Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System

ICR 202003-0920-006

OMB: 0920-0612

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2020-03-12
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Supplementary Document
2019-05-10
Justification for No Material/Nonsubstantive Change
2018-04-11
Supporting Statement B
2019-05-10
Supporting Statement A
2019-05-10
ICR Details
0920-0612 202003-0920-006
Historical Active 201905-0920-005
HHS/CDC 0920-0612-20LC
Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 03/17/2020
Retrieve Notice of Action (NOA) 03/12/2020
  Inventory as of this Action Requested Previously Approved
08/31/2022 08/31/2022 08/31/2022
72 0 63
1,536 0 1,344
0 0 0

WISEWOMAN was able to accommodate three additional programs with the current levels of funding. The number of programs went from 21 to 24 with a corresponding minor increase in the burden table. There are no changes to the Minimum data elements or response options. modify the WISEWOMAN program’s reporting system, used to both screen and monitor participants, and to evaluate and improve program efficacy. The current WISEWOMAN information collection consists of two parts, a Progress Report and Minimum Data Elements. The are no proposed changes to the approved collection. This change request is simply to report that three additional recipients were accommodated within the existing level of federal funding. Having 24 recipients instead of 21 recipients does slightly change the number of responses collected annually with a minor increase in burden.

PL: Pub.L. 101 - 354 300 Name of Law: The Breast and Cervical Cancer Mortality Prevention Act of 1990
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  83 FR 66269 12/26/2018
84 FR 26107 06/05/2019
Yes

  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 72 63 0 9 0 0
Annual Time Burden (Hours) 1,536 1,344 0 192 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
A minor change in burden is projected based on the increase of three additional programs.

$376,950
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Kevin Joyce 404 639-1944 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
03/12/2020


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