Who’s at Risk: From Hazards to Communities—An Approach for Operationalizing CDC Guidelines to Determine Risks, and Define, Locate and Reach At-Risk Populations in Public Health Emergencies

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Los Angeles County - Community Partner Stakeholders	Form and Instruction	New	Repair queued
Los Angeles County - Public Health Center Guests	Form and Instruction	New	Available
Public Health and Medical Emergency Planners/Key Informants - Questionnaire	Form and Instruction	New	Available
SSB-Who'sAtRisk20171016-clean.docx	Supporting Statement B	Uploaded 2017-11-08	Available
SSA-WhosAtRisk_13MAR2018.docx	Supporting Statement A	Uploaded 2018-03-14	Available
AttE-HumanResearchExemption-CDC.DOCX	Supplementary Document	Uploaded 2017-10-31	Available
AttE1-HumanResearchExemption-LAC.PDF	Supplementary Document	Uploaded 2017-10-31	Available
AttB-60-DayFRN.PDF	Supplementary Document	Uploaded 2017-10-31	Available
AttA-AuthLeg.docx	Supplementary Document	Uploaded 2017-10-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
228845	Los Angeles County - Community Residents		New
228844	Los Angeles County - Community Partner Stakeholders	Form and Instruction	New
228843	Los Angeles County - Public Health Center Guests	Form and Instruction	New
228842	Public Health and Medical Emergency Planners/Key Informants - Questionnaire	Form and Instruction	New

ICR Details

OMB Control No: 0920-1221	ICR Reference No: 201710-0920-011
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-17ADT
Title: Who’s at Risk: From Hazards to Communities—An Approach for Operationalizing CDC Guidelines to Determine Risks, and Define, Locate and Reach At-Risk Populations in Public Health Emergencies
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: 03/14/2018
	Date Received in OIRA: 11/13/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2020	24 Months From Approved
Responses	1,600	0	0
Time Burden (Hours)	226	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: CDC requests OMB Clearance to conduct participatory research to develop a comprehensive methodology and practical Tool(s) to empower local and state health agencies to identify, analyze, and depict health risks at the community level and develop emergency plans and response capabilities that improve emergency health outcomes. Key project outcomes: 1) Assess and develop risk formula and 2) Assess and develop risk assessment tool. Project includes 2 types of information collection: 1) 100 key informant interviews/focus groups; 2) Anonymous survey of ~1,500 individuals in Los Angeles County.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. Public Health Service Act
  

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 22833	05/18/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 51842	11/08/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Public Health and Medical Emergency Planners/Key Informants - Questionnaire	NA	Key Informant/Stakeholder Questionnaire
Los Angeles County - Public Health Center Guests	NA	Los Angeles County Community Emergency Preparedness Survey
Los Angeles County - Community Partner Stakeholders	NA	Los Angeles County Community Emergency Preparedness Survey
Los Angeles County - Community Residents	NA

---

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	1,600	0	0	1,600	0	0
Annual Time Burden (Hours)	226	0	0	226	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 0920-17ADT - Who’s at Risk: From Hazards to Communities—An Approach for Operationalizing CDC Guidelines to Determine Risks, and Define, Locate and Reach At-Risk Populations in Public Health Emergencies is a New ICR.

---

Annual Cost to Federal Government: $540,038

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]? 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: 11/13/2017

---