Paul Coverdell National Acute Stroke Program (PCNASP) Reporting System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Crosswalk of data element changes.docx	Supplementary Document	Uploaded 2020-01-13	Available
Change Request Justification.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-01-13	Available
Attachment 12_Data burden excerpt from PCNASP reference guide.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 11_Table shells of performance measure reports.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 10d_Crosswalk of hospital inventory changes.xlsx	Supplementary Document	Uploaded 2019-05-23	Repair queued
Attachment 10c_Crosswalk post-hospital changes.xlsx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 10b_Crosswalk in-hospital changes.xlsx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 10a_Crosswalk pre-hospital changes.xlsx	Supplementary Document	Uploaded 2019-05-23	Repair queued
Attachment 9_Collection and transmission diagram.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 8_Screenshot SAMS web portal.pdf	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 7_IRB approval letter 2019.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 6_PCNASP 60day FRN.pdf	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 3b_Crosswalk outcomes, measures, data sources.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 3a_Crosswalk aims and outcomes.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 1_PCNASP Awardees 2015-2020.docx	Supplementary Document	Uploaded 2019-05-23	Available
Attachment 2_Section 317 Public Health Service Act.pdf	Supplementary Document	Uploaded 2019-05-23	Available
Coverdell SSB.docx	Supporting Statement B	Uploaded 2019-05-23	Available
Coverdell SSA.docx	Supporting Statement A	Uploaded 2019-05-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
236182	Post-Hospital Transition of Care Data - PCNASP Awardee -other respondents	Other-Data elements	Modified
236180	Pre-Hospital Care Data - PCNASP Awardee -EMS respondents	Other-Data elements	Modified
219135	Hospital Inventory Data - PCNASP Awardee	Other-Data elements	Unchanged
219134	Post-Hospital Transition of Care Data - PCNASP Awardee - hospital respondents	Other-Data elements	Modified
219132	In-Hospital Quality of Care Data - PCNASP Awardee	Other-Data elements	Modified
219131	Pre-Hospital Care Data - PCNASP Awardee - hospital respondents	Other-Data elements	Modified
219130	Hospital Inventory Data - Hospital Partners	Other-Data elements	Unchanged

ICR Details

OMB Control No: 0920-1108	ICR Reference No: 202001-0920-002
Status: Active	Previous ICR Reference No: 201905-0920-010
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1108-20FH
Title: Paul Coverdell National Acute Stroke Program (PCNASP) Reporting System
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/21/2020
	Date Received in OIRA: 01/13/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2022	09/30/2022	09/30/2022
Responses	495	0	495
Time Burden (Hours)	361	0	361
Cost Burden (Dollars)	12,987	0	12,987

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Abstract: The CDC's Paul Coverdell National Acute Stroke Program (PCNASP) seeks to improve quality of care for acute stroke patients through systematic approaches to quality improvement. CDC will work with selected state health departments to collect data and improve quality of care throughout the 3 phases of the stroke continuum of care: (1) pre-hospital care, (2) in-hospital care, and (3) post-discharge care. Information on infrastructure and hospital capacity will also be collected. This change request is to update data elements with no change in burden.

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Authorizing Statute(s): US Code: 42 USC 247 Name of Law: Publilc 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:
	84 FR 2510	02/07/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 28820	06/20/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Post-Hospital Transition of Care Data - PCNASP Awardee - hospital respondents
Hospital Inventory Data - PCNASP Awardee
Hospital Inventory Data - Hospital Partners
Pre-Hospital Care Data - PCNASP Awardee - hospital respondents
In-Hospital Quality of Care Data - PCNASP Awardee
Pre-Hospital Care Data - PCNASP Awardee -EMS respondents
Post-Hospital Transition of Care Data - PCNASP Awardee -other respondents

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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	495	495	0	0	0	0
Annual Time Burden (Hours)	361	361	0	0	0	0
Annual Cost Burden (Dollars)	12,987	12,987	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $6,821,665

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: 01/13/2020

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