Asthma Information Reporting System (AIRS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0853 Hospital Discharge Reporting Form	Form and Instruction	New	Available
Form 0920-0853 Emergency Department Visits Reporting Form	Form and Instruction	New	Available
Form 0920-0853 Performance Measures Reporting Tool	Form and Instruction	New	Available
Form 0920-0853 STATE [Year] Hospital Discharge Data	Form	Removed	Available
Form 0920-0853 STATE [Year] Emergency Department Data	Form	Removed	Available
Form 0920-0853 AIRS Performance Measure A. Health Care Reform Opportunities	Form	Removed	Available
Att3d1a_AIRS Instructions_HD_ED_Data_tracked changes_OMB_ae20200429.docx	Supplementary Document	Uploaded 2020-05-04	Available
Att2a Public Comment Received.pdf	Supplementary Document	Uploaded 2020-03-05	Available
Att10_RDF.pdf	Supplementary Document	Uploaded 2020-03-02	Available
Att9_PIA.pdf	Supplementary Document	Uploaded 2020-03-02	Available
Att5b_PM Reporting Tool_screenshots.pdf	Supplementary Document	Uploaded 2020-03-02	Available
Att4_NOFO EH19-1902.pdf	Supplementary Document	Uploaded 2020-03-02	Available
Att1b_42USC247b.pdf	Supplementary Document	Uploaded 2020-03-02	Available
Att1a_42USC241.pdf	Supplementary Document	Uploaded 2020-03-02	Available
Att3_List of Funded Recipients.docx	Supplementary Document	Uploaded 2020-03-02	Available
Att4_AIRS Research Determination Form.pdf	Supplementary Document	Uploaded 2019-04-04	Available
Att3d2a_AIRS Instructions_HD_ED_HowtoDocSharing _tracked changes.docx	Supplementary Document	Uploaded 2019-04-04	Available
Att3d2 _AIRS Instructions_HD_ED_HowtoDocSharing_clean.docx	Supplementary Document	Uploaded 2019-04-04	Available
Att3d1a_AIRS Instructions_HD_ED_Data_tracked changes.docx	Supplementary Document	Uploaded 2019-04-04	Available
Att1b_42USC247b.pdf	Supplementary Document	Uploaded 2019-04-04	Available
Att1a_42USC241.pdf	Supplementary Document	Uploaded 2019-04-04	Available
1 - SSA_AIRS Revision 20200304 clean_OMB_ae20200429_clean.docx	Supporting Statement A	Uploaded 2020-05-04	Available
1 - SSB_AIRS Revision 20200304 clean.docx	Supporting Statement B	Uploaded 2020-03-05	Available
Att2a Public Comment.pdf	Supplementary Document	Uploaded 2016-03-23	Available
Att2_60dayFRN.pdf	Supplementary Document	Uploaded 2019-04-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
240167	Analysis and Use of Core Data Sets	Form and Instruction	New	Hospital Discharge Reporting Form
240167	Analysis and Use of Core Data Sets	Form and Instruction	New	Emergency Department Visits Reporting Form
240167	Analysis and Use of Core Data Sets	Form and Instruction	New	Performance Measures Reporting Tool
220723	AIRS Hospital Discharge Reporting	Form	Removed	STATE [Year] Hospital Discharge Data
220722	AIRS Emergency Department Visits Reporting	Form	Removed	STATE [Year] Emergency Department Data
192746	AIRS Performance Measures Reporting	Form	Removed	AIRS Performance Measure A. Health Care Reform Opportunities

ICR Details

OMB Control No: 0920-0853	ICR Reference No: 202003-0920-002
Status: Historical Active	Previous ICR Reference No: 201904-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0853
Title: Asthma Information Reporting System (AIRS)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/04/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/09/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2023	36 Months From Approved	05/31/2020
Responses	90	0	75
Time Burden (Hours)	105	0	89
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this information collection (IC) is to continue CDC's monitoring of recipient programs' planning and delivery of public health activities and the programs' collaboration with health care systems. The 30 recipients receive funding to implement a variety of public health strategies and activities related to asthma. AIRS is the system by which state asthma programs report their progress on National Asthma Control Program developed performance measures (PM), as well as state-level asthma emergency department (ED) visit and hospital discharge (HD) data.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: 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:
	84 FR 66904	12/06/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 13653	03/09/2020
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
AIRS Emergency Department Visits Reporting	0920-0853	STATE [Year] Emergency Department Data
AIRS Hospital Discharge Reporting	0920-0853	STATE [Year] Hospital Discharge Data
AIRS Performance Measures Reporting	0920-0853	AIRS Performance Measure A. Health Care Reform Opportunities
Analysis and Use of Core Data Sets	0920-0853, 0920-0853, 0920-0853	Performance Measures Reporting Tool ,   Emergency Department Visits Reporting Form ,   Hospital Discharge Reporting Form

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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	90	75	0	90	-75	0
Annual Time Burden (Hours)	105	89	0	105	-89	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: The number of recipients funded increased from 25 to 30, resulting in an increase in requested burden hours from 89 to 105. The number of performance measures (PMs) was reduced from 18 to 8. A new electronic reporting tool was developed for receipt of PMs from recipients.

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Annual Cost to Federal Government: $841,271

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.     Yes

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.     Yes

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: 03/09/2020

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