Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
HIV Surveillance Data System Needs and IT Capability Assessment	Form and Instruction	New	Available
Customer Service GenIC Clearance Template.docx	Supplementary Document	Uploaded 2020-06-02	Available
Att 2 60 Day FRN Published 3-9-2020.pdf	Supplementary Document	Uploaded 2020-06-02	Available
Executive_Order_12862.pdf	Supplementary Document	Uploaded 2020-06-02	Available
Att 1 Authorizing Legislation Sec_301 PHSA.docx	Supplementary Document	Uploaded 2020-06-02	Available
SSB-NCHHSTP FastTrack .docx	Supporting Statement B	Uploaded 2020-06-02	Available
SSA-NCHHSTP FastTrack.docx	Supporting Statement A	Uploaded 2020-06-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244939	HIV Surveillance Data System Needs and IT Capability Assessment	Form and Instruction	New
244515	DTBE/FSB Rifampin (RIF) Email Assessment	Other-WORD	New

ICR Details

OMB Control No: 0920-1027	ICR Reference No: 202005-0920-010
Status: Active	Previous ICR Reference No: 201705-0920-017
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-14AMW
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (NCHHSTP)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/07/2020
	Date Received in OIRA: 06/02/2020
Terms of Clearance: Previous terms continue: OMB approves this collection for a period of three years. To request approval of information collections under this generic approval, the agency must do the following: 1) Unless an agency is using multiple modes of collection (e.g., paper forms and electronic submissions), provide a Generic Clearance Submission Template for each Instrument; 2) If the agency is using multiple modes of collection (e.g., paper forms and electronic submissions), the same Generic Clearance Submission Template may be used for both instruments; 3) each Generic Clearance Submission Template must be uploaded as a Supplementary document using a naming convention that allows the public to identify the associated instrument; 4) submit no more than five Generic Submission Templates with each request.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	36 Months From Approved	08/31/2020
Responses	42,660	0	42,660
Time Burden (Hours)	29,070	0	29,070
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable the Agency to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will continue to ensure that users have an effective, efficient, and satisfying experience with the Agency's programs.

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Authorizing Statute(s): US Code: 42 USC Section 301 Name of Law: Public Health Service Act
   EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

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:
	85 FR 13650	03/09/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 33672	06/02/2020
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
DTBE/FSB Rifampin (RIF) Email Assessment
HIV Surveillance Data System Needs and IT Capability Assessment	n/a	HIV Surveillance System and IT Capability Survey

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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	42,660	42,660	0	0	0	0
Annual Time Burden (Hours)	29,070	29,070	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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: $370,500

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? No

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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: 06/02/2020

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