Investigating the Implementation and Evaluation of Top-ranked HSMS Elements

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment F_HSRB 14-OMSHR-11XM 112614 approval HaasE HSMS element.pdf	Supplementary Document	Uploaded 2015-07-06	Available
Attachment D_Informed Consent Form.docx	Supplementary Document	Uploaded 2015-07-06	Available
Attachment B - 60-day - 2014-29252.pdf	Supplementary Document	Uploaded 2015-07-06	Available
Attachment A_MSHA.doc	Supplementary Document	Uploaded 2015-07-06	Available
HSMS Imple SupStaB_02.04.15.docx	Supporting Statement B	Uploaded 2015-07-06	Available
HSMS Imple SupSta A_7 22 15.docx	Supporting Statement A	Uploaded 2015-07-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217328	Interview/Focus Group Protocol	Other-WORD	New
217327	Mine Recruitment Script	Other-WORD	New

ICR Details

OMB Control No: 0920-1089	ICR Reference No: 201507-0920-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15GJ
Title: Investigating the Implementation and Evaluation of Top-ranked HSMS Elements
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: 12/15/2015
	Date Received in OIRA: 08/11/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved
Responses	41	0	0
Time Burden (Hours)	31	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This study aims to determine and assess the optimal use of health and safety management system (HSMS) elements and practices to understand how to best manage and execute a safety system within mining. Interviews and focus groups will occur with mine health and safety managers of various mining commodities and take no more than 60 minutes of respondents' time. Data will be coded using HSMS elements and practices as categorizing mechanisms. Data will be used to provide suggestions to mine health and safety operators and industry about best practices in HSMS implementation and evaluation.

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Authorizing Statute(s): PL: Pub.L. 95 - 164 501 Name of Law: Federal Mine Safety & Health Act of 1977
  

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 74098	12/15/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 44964	07/28/2015
Did the Agency receive public comments on this ICR? No

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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
Interview/Focus Group Protocol
Mine Recruitment 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	41	0	0	41	0	0
Annual Time Burden (Hours)	31	0	0	31	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 collection request for a new OMB Control Number.

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Annual Cost to Federal Government: $14,438

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: 08/11/2015

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