Consumer Health Information in Public Libraries User Needs Survey (NLM)

Forms and Documents

Document Name	Status
Form 1 NLM ACA Survey Instrument Form and Instruction	New
30-day FRN 2016-02181.pdf Supplementary Document	2016-02-05
Attachment 3_ 60-day comment submission from ALA.pdf Supplementary Document	2016-02-01
NLM Supporting Statement B _ACA Survey 2016.docx Supporting Statement B	2016-02-01
NLM Supporting Statement A_ACA Survey 2016.docx Supporting Statement A	2016-02-01

IC Document Collections

IC ID	Document Title	Status
219924	NLM ACA Survey Instrument Form and Instruction	New

ICR Details

OMB Control No: 0925-0741	ICR Reference No: 201602-0925-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/NIH	Agency Tracking No:
Title: Consumer Health Information in Public Libraries User Needs Survey (NLM)
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: 06/03/2016
	Date Received in OIRA: 02/08/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved
Responses	779	0	0
Time Burden (Hours)	390	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The purpose of the proposed data collection is to conduct an online national anonymous survey of library staff to better understand challenges and successes of Patient Protection and Affordable Care Act (PPACA) information provision in public libraries. Data collection and analysis will be conducted by the University of Wisconsin-Madison Survey Center that has extensive expertise in such survey research. Questions will focus on library staff training in PPACA information provision, experience with PPACA information provision, resources used, challenges, successes, and information needs.

---

Authorizing Statute(s): US Code: 42 USC 286 Name of Law: Public Health and Welfare
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 66914	10/30/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 6283	02/05/2016
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
NLM ACA Survey Instrument	1	Attachment 1 NLM ACA Survey Instrument

---

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	779	0	0	779	0	0
Annual Time Burden (Hours)	390	0	0	390	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 request.

---

Annual Cost to Federal Government: $27,266

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]? Yes

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

---

Common Form ICR:  No

---

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: 02/08/2016

---