Awardee Lead Profile Assessment (ALPA)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Awardee Lead Profile Assessment (ALPA) Questionnaire	Form and Instruction	New	Available
Att 9 Research Determination EH17-1701PPHF17 signed OS.pdf	Supplementary Document	Uploaded 2017-10-19	Available
Att 8 Follow-Up Email_07-25-2017.docx	Supplementary Document	Uploaded 2017-10-19	Repair queued
Att 7 Invitation to Participate_07-25-2017.docx	Supplementary Document	Uploaded 2017-10-19	Available
Att 3 FY17 FOA.pdf	Supplementary Document	Uploaded 2017-10-19	Available
SS Part B 18OCT2017.docx	Supporting Statement B	Uploaded 2017-10-18	Available
SS Part A 18OCT2017.docx	Supporting Statement A	Uploaded 2017-10-18	Available
Att 2a Public Comment Received_60FRN.pdf	Supplementary Document	Uploaded 2017-10-17	Available
Att 2 60-day FRN_ALPA.pdf	Supplementary Document	Uploaded 2017-10-17	Available
Att 1 Authorizing Legislation_STATUTE-102-Pg2884 (TEXT Lead Contamination Control Act).pdf	Supplementary Document	Uploaded 2017-10-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
228696	Awardee Lead Profile Assessment (ALPA) Questionnaire	Form and Instruction	New

ICR Details

OMB Control No: 0920-1215	ICR Reference No: 201710-0920-009
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-17ADS
Title: Awardee Lead Profile Assessment (ALPA)
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: 02/09/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/24/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved
Responses	48	0	0
Time Burden (Hours)	6	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is an annual assessment disseminated to project managers of funded lead poisoning prevention programs under the cooperative agreement that will be used to identify jurisdictional legal frameworks governing CDC-funded childhood lead poisoning prevention programs in the United States. This assessment will also identify strategies for implementing childhood lead poisoning prevention activities and allow the CDC Healthy Homes and Lead Poisoning Prevention Program (HHLPPP) to identify common characteristics of funded childhood lead poisoning programs and inform guidance resource development and technical assistance activities conducted by the program.

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Authorizing Statute(s): PL: Pub.L. 114 - 322 2204 Name of Law: Water Infrastructure Improvements for the Nation
   US Code: 42 USC 241 Name of Law: U.S. Public Health Service Act
  

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:
	82 FR 19375	04/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 48815	10/20/2017
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Awardee Lead Profile Assessment (ALPA) Questionnaire	NA, NA	ALPA Questionnaire - Web version ,   ALPA Questionnaire - Word format

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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	48	0	0	48	0	0
Annual Time Burden (Hours)	6	0	0	6	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: 0920-17ADS is a New ICR, designed to identify strategies for implementing childhood lead poisoning prevention activities.

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Annual Cost to Federal Government: $1,640,000

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? 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

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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: 10/24/2017

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