WOMEN’S HEALTH CAMPUS SEXUAL ASSAULT POLICY AND PREVENTION INITIATIVE CROSS-SITE EVALUATION

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
OWH CSAPP 2018 OMB Supporting Statement_Section A_REVISED.doc	Supporting Statement A	Uploaded 2019-04-15	Available
30-day FRN-0990-College Sexual Assault Policy.doc	Supplementary Document	Uploaded 2018-12-21	Available
Attachment E_60day FRN-0990-College Sexual Assault Policy.doc	Supplementary Document	Uploaded 2018-12-21	Available
OWH CSAPP 2018 OMB Supporting Statement_Section B.docx	Supporting Statement B	Uploaded 2018-12-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
234626	Partner Campus Representative	Other-guide	New
234623	Cross-Site Evaluation on the Women's Health College Sexual Assault Policy and Prevention Initiative	Other-Interview Guide	New

ICR Details

OMB Control No: 0990-0467	ICR Reference No: 201808-0990-003
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: WOMEN’S HEALTH CAMPUS SEXUAL ASSAULT POLICY AND PREVENTION INITIATIVE CROSS-SITE EVALUATION
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: 04/15/2019
	Date Received in OIRA: 02/12/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2022	36 Months From Approved
Responses	45	0	0
Time Burden (Hours)	45	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this data collection is to gather qualitative data across the nine grantee organizations and their partners to gain a full understanding of grantee and partner perceived success over the course of the three year project; grantee and partner experiences with the initiative; barriers and facilitators to project implementation; and sustainability of grantee efforts; and anecdotal or other evidence of reductions in sexual violence on campus.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Section 301 of the 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:
	83 FR 43882	08/28/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 2886	02/08/2019
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Cross-Site Evaluation on the Women's Health College Sexual Assault Policy and Prevention Initiative
Partner Campus Representative

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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	45	0	0	45	0	0
Annual Time Burden (Hours)	45	0	0	45	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: There are no changes in burden. This is a new project.

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Annual Cost to Federal Government: $593,595

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: 02/12/2019

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