Sudden Death in the Young Registry

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SDY Module - Forensic Pathologists	Form	New	Available
SDY Module - Neurologists	Form	New	Available
SDY Module - Epileptologists	Form	New	Available
SDY Module - Pediatric Cardiologists	Form	New	Available
SDY Module - State Health Personnel	Form	New	Available
Att 1b_SUDDEAA_12-9-15.pdf	Supplementary Document	Uploaded 2015-12-22	Available
Att 1a_PHSA_12-9-15.pdf	Supplementary Document	Uploaded 2015-12-22	Available
SS-B SDY 0920-15CT_12-9-15.docx	Supporting Statement B	Uploaded 2015-12-22	Available
SS-A SDY 0920-15CT_12-9-15.doc	Supporting Statement A	Uploaded 2015-12-22	Repair queued
Attachment 8_SDY Steering Committee members SDY 0920-15CT.docx	Supplementary Document	Uploaded 2015-07-23	Available
Attachment 7_NCRPCD secured login screen SDY 0920-15CT.docx	Supplementary Document	Uploaded 2015-07-23	Repair queued
Attachment 6_SDY grantees and expected case numbers SDY 0920-15CT.docx	Supplementary Document	Uploaded 2015-07-23	Available
Attachment 5_NCRPCD Case Reporting System Security Information SDY 0920-15CT.pdf	Supplementary Document	Uploaded 2015-07-23	Available
Attachment 4_MPHI Security Policy Number 06-02 SDY 0920-15CT.pdf	Supplementary Document	Uploaded 2015-07-23	Available
Research determination 684 Form SDY 0920-15CT.pdf	Supplementary Document	Uploaded 2015-07-23	Available
Attachment 2b_Summary of Public Comments.doc	Supplementary Document	Uploaded 2015-07-23	Available
Attachment 2_60-day FRN SDY 0920-15CT.pdf	Supplementary Document	Uploaded 2015-07-23	Available
Attachment 1_Applicable Laws SDY 0920-15CT.pdf	Supplementary Document	Uploaded 2015-07-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217626	SDY Module - Forensic Pathologists	Form	New
217625	SDY Module - Neurologists	Form	New
217624	SDY Module - Epileptologists	Form	New
217618	SDY Module - Pediatric Cardiologists	Form	New
217617	SDY Module - State Health Personnel	Form	New

ICR Details

OMB Control No: 0920-1092	ICR Reference No: 201507-0920-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15CT
Title: Sudden Death in the Young Registry
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: 12/24/2015
	Date Received in OIRA: 07/30/2015
Terms of Clearance: CDC will not be conducting any general research on the information collected from SDY cases within this pilot evaluation. When communicating findings from this collection, all publications will clearly describe the scope and limitations of the study findings.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2018	36 Months From Approved
Responses	13,500	0	0
Time Burden (Hours)	2,250	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Sudden Death in the Young Registry seeks to provide data improvement guidance to states that are already compiling information on children's deaths per their state's Child Death Review program mandate. This request seeks approval for 2 additional activities that state Child Death Review programs are not consistently performing: 1) convening a clinical review on a sub-set of cases and 2) entering that information into Child Death Review's existing Case Reporting System.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
   PL: Pub.L. 113 - 236 2 Name of Law: Sudden Unexpected Death Data Enhancement and Awareness 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:
	79 FR 65217	11/03/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 44129	07/24/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
SDY Module - Pediatric Cardiologists	NA	NCRPCD Case Reporting System - SDY Module
SDY Module - Epileptologists	NA	NCRPCD Case Reporting System - SDY Module
SDY Module - Neurologists	NA	NCRPCD Case Reporting System - SDY Module
SDY Module - Forensic Pathologists	NA	NCRPCD Case Reporting System - SDY Module
SDY Module - State Health Personnel	NA	NCRPCD Case Reporting System - SDY Module

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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	13,500	0	0	13,500	0	0
Annual Time Burden (Hours)	2,250	0	0	2,250	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: Submission of 0920-15CT is a New ICR.

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Annual Cost to Federal Government: $125,423

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 07/30/2015

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