ASSESSING THE INFRASTRUCTURE FOR PUBLIC STD PREVENTION SERVICES

Forms and Documents

Document Name	Status
SHD Survey Form and Instruction	New
LHD Survey Form and Instruction	New
SSB.docx Supporting Statement B	2017-08-14
SSA 0920-17NS Assessing Infrastructure 14AUG2017.docx Supporting Statement A	2017-08-14
Att 10_web survey reminders - LHD and SHD.docx Supplementary Document	2017-06-13
Att 9_Web Survey Invite LHD and SHD.docx Supplementary Document	2017-06-13
Att 2_60-Day FRN.pdf Supplementary Document	2017-06-13
Att 8_ProjectDeterminationForm.pdf Supplementary Document	2017-06-13
Att 7_Definitions for Survey Terms.docx Supplementary Document	2017-06-13
Att 1_Sect 301 PHSA.doc Supplementary Document	2017-06-13

IC Document Collections

IC ID	Document Title	Status
227898	SHD Survey Form and Instruction	New
227897	LHD Survey Form and Instruction	New

ICR Details

OMB Control No: 0920-1210	ICR Reference No: 201706-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-17NS
Title: ASSESSING THE INFRASTRUCTURE FOR PUBLIC STD PREVENTION SERVICES
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: 12/22/2017
	Date Received in OIRA: 08/17/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2020	36 Months From Approved
Responses	378	0	0
Time Burden (Hours)	146	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The goal of this study is to monitor STD preventive and clinical treatment services provided by local and state health departments. Web surveys will be sent to a sample of 668 local health departments & all 50 state health departments. Reminders will be sent to non-responders in order to reach the target of 334 completed local health department & 44 state health departments. Data will be used to help CDC assess the delivery of timely public STD preventive and clinical services to reduce the number of newly acquired STDs and prevent STD-related sequelae.

---

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

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:
	82 FR 12357	03/02/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 37860	08/14/2017
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
LHD Survey	NA	Local Health Department Survey
SHD Survey	NA	State Health Department Survey

---

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	378	0	0	378	0	0
Annual Time Burden (Hours)	146	0	0	146	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 0920-17NS - ASSESSING THE INFRASTRUCTURE FOR PUBLIC STD PREVENTION SERVICES is a New ICR.

---

Annual Cost to Federal Government: $151,026

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.     No

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.     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

---

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: 08/17/2017

---