Effective Communication in Public Health Emergencies – Developing Community-Centered Tools for People with Special Health Care Needs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Provider - Evaluation Focus Group	Form and Instruction	New	Available
Health IT Professional - Focus Group	Form and Instruction	New	Available
Emergency Response Organization - Focus Group	Form and Instruction	New	Available
Provider Focus Group - ASD	Form and Instruction	New	Available
Provider Focus Group - CYSHCN	Form and Instruction	New	Available
Family/Caregiver Focus Group - CYSHCN and ASD	Form and Instruction	New	Available
Family/Caregiver Interview - ASD	Form and Instruction	New	Available
Family/Caregiver Interview - CYSHCN	Form and Instruction	New	Available
Provider Study - ASD	Form and Instruction	New	Available
Provider Survey - CYSHCN	Form and Instruction	New	Available
Family/Caregiver - ASD	Form and Instruction	New	Available
Family/Caregiver Survey - CYSHCN	Form and Instruction	New	Available
Attachment Z. Recruitment Email for Message Testing.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment Y. Recruitment Email for Provider Focus Groups.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment X. Recruitment Email for Families_Caregivers Interviews.docx	Supplementary Document	Uploaded 2018-03-02	Repair queued
Attachment W. Study Fact Sheet for Families_Caregivers.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment V. Pre-Interview Survey.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment I. Drexel IRB Approval Letter.pdf	Supplementary Document	Uploaded 2018-03-02	Available
Attachment G. Assent Form.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment F. 502 Consent Document for Qualitiative Tools.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment E. Consent and Recruitment Email for ASD Patient and Provider Survey.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment D. Consent and Recruitment Email for CYSHCN Provider Survey.docx	Supplementary Document	Uploaded 2018-03-02	Available
Attachment C. Consent and Recruitment Email for CYSHCN Families_Caregivers Survey.docx	Supplementary Document	Uploaded 2018-03-02	Available
AttCe-CDC Response to Public Comment 2.docx	Supplementary Document	Uploaded 2018-03-02	Available
AttCd-CDC Response to Public Comment 1.docx	Supplementary Document	Uploaded 2018-03-02	Available
AttCb-PublicComment2.pdf	Supplementary Document	Uploaded 2018-03-02	Available
AttCa-PublicComment1.txt	Supplementary Document	Uploaded 2018-03-02	Available
Attachment B. Published 60 Day FRN CDC-2017-0071-0001.pdf	Supplementary Document	Uploaded 2018-03-02	Available
Attachment A. Authorizing Legislation.docx	Supplementary Document	Uploaded 2018-03-02	Available
EffectiveCommSSBv2.docx	Supporting Statement B	Uploaded 2018-03-01	Available
EffectiveComm-SSA 19APR2018.docx	Supporting Statement A	Uploaded 2018-04-19	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
230326	Provider - Evaluation Focus Group	Form and Instruction	New
230325	Health IT Professional - Focus Group	Form and Instruction	New
230324	Emergency Response Organization - Focus Group	Form and Instruction	New
230322	Provider Focus Group - ASD	Form and Instruction	New
230321	Provider Focus Group - CYSHCN	Form and Instruction	New
230320	Family/Caregiver Focus Group - CYSHCN and ASD	Form and Instruction	New
230319	Family/Caregiver Interview - ASD	Form and Instruction	New
230317	Family/Caregiver Interview - CYSHCN	Form and Instruction	New
230315	Provider Study - ASD	Form and Instruction	New
230314	Provider Survey - CYSHCN	Form and Instruction	New
230312	Family/Caregiver - ASD	Form and Instruction	New
230311	Family/Caregiver Survey - CYSHCN	Form and Instruction	New

ICR Details

OMB Control No: 0920-1225	ICR Reference No: 201801-0920-006
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-17AYG
Title: Effective Communication in Public Health Emergencies – Developing Community-Centered Tools for People with Special Health Care Needs
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: 04/20/2018
	Date Received in OIRA: 03/02/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2021	36 Months From Approved
Responses	930	0	0
Time Burden (Hours)	419	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Children and youth with special health care needs and individuals with autism spectrum disorders have unique disaster communication needs, and often rely on health care and other professional providers for information during emergencies. The proposed study will conduct surveys, interviews and focus groups with families as well as provider communities and emergency response agencies, to identify the disaster communication needs of families with children and youth with special health care needs (CYSHCN) and families and individuals with autism spectrum disorders (ASD). Results will be used to develop communication tools, protocols and messages that can be used to improve the outcomes of these families after disasters.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. 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:
	82 FR 43984	09/20/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 8872	03/01/2018
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
Family/Caregiver Survey - CYSHCN	NA	CYSHCN Family/Caregiver Survey
Family/Caregiver - ASD	NA	ASD Family/Caregiver Survey
Provider Study - ASD	NA	ASD Provider Survey
Emergency Response Organization - Focus Group	NA	Emergency Response Organization - Emergency Response Focus Group
Health IT Professional - Focus Group	NA	Health IT Professional - Health IT Focus Group
Provider Survey - CYSHCN	NA	CYSHCN Provider Study
Family/Caregiver Focus Group - CYSHCN and ASD	NA	CYSHCN and ASD Family/Caregiver Focus Group
Provider Focus Group - ASD	NA	ASD Provider Focus Group
Family/Caregiver Interview - CYSHCN	NA	CYSHCN Family/Caregiver Interview
Family/Caregiver Interview - ASD	NA	ASD Family/Caregiver Interview
Provider Focus Group - CYSHCN	NA	CYSHCN Provider Focus Group
Provider - Evaluation Focus Group	NA	Provider - Provider Evaluation Focus Group

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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	930	0	0	930	0	0
Annual Time Burden (Hours)	419	0	0	419	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 0920-17AYG - Effective Communication in Public Health Emergencies – Developing Community-Centered Tools for People with Special Health Care Needs is a New ICR.

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Annual Cost to Federal Government: $382,619

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.     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

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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: 03/02/2018

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