National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Clinic-level Cervical Cancer Screening Data	Form and Instruction	New	Available
Clinic-level Breast Cancer Screening Data	Form and Instruction	New	Available
NBCCEDP Annual Grantee Survey	Form and Instruction	New	Repair queued
Annual Survey of NBCCEDP Grantees' Program Implementation	Form	Removed	Available
Att 11_DP17-1701 Awardee Program List_09282018.docx	Supplementary Document	Uploaded 2018-10-24	Available
Att 10_0920-1046 PIA 8-21-18.pdf	Supplementary Document	Uploaded 2018-10-24	Available
Att 9_684 Form.pdf	Supplementary Document	Uploaded 2018-10-24	Available
Att 8_60-Day Federal Register Announcement.pdf	Supplementary Document	Uploaded 2018-10-24	Available
Att 7d_NBCCEDP Clinic-Level Data Collection Reminder Email.docx	Supplementary Document	Uploaded 2018-10-24	Available
Att 7c_NBCCEDP Clinic-Level Data Collection Introductory Email.docx	Supplementary Document	Uploaded 2018-10-24	Available
Att 6b_NBCCEDP Grantee Survey Reminder Email.docx	Supplementary Document	Uploaded 2018-10-24	Available
Att 6a_NBCCEDP Grantee Survey Introductory Email.docx	Supplementary Document	Uploaded 2018-10-24	Available
Att 5_NBCCEDP Evaluation Question Matrix.docx	Supplementary Document	Uploaded 2018-10-24	Available
Att 4_EBI Logic Models.pdf	Supplementary Document	Uploaded 2018-10-24	Available
Att 3_NBCCEDP Logic Model.pdf	Supplementary Document	Uploaded 2018-10-24	Available
Att 2_Breast and Cervical Cancer Prev and Trt Act of 2000.pdf	Supplementary Document	Uploaded 2018-10-24	Available
Att 1_Authorizing Legislation.pdf	Supplementary Document	Uploaded 2018-10-24	Available
SS Part B_NBCCEDP_09282018.docx	Supporting Statement B	Uploaded 2018-10-24	Available
SS Part A_NBCCEDP_09282018.docx	Supporting Statement A	Uploaded 2018-10-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
233708	Clinic-level Cervical Cancer Screening Data	Form and Instruction	New
233707	Clinic-level Breast Cancer Screening Data	Form and Instruction	New
233706	NBCCEDP Annual Grantee Survey	Form and Instruction	New
213483	Annual Survey of NBCCEDP Grantees' Program Implementation	Form	Removed

ICR Details

OMB Control No: 0920-1046	ICR Reference No: 201805-0920-008
Status: Historical Active	Previous ICR Reference No: 201410-0920-018
Agency/Subagency: HHS/CDC	Agency Tracking No: 14BA
Title: National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/26/2018
	Date Received in OIRA: 10/31/2018
Terms of Clearance: Any changes to the instruments after year one need to be submitted for OMB approval (either as revisions or non-substantive changes requests, depending on the nature and extent of the changes) prior to use.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2021	36 Months From Approved	02/01/2018
Responses	910	0	67
Time Burden (Hours)	683	0	45
Cost Burden (Dollars)	38,976	0	0

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Abstract: The goal of this data collection is to systematically collect information about the implementation and outcomes of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which funds 70 grantees. CDC will conduct an annual grantee survey and collect clinic-level information from grantees’ health system partners. The subpopulation for the grantee survey is the 70 NBCCEDP program directors/program managers. Clinic-level information, including breast and cervical screening rates, represents clients ages 50-74 for breast cancer screenings and 21-65 for cervical cancer screenings within partner health systems. This information collection will allow CDC to conduct routine monitoring, tailor technical assistance, support program planning, and assess program outcomes.

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Authorizing Statute(s): PL: Pub.L. 101 - 354 2 Name of Law: Breast and Cervical Cancer Prevention and Treatment Act of 2000
   US Code: 42 USC 300k Name of Law: Breast and Cervical Cancer Mortality Prevention Act of 1990
  

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:
	83 FR 3711	01/26/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 53877	10/25/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
NBCCEDP Annual Grantee Survey	n/a	NBCCEDP Annual Grantee Survey
Clinic-level Breast Cancer Screening Data	n/a	Screen Shots of the Clinic Baseline and Annual Reporting System (CBARS)
Clinic-level Cervical Cancer Screening Data	n/a	Screen shots of the Clinic Baseline and Annual Reporting System (CBARS)
Annual Survey of NBCCEDP Grantees' Program Implementation	none	Annual Survey of NBCCEDP Grantees' Program Implementation

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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	910	67	0	843	0	0
Annual Time Burden (Hours)	683	45	0	638	0	0
Annual Cost Burden (Dollars)	38,976	0	0	38,976	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: In 2017, CDC redesigned the NBCCEDP to have a stronger focus on grantees partnering with health system clinics to implement evidence-based interventions (EBIs). Consistent with these programmatic changes, CDC proposes redesigned information collection to include a revised grantee survey and 2 new clinic-level data collections. The number of respondents will increase from 67 to 70, and the estimated annualized burden will increase from 45 hours to 683 hours.

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Annual Cost to Federal Government: $507,284

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

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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: 10/31/2018

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