Rapid Response Suicide Investigation Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att. F PIA-18CV_Generic Suicide_051818.pdf	Supplementary Document	Uploaded 2018-09-20	Available
Att. E Burden Memo Generic Suicide_30 day.docx	Supplementary Document	Uploaded 2018-09-20	Available
Att. D Investigation Protocol Template Generic Suicide_30 day.docx	Supplementary Document	Uploaded 2018-09-20	Available
Att. C CDC 0.1485 NCIPC Determination Form.pdf	Supplementary Document	Uploaded 2018-09-20	Available
ATT. B 60-day FRN Generic Suicide.pdf	Supplementary Document	Uploaded 2018-09-20	Available
Att. A_AuthLeg.docx	Supplementary Document	Uploaded 2018-09-20	Available
SSB_18CV_Generic Suicide_30dy.docx	Supporting Statement B	Uploaded 2018-09-20	Available
SSA_18CV_Generic Suicide_modifications_09142018_clean.docx	Supporting Statement A	Uploaded 2018-09-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form

ICR Details

OMB Control No: 0920-1243	ICR Reference No: 201809-0920-006
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 18CV
Title: Rapid Response Suicide Investigation Data Collection
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: 09/24/2018
	Date Received in OIRA: 09/20/2018
Terms of Clearance: Approved consistent with the understanding that this generic clearance will not be used to conduct research or to collect data to inform Federal policies or funding priorities. A mini supporting statement that describes the initiating event, context for using the data, methodology, and burden must be submitted with each GenIC request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved
Responses	6,000	0	0
Time Burden (Hours)	3,000	0	0
Cost Burden (Dollars)	73,020	0	0

---

Abstract: CDC requests approval for a new generic clearance to rapidly respond to urgent requests for CDC assistance to investigate an apparent and unexplained potential cluster or increase in suicidal behavior. Rapid Response Suicide Investigation Data Collections are specifically designed to inform the implementation of prevention strategies where a possible suicide cluster or increasing trend has been observed..

---

Authorizing Statute(s): US Code: 42 USC 301 Name of Law: PHSA
  

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 52046	11/09/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 30938	07/02/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 0

---

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	6,000	0	0	6,000	0	0
Annual Time Burden (Hours)	3,000	0	0	3,000	0	0
Annual Cost Burden (Dollars)	73,020	0	0	73,020	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: This is a new generic ICR.

---

Annual Cost to Federal Government: $248,249

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

---

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: 09/20/2018

---