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pdfDate: 3/7/2017
PAPERWORK REDUCTION ACT (PRA)
EXECUTIVE SUMMARY FORM
TITLE OF COLLECTION:
2017 National Survey of Children’s Health (NSCH)
OMB CONTROL NUMBER:
0607-0990
DIVISION/PROGRAM OFFICE:
Associate Director of Demographic Programs – Survey Operations (ADDP – SO)
AGENCY CONTACT:
Jason M. Fields
TYPE OF INFORMATION COLLECTION REQUEST:
☐
☒
☐
☐
☐
☐
New collection
Revision of a currently approved collection
[current expiration date: 4/30/2019]
Extension, without change, of a currently approved collection
[current expiration date: Enter date]
Reinstatement, without change, of a previously approved collection for which approval has expired
Reinstatement, with change, of a previously approved collection for which approval has expired
Existing collection in use without an OMB Control Number
PURPOSE OF COLLECTION:
Sponsored by the U.S. Department of Health and Human Services’ (HHS’) Health Resources Services Administration’s
Maternal and Child Health Bureau (HRSA MCHB), the National Survey of Children’s Health (NSCH) is designed to
produce data on the physical and emotional health of American children under 18 years of age. The NSCH collects
information on factors related to the well-being of children, including access to health care, in-home medical care,
family interactions, parental health, school and after-school experiences, and neighborhood characteristics.
For the 2017 NSCH, a sample frame of 156,054 household addresses will be used. The sample file is selected from the
Census Master Address File (MAF) and supplemented with an administrative records-based flag identifying households
with children. The target population consists of children aged 17 or younger living in mailable residential housing units
in the United States.
DATA COLLECTION START DATE:
7/19/2017
REQUESTED OMB EXPIRATION DATE:
☒
60-DAY FEDERAL REGISTER CITATION:
MANDATORY OR VOLUNTARY
COLLECTION?
Three years from approval date
81 FR 95562-95565
☐ Mandatory
☐
Other date: [d
a
te]
DATE PUBLISHED: 12/28/2016
☒ Voluntary
☐ N/A
IS THIS A REIMBURSABLE COLLECTION CONDUCTED BY CENSUS ON BEHALF OF ANOTHER AGENCY/ENTITY?
☒ Yes
[Specify agency/entity: HRSA MCHB ]
☐ No
☐ Shared Sponsorship
Version 1.2 (2/17/17)
[Specify agency/entity:
]
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Date: 3/7/2017
LEGAL AUTHORITY(IES) FOR INFORMATION COLLECTION:
Census Authority: 13 U.S.C. Section 8(b)
HRSA MCHB Authority: Section 501(a)(2) of the Social Security Act (42 USC §701)
USDA Authority: The Healthy, Hunger-Free Kids Act of 2010, Pub. L. 111-296. In particular, 42 U.S.C. 1769d(a)
authorizes USDA to conduct research on the causes and consequences of childhood hunger included in 1769d(a)(4)(B),
the geographic dispersion of childhood hunger and food insecurity.
CDC/NCBDDD Authority: Public Health Service Act, Section 301, 42 U.S.C. § 241
EPA Authority: FIFRA: Section 20(a); Toxic Substances Control Act: Section 10; 15 U.S.C. § 2609
SURVEY INFORMATION:
What is the source of the sampling frame for this collection? Census Master Address File (MAF)
What are the mode(s) for collection?
☒ Paper
☒ Internet
☐ Computer Assisted Personal Interviewing (CAPI)
☐ Computer Assisted Telephone Interviewing (CATI)
☒ Other Telephone Questionnaire Assistance (TQA) has the
ability to collect responses over the phone when respondents call in through the Centurion Web Instrument
PUBLIC BURDEN:
Average Estimated Time per Response:
Hours
5-30 Minutes
ANNUAL REPORTING AND RECORDKEEPING HOUR BURDEN:
Number of Respondents
81,805
Number of Responses
81,805
Requested Annual Burden Hours
16,573
Current Annual OMB Inventory
54,117
Difference (+, -)
-37,544
Reason for Difference in Burden Hours:
☒ Program Change
☐ Adjustment
☐ No Difference
Explanation of Difference (if applicable): Due to budgetary limitations, the sponsoring agency had to reduce the sample size
of the survey from 2016 to 2017 which then in turn reduced the number of respondents and total annual burden hours.
PRIVACY ACT (PA):
Is this collection a Privacy Act System
of Records?
☐ No
☒ Yes
- If yes, a Privacy Act Statement that identifies the appropriate
Systems of Records Notice (SORN) is required.
TITLE 13 CONFIDENTIALITY:
Is this collection of information confidential under Title 13, Section 9?
Version 1.2 (2/17/17)
☒ Yes
☐ No
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Date: 3/7/2017
If yes, has the confidentiality pledge been updated per the Federal
Cybersecurity Enhancement Act of 20151?
☒ Yes
☐ No
Has the respondent messaging been reviewed and updated in the
collection materials per the “Updates to Census Bureau Confidentiality
Messaging and PRA Required Language” memo, if applicable?
☒ Yes
☐ No
PLACEMENT OF REQUIRED PAPERWORK REDUCTION ACT AND PRIVACY ACT LANGUAGE: In the table below, please indicate
where the following PRA/PA statement requirements are located in the respondent materials:
Required PRA/PA Language
PRA
PA
Invitation
Collection
FAQs
Instructions
Statement
letter
Instrument
Other
N/A
Reason/purpose for the information
collection, including the way the
information will be used.
X
X
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☒
☒
☐
☐
The legal authority(ies) that authorize the
collection of information.
X
X
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☒
☒
☐
☐
Whether responses are mandatory or
voluntary (citing the authority)
X
X
☒
☒
☒
☐
☐
The nature and extent of confidentiality to
be provided (if any) citing authority
X
☒
☒
☒
☐
☐
An estimate of the average respondent
burden together with a request that the
public direct to the agency any comments
concerning the accuracy of this burden
estimate and any suggestions for reducing
this burden
X
☒
☒
☒
☐
☐
OMB control number
X
☒
☒
☒
☐
☐
A statement that an agency may not
conduct (and a person is not required to
respond to) an information collection
request unless it displays a currently valid
OMB control number.
X
☒
☐
☐
☐
☐
Published routine use for which
information is subject and citation to
relevant SORN
X
☐
☐
☒
☐
☐
The effects on the individual for not
providing the requested information
X
☒
☐
☒
☐
☐
1
Please refer to the “Updates to Census Bureau Confidentiality Messaging and PRA Required Language” Memo
Version 1.2 (2/17/17)
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Date: 3/7/2017
PLACEMENT OF REQUIRED PAPERWORK REDUCTION ACT AND PRIVACY ACT LANGUAGE: In the table below, please indicate
where the following PRA/PA statement requirements are located in the respondent materials:
Required PRA/PA Language
PRA
PA
Invitation
Collection
FAQs
Instructions
Statement
letter
Instrument
Other
N/A
Comments:
ADDITIONAL INFORMATION:
Please include any special circumstances or other information that would help expedite the review of this package
(ex. if the collection is at the request of a congressional inquiry).
Clearance needed no later than 6/15/17 in order to allow for enough time for overprinting on the paper questionnaires
and initial invite letters.
Version 1.2 (2/17/17)
4|Page
File Type | application/pdf |
Author | Ramon Taylor (CENSUS/PCO FED) |
File Modified | 2017-04-12 |
File Created | 2017-04-12 |