2020 Q3 Emergency COVID-19 Items - OMB Approval

Attachment 4 c- NHIS 2020 Q3 Emergency COVID-19 Items - OMB Approval

NOTICE OF OFFICE OF MANAGEMENT AND BUDGET ACTION
Date

06/22/2020

Department of Health and Human Services
Centers for Disease Control and Prevention
FOR CERTIFYING OFFICIAL:

Jose Arrieta

FOR CLEARANCE OFFICER:

Debbie Kramer

In accordance with the Paperwork Reduction Act, OMB has taken action on your request received
06/17/2020
ACTION REQUESTED:

Revision of a currently approved collection

TYPE OF REVIEW REQUESTED:

Emergency

ICR REFERENCE NUMBER:

202006-0920-009

AGENCY ICR TRACKING NUMBER:
TITLE:

0920-0214

Changes to 2020 National Health Interview Survey in light of Novel Coronavirus (2019-nCoV)

LIST OF INFORMATION COLLECTIONS: See next page
OMB ACTION: Approved with change
OMB CONTROL NUMBER:

0920-0214

The agency is required to display the OMB Control Number and inform respondents of its legal significance in
accordance with 5 CFR 1320.5(b).
EXPIRATION DATE: 12/31/2020

BURDEN:

DISCONTINUE DATE:

RESPONSES

HOURS

COSTS

88,450

34,371

0

122,579

49,893

0

0

0

0

34,129

15,522

0

Change due to Agency Adjustment

0

0

0

Change due to PRA Violation

0

0

0

Previous
New
Difference
Change due to New Statute
Change due to Agency Discretion

TERMS OF CLEARANCE:

Previous terms continue: Approved consistent with NCHS's commitment to develop guidelines
for sponsored content, including the impact on the total length of the NHIS and the criteria to
be used to determine if the sponsored content is appropriate for the NHIS. Non-substantive
change mechanism may be used to modify existing questions and add depth/additional detail
to existing questions. Requests to add questions, including cycling modules in or out, must be
consistent with the principles of the recent redesign.

OMB Authorizing Official:

Paul Ray
Administrator,
Office Of Information And Regulatory Affairs

List of ICs
IC Title

Form No.

Re-Designed Household
Roster
Re-Designed Adult
Questionnaire
Re-Designed Child
Questionnaire
Methodological Projects

0920-0214

Re-Designed Re-Interview
Survey
COVID-Related Questions
Sample Adult
COVID-Related Questions
Adult Family Member
COVID-Related Questions
Sample Adult 2019 Followback

0920-0214

0920-0214
0920-0214
0920-0214

Form Name
Redesigned Household
Rooster
Redesigned Adult
Questionnaire
Redesigned Child
Questionnaire
Methodological Projects

0920-0214

Re-Designed Re-Interview
Survey
Sample Adult

0920-0214

Adult Family Member

0920-0214

Sample Adult 2019 Followback

CFR Citation