Justification for Change

Change Request for

“Environmental Public Health Tracking Network (Tracking Network)”

OMB Control Number 0920-1175, expiration date: 04/30/2020

Justification: This is a nonmaterial/non-substantive change request for OMB Control No. 0920-1175 (Expiration Date: 04/30/2020). In working with our funded state and local health department partners, we identified opportunities to increase the efficiency of our data collection and identified the need for additional values. CDC is requesting to:

1. Move three questions from Attachment 4a: Birth Defects Prevalence Form and three questions from Attachment 4d: Emergency Department Visits Form/Attachment 4e: Hospitalizations Form to Attachment 4g: Metadata Records. This move will streamline the reporting of the questions moved by only requiring the question to be answered once per year.

2. Remove one question from Attachment 4d: Emergency Department Visits Form and Attachment 4e: Hospitalizations Form. This question is no longer needed.

3. Add to code scheme of one question in Attachment 4d: Emergency Department Visits Form and Attachment 4e: Hospitalizations Form. Our partners identified additional values needed to report outcomes with potential environmental etiology.

4. Add one question to Attachment 4d: Emergency Department Visits Form and Attachment 4e: Hospitalizations Form. This question is added to improve data quality. By collecting information about the geocoding process, we can ensure that data were geocoded adequately.

5. Remove ten questions and add 14 new questions to Attachment 4g: Metadata Records. With our partners we identified ten questions that are not being used and can therefore be removed. We are adding questions from other collection forms so that the questions can be answered more efficiently and only once per year per dataset. We are also adding questions regarding the geocoding process to again ensure that data are adequately coded and to improve data quality.

6. Decrease the number of performance measures from 47 to 29. This includes revising four performance measures and adding three new impact performance measures. We have identified performance measures that are not needed as well as new measures or changes to measures that will streamline our process and increase efficiency in our collection of performance measures.

The tables below detail the requested changes.

Information Collection Form	Current Question/Item	Requested Change
Attachment 4a: Birth Defects Prevalence Form	SURVEILLANCETYPE: State birth defects surveillance system uses only active case finding procedures, only passive reporting, or a combination of active and passive methods.	Remove
Attachment 4a: Birth Defects Prevalence Form	ASCERTAINMENT: State birth defects surveillance system routinely ascertains cases of birth defects among live births only, or also covers other outcomes of pregnancy (fetal deaths and/or terminations).	Remove
Attachment 4a: Birth Defects Prevalence Form	CODESET: Indicates the standard under which birth defects cases are coded and classified.	Remove
Attachment 4d: Emergency Department Visits Form	EXCLUSIONMETHOD: Variable used to identify & exclude transfers from dataset	Remove
Attachment 4d: Emergency Department Visits Form	OutOfStateExclusion: Exclusion of residents admitted to hospitals located in another state	Remove
Attachment 4d: Emergency Department Visits Form	RACEETHNICITYREPORTED: Race and ethnicity fields reported in source data	Remove
Attachment 4d: Emergency Department Visits Form	TRANSFEREXCLUSION: Exclusion of transfers from dataset	Remove
Attachment 4d: Emergency Department Visits Form	HEALTHOUTCOMEID: Health outcome	Add to Code Scheme: 15 = Cold illness 16 = Hyperthermia 17 = Renal failure 18 = Electrolyte imbalance 19 = Diabetes 20 = Allergic rhinitis
Attachment 4d: Emergency Department Visits Form	SUBCOUNTY	Change to: Field Name – CensusTract Field Description: Census tract of residence Data Type – String Code Scheme – FIPS, U = Unknown Legal values – FIPS code, U Field length = 11
Attachment 4d: Emergency Department Visits Form		Add new question: Field Name – GeoCodingPrecision Field Description – Describes the degree of precision achieved during the geocoding process Data Type – Text Code Scheme – H = high precision; L = low precision; U = unknown precision; C = county only, S = state only Legal Values – H, L, U, C, S Field Length – 1
Attachment 4e: Hospitalizations Form	EXCLUSIONMETHOD: Variable used to identify & exclude transfers from dataset	Remove
Attachment 4e: Hospitalizations Form	OutOfStateExclusion: Exclusion of residents admitted to hospitals located in another state	Remove
Attachment 4e: Hospitalizations Form	RACEETHNICITYREPORTED: Race and ethnicity fields reported in source data	Remove
Attachment 4e: Hospitalizations Form	TRANSFEREXCLUSION: Exclusion of transfers from dataset	Remove
Attachment 4e: Hospitalizations Form	HEALTHOUTCOMEID: Health outcome	Add to Code Scheme: 15 = Cold illness 16 = Hyperthermia 17 = Renal failure 18 = Electrolyte imbalance 19 = Diabetes 20 = Allergic rhinitis
Attachment 4e: Hospitalizations Form	SUBCOUNTY	Change to: Field Name – CensusTract Field Description: Census tract of residence Data Type – String Code Scheme – FIPS, U = Unknown Legal values – FIPS code, U Field length = 11
Attachment 4e: Hospitalizations Form		Add new question: Field Name – GeoCodingPrecision Field Description – Describes the degree of precision achieved during the geocoding process Data Type – Text Code Scheme – H = high precision; L = low precision; U = unknown precision; C = county only, S = state only Legal Values – H, L, U, C, S Field Length – 1
Attachment 4g: Metadata Records	NATIVE DATASET ENVIRONMENT	Remove
Attachment 4g: Metadata Records	PROGRESS	Remove
Attachment 4g: Metadata Records	WEST, EAST, NORTH, and SOUTH COORDINATE	Remove
Attachment 4g: Metadata Records	SECURITY CLASSIFICATION SYSTEM	Remove
Attachment 4g: Metadata Records	LOGISTICAL CONSISTENCY REPORT	Remove
Attachment 4g: Metadata Records	OVERVIEW	Remove
Attachment 4g: Metadata Records	RESOURCE DESCRIPTION	Remove
Attachment 4g: Metadata Records	CUSTOM ORDER PROCESS	Remove
Attachment 4g: Metadata Records	ACCESS CONSTRAINTS	Remove
Attachment 4g: Metadata Records	USE CONSTRAINTS	Remove
Attachment 4g: Metadata Records		Add question from attachments 4d and 4e: Are hospitalizations or ED visits by state residents to hospitals/EDs in other states included in the dataset? If other, please explain.
Attachment 4g: Metadata Records		Add question from attachments 4d and 4e: Are hospital transfers excluded from the dataset? Note that exclusion of transfers is only required for AMI hospitalizations.
Attachment 4g: Metadata Records		Add question from attachments 4d and 4e: How did you exclude transfers from data set? If other, please explain.
Attachment 4g: Metadata Records		Add question from attachment 4a: What was the surveillance method used to ascertain birth defect cases? If other, please explain.
Attachment 4g: Metadata Records		Add new question: Were maternal race and ethnicity collected and reported separately by the primary data steward? If other, please explain.
Attachment 4g: Metadata Records		Add question from attachment 4a: What medical coding standard was used to classify birth defects?
Attachment 4g: Metadata Records		Add new question: Were birth defects data collected and reported in every county within your state? Provide additional details as needed.
Attachment 4g: Metadata Records		Add question from attachment 4a: What pregnancy outcomes were included in your case ascertainment? Provide additional details as needed.
Attachment 4g: Metadata Records		Add new question: Were data geocoded using the Tracking Network Geocoding Standards?
Attachment 4g: Metadata Records		Add new question: What geocoding software was used?
Attachment 4g: Metadata Records		Add new question: What underlying databases were used by the geocoding software?
Attachment 4g: Metadata Records		Add new question: How many individual records were included in the input dataset?
Attachment 4g: Metadata Records		Add new question: How many rural routes were included in the input dataset?
Attachment 4g: Metadata Records		Add new question: How many PO Boxes were included in the input dataset?
Attachment 4g: Metadata Records		Add new question: Did you remove PO Boxes before geocoding the data? If you did not remove PO Boxes, please describe the process used to geocode PO Boxes to a census tract.

Information Collection Form	Requested Change	Justification
Environmental Public Health Tracking Work Plan Template	Decrease the number of performance measures from 47 to 29 (Includes the addition of 3 new measures).	There were 47 previously approved performance measures, which now have been decreased to 29. The Tracking program decided to focus on measures that will aid in capturing overall program impact, monitor progress, and provide data that can be used to drive programmatic decision-making, while further minimizing respondent burden.

Change in Performance Measures:

The table below shows the list of previously approved performance measures (PMs). The Program is requesting a few changes based on need and desired outcome. The suggested changes are: delete 18 PMs (crossed out with a single line), revise 4 PM’s (highlighted in yellow), and add 3 new PMs (listed at the bottom of the table). We expect a significant reduction in burden due to the removal of 18 PMs. The remaining PMs will allow the Tracking program to focus on overall program impact and provide information that can be used to drive programmatic decision-making.

Science and Content (16) (10)

OUTPUTS
1. Standardized and accessible environmental and health surveillance data

2. Generated and disseminated environmental public health evidence

MEASURES

Number and list of data sets evaluated

Number of datasets within grantee Tracking Network accessible to program staff for indicator development, exploration, analysis, and other work-related tasks.

Number of datasets within grantee Tracking Network accessible to partners.

Number of required NCDM datasets integrated into grantee Tracking Network with all required elements and accessible by appropriate program staff

Number of required NCDM datasets integrated into grantee Tracking Network with advanced elements and accessible by appropriate program staff.

Number and list of new indicators and measures displayed that are optional NCDM

Number and list new indicators and measures developed that are not NCDM

Number of Tracking datasets for which routine descriptive analyses are conducted

Number and description of program activities developed, informed, or improved by analysis of Tracking datasets

Number of analyses (routine or other) conducted using Tracking datasets which resulted in a disseminated report, or publication

Advanced Activities

Number and description of data gaps or limitations addressed

Number and description of routine analyses (beyond descriptive analysis) that discover patterns, identify potential concerns, or otherwise provide new insights or solutions for environmental public health

Number and description of either (1) planned public health actions developed/informed or (2) past public health actions evaluated by analyses conducted using Tracking datasets

SHORT-TERM OUTCOMES
1. Health and Environmental data are accessed and used by internal and external audiences
2. Development of targeted jurisdiction-specific program activities based on generated evidence

MEASURES

10% increase in required Popular Content web statistics

Number and description of data requests made by partners

Number of jurisdiction specific activities developed based on Tracking data or analysis (serve as baseline, will determine increase for Year 2).

Technology and Informatics (5) (4)

OUTPUT
1. Comprehensive surveillance system with tools, guides, and best practices

MEASURES

Number of new tools and processes developed to improve the quality, usefulness, availability, and timeliness of data related to grantee Tracking systems

List and Description of barriers discovered/ addressed based on results obtained from the gap analysis.

Submission of complete standardized NCDMs to CDC during scheduled data calls

Advanced Activities

Number of new tools and processes developed to improve the quality, usefulness, availability, and timeliness of data

(refers to the development of advanced tools)

SHORT-TERM OUTCOME
1. Efficient, accessible, and higher quality display of data on a public portal

MEASURE

Adherence to 100% of the required portal standards found in the Portal Requirements and Recommendations document.

Communications (16) (6)

OUTPUTS
1. Targeted communications products and messages

2. Partnerships with environmental health stakeholders

MEASURES

Record of participation in at least one coordinated, program wide communication activity

Revision - Number of program announcements/updates disseminated by medium/channel (e.g., listserv, email, social media, etc.)

Number of social media posts with number of impressions for each

Revision - Number of presentations given (live or webinar) with the number of participants in each

Revision - Number of presentations and exhibiting events with number of participants in each

List of communication messages or products used with distribution method (e.g., posted on grantee website with URL; handed out at exhibits, meetings, presentations)

Revision - List of new and existing internal and external partners (listed by organization name)

Record of Technical Advisory Group (TAG) activities (minimum of one meeting per year)

Record of collaboration with at least one university

Advanced Activities

List collaborative communication activity with participating grantees

List of developed communications products based on results of completed needs assessment

Document any traditional/earned media-related products (e.g. newspaper article, TV segments)

Number of co-presented/co-sponsored national or regional meetings/conference or webinars completed with list of participating grantees or partners

SHORT-TERM OUTCOMES
1. Increased awareness of the Tracking Network and environmental health issues

2. Engaged partners and users

MEASURES

Increase in Outreach Efforts: Presentations, Exhibits, Trainings (increase based on jurisdiction’s previous years)

10% increase in required Overall Usage web statistics (increase based on previous year)

Record of collaboration with at least 1 new partner and 1 existing partner

(e.g., guest lecturing; mentoring students; co-presenting (webinar/meeting/conference)collaborating on GIS, data analysis, or other projects

Program Services (10) (9)

OUTPUTS
1. Environmental health workforce participate in workgroups and provide training

2. Systematic approach to assessing program activities and overall performance

MEASURES

Number of CDC Tracking work groups and sub-groups (e.g. SND, PMO, CWG, Evaluation), along with the title and description of roles and responsibilities for participating jurisdiction?

Number of personnel supported directly and in-kind under this cooperative agreement

Number & List of internal and external technical assistance requests completed* to the state health department, local health departments, and other public health system partners

Revision - Number & List of internal and external emergency response related support and technical assistance requests completed to the state health department, local health departments, and other public health system partners.

Number of Environmental Tracking trainings provided to state and local public health workforce and partners

Number of PHAs submitted annually

Number and list of peer-reviewed publications, white papers, and scientific reports produced

Advanced Activity

Number of program training opportunities for student interns or fellows

Additions

1. Does your Tracking Program provide the platform for other/all data streams for the health department? If yes, please provide a brief summary of the multiple data streams or acting as the central data network for the health department.

2. Does your tracking program provide sustained support and technical assistance to programs within the health department (e.g., data analysis, mapping/GIS assistance, data visualization, program evaluation, etc.). If so, please provide the program name and briefly describe the support/assistance provided.

3. Description of at least 1 action taken during the reporting period to improve program activities and increase program effectiveness based on evaluation findings.

Decrease in Annualized Total Burden Hours:

The original burden calculated for completing and submitting the Environmental Public Health Tracking Work Plan Template was 1,560 hours. Removing 18 PMs will reduce the burden by 28%, so the updated estimated burden for completing and submitting the Environmental Public Health Tracking Work Plan Template is 1,144 hours (26 recipients x 2 responses x 22 hours/response).

Attachments

Att4a_Birth Defects Prevalence_2019_clean

Att4a_Birth Defects Prevalence_2019_trackedchanges

Att4d_Emergency Department Visits_2019_clean

Att4d_Emergency Department Visits_2019_trackedchanges

Att4e_Hospitalizations _2019_clean

Att4e_Hospitalizations _2019_trackedchanges

Att4g_MetadataRecords_2019_clean

Att4g_MetadataRecords_2019_trackedchanges

Att5a_Environmental Public Health Tracking Work Plan Template_2019_clean

Att5a_Environmental Public Health Tracking Work Plan Template_2019_trackedchanges