Survey of Sexually Transmitted Diseases (STD) Provider Policies and Practices in the United States

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Web Survey of STD Provider Practices	Form	New	Available
Mail Survey of STD Provider Practices	Form	New	Available
Att 11_IRB approval.pdf	Supplementary Document	Uploaded 2017-02-15	Available
Att 10_Thank you Letter.docx	Supplementary Document	Uploaded 2017-02-15	Repair queued
Att 9_Web Survey Reminder.docx	Supplementary Document	Uploaded 2017-02-15	Available
Att 8_Web Survey Invite.docx	Supplementary Document	Uploaded 2017-02-15	Available
Att 7_Mail Survey Reminder 2.docx	Supplementary Document	Uploaded 2017-02-15	Available
Att 6_ Mail Survey Reminder 1.docx	Supplementary Document	Uploaded 2017-02-15	Available
Att 5_Mail Survey Invite.docx	Supplementary Document	Uploaded 2017-02-15	Available
Att 2a_Public Comments_Responses.docx	Supplementary Document	Uploaded 2017-02-15	Available
Att 2 60 Day FRN.pdf	Supplementary Document	Uploaded 2017-02-15	Available
Att 1_Sect 301 PHSA.doc	Supplementary Document	Uploaded 2017-02-15	Available
SSB.docx	Supporting Statement B	Uploaded 2017-02-15	Available
0920-16BFQ_SSA_Survey of STD Provider policies clean11-09.docx	Supporting Statement A	Uploaded 2017-11-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
225725	Web Survey of STD Provider Practices	Form	New
225724	Mail Survey of STD Provider Practices	Form	New

ICR Details

OMB Control No: 0920-1207	ICR Reference No: 201702-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16BFQ
Title: Survey of Sexually Transmitted Diseases (STD) Provider Policies and Practices in the United States
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: 11/17/2017
	Date Received in OIRA: 03/28/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2020	36 Months From Approved
Responses	3,500	0	0
Time Burden (Hours)	1,342	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The goal of the study is to better understand policies and practices for STD care delivery among medical providers in 5 specialties. A secondary goal is to assess awareness and use of CDC STD treatment guidelines. The survey will allow DSTDP to make comparisons over time for provider practices related to STD screening, clinical actions and partner notification.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

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:
	81 FR 68417	10/04/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 15221	03/27/2017
Did the Agency receive public comments on this ICR? Yes

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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
Web Survey of STD Provider Practices	none	Survey of STD Provider Practices
Mail Survey of STD Provider Practices	none	Survey of STD Provider Practices

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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	3,500	0	0	3,500	0	0
Annual Time Burden (Hours)	1,342	0	0	1,342	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.

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Annual Cost to Federal Government: $465,248

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 03/28/2017

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