Occupational Health Safety Network (OHSN)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att H_IRB.pdf	Supplementary Document	Uploaded 2016-03-21	Available
Att B_Published 60d FRN.pdf	Supplementary Document	Uploaded 2016-03-21	Available
Att A_Authorizing Legislation.docx	Supplementary Document	Uploaded 2016-03-21	Available
OHSN Revised Sup Sta B.110316.docx	Supporting Statement B	Uploaded 2016-11-09	Available
OHSN_Revised Sup Sta A-110316.docx	Supporting Statement A	Uploaded 2016-11-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
220706	OHSN Data Upload file (XML format)	Other-WORD	New
220705	OHSN Enrollment Form	Other-WORD	New

ICR Details

OMB Control No: 0920-1144	ICR Reference No: 201603-0920-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16CQ
Title: Occupational Health Safety Network (OHSN)
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: 11/15/2016
	Date Received in OIRA: 03/30/2016
Terms of Clearance: Approved consistent with the understanding that due to the limitations inherent in the rate of participation in this network and the collection methods (i.e., participating hospitals will participate on a voluntary basis and no sampling methodology will be employed during recruitment of hospitals)—the information collected will not be representative of healthcare facilities throughout the US or any segment thereof. This will subsequently not permit for inter-facility comparisons of data. Any reports, presentations, or MMWR publications of the data collected will clearly specify that the OHSN is not a nationally or otherwise representative network of hospitals. The OHSN website will also refrain from describing any activities related to comparison of injury rates between facilities within the network.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2019	36 Months From Approved
Responses	3,900	0	0
Time Burden (Hours)	185	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is an Existing Collection in Use Without an OMB Control Number. The OHSN study collects data from hospital and other healthcare facilities to provide data needed to identify problem areas and work practices, evaluate the effectiveness of prevention efforts, and ultimately minimize or eliminate occupational injury among healthcare personnel working in hospitals or other healthcare facilities belonging to hospitals in the United States.

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Authorizing Statute(s): US Code: 29 USC 669 Name of Law: Occupational Safety and Health
  

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 69681	11/10/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 17166	03/28/2016
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
OHSN Data Upload file (XML format)
OHSN Enrollment Form

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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	3,900	0	0	3,900	0	0
Annual Time Burden (Hours)	185	0	0	185	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 anew OMB Control Number.

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Annual Cost to Federal Government: $342,608

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: 03/30/2016

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