for all; and to promote quality of life, healthy development, and health behaviors across all life stages. HP2020 consists of over 1200 objectives organized under 42 topic areas.

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Authorizing Statute(s): US Code: 30 USC 241 Name of Law: U.S. Public Health Service Act
  

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:
	80 FR 13573	03/16/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 34443	06/16/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Senior Deputy Directors
Local Health Organizations
Tribal Health Organizations
Tribal Area Health Boards
Healthy People Consortium Organizations
Healthy People Webinar Attendees
Healthy People State Coordinators

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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	1,102	0	0	1,102	0	0
Annual Time Burden (Hours)	331	0	0	331	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 a new collection.

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Annual Cost to Federal Government: $267,222

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: 06/17/2015

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