Annual Reporting of the Rape Prevention and Education (RPE) Program: CE19-1902 Cooperative Agreement

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-XXXX Annual Reporting Data Elements for RPE (Subsequent Reporting)	Form and Instruction	New	Available
Form 0920-XXXX Annual Reporting Data Elements for RPE	Form and Instruction	New	Available
Att_7_Human_Subject_Determination_Form.pdf	Supplementary Document	Uploaded 2019-08-29	Available
Att_6_PIA Partners Portal.pdf	Supplementary Document	Uploaded 2019-08-29	Available
Att_5_60-Day_FRN.pdf	Supplementary Document	Uploaded 2019-08-29	Available
Att_4_Crosswalk_of_RPE_Program_Evaluation_Questions_and_Indicators.docx	Supplementary Document	Uploaded 2019-08-29	Repair queued
Att_2_List_of_RPE-funded_Recipients.docx	Supplementary Document	Uploaded 2019-08-29	Available
Att_1b_PHSA_393a_USC_280b-a.pdf	Supplementary Document	Uploaded 2019-08-29	Available
Att_1a_PHSA_301a_USC_241a.pdf	Supplementary Document	Uploaded 2019-08-29	Repair queued
SSB_1902_RPE_Partners_Portal_080619.docx	Supporting Statement B	Uploaded 2019-08-29	Available
SSA_RPE Program_082919.docx	Supporting Statement A	Uploaded 2019-08-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
237592	Annual Reporting Data Elements for RPE (Subsequent Reporting)	Form and Instruction	New
237591	Annual Reporting Data Elements for RPE	Form and Instruction	New

ICR Details

OMB Control No: 0920-1286	ICR Reference No: 201908-0920-011
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-19AXA
Title: Annual Reporting of the Rape Prevention and Education (RPE) Program: CE19-1902 Cooperative Agreement
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 without change	Conclusion Date: 03/03/2020
	Date Received in OIRA: 11/07/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	36 Months From Approved
Responses	165	0	0
Time Burden (Hours)	440	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: To collect information related to implementation and outcomes annually from recipients of the new funding opportunity CDC-RFA-CE19-1902: Rape Prevention and Education (RPE): Using The Best Available Evidence for Sexual Violence Prevention cooperative agreement. Information will be collected to provide crucial information for performance monitoring and program evaluation of the implementation of prevention strategies and approaches, outcomes, and budget of the cooperative agreement.Information to be collected will be used to inform technical assistance, program improvement, capacity building, and RPE Program’s impacts on SV outcomes over time. Implementation and outcomes information to be collected will be used to inform technical assistance, program improvement, capacity building, and RPE Program’s impacts on SV outcomes over time.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: US Code: 42 USC 241a Name of Law: Public Health Service Act
US Code: 42 USC 280b-a Name of Law: Public Health Service Act

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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:
	84 FR 26116	06/05/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 52110	10/01/2019
Did the Agency receive public comments on this ICR? Yes

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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
Annual Reporting Data Elements for RPE (Subsequent Reporting)	0920-XXXX	Annual Reporting Data Elements for RPE (Subsequent Reporting)
Annual Reporting Data Elements for RPE	0920-XXXX	Annual Reporting Data Elments for RPE

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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	165	0	0	165	0	0
Annual Time Burden (Hours)	440	0	0	440	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: This is a NEW collection request for a new OMB Control Number.

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Annual Cost to Federal Government: $167,006

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: 11/07/2019

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