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

ICR 202208-0920-002

OMB: 0920-0612

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2022-08-11
Supplementary Document
2022-08-11
Supplementary Document
2022-08-11
Supplementary Document
2022-08-11
Supplementary Document
2022-08-11
Supplementary Document
2022-08-11
Supporting Statement B
2022-08-11
Supporting Statement A
2022-08-11
IC Document Collections
ICR Details
0920-0612 202208-0920-002
Received in OIRA 202010-0920-002
HHS/CDC 0920-0612
Well-Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) Reporting System
Extension without change of a currently approved collection   No
Regular 08/16/2022
  Requested Previously Approved
24 Months From Approved 08/31/2022
105 105
2,240 2,240
0 0

Well-Integrated Screening and Evaluation for Women Across the Nation, sponsored by CDC, provides cardiovascular disease risk reduction services to low income, uninsured, or underinsured women aged 40-64. There are no changes to the information collected. CDC will continue to use the information collected from WISEWOMAN awardees to support program monitoring and improvement activities, evaluation, and assessment of program outcomes. The information collection consists of two parts, a Progress Report and Minimum Data Elements. A two-year extension is requested.

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

  87 FR 33487 06/02/2022
87 FR 49848 08/12/2022
No

  Total Request 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 105 105 0 0 0 0
Annual Time Burden (Hours) 2,240 2,240 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$384,750
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Renita Macaluso 770 488-6458 [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.
08/16/2022


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