[NCCDPHP] Paul Coverdell National Acute Stroke Program (2015-2020) Assessment

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1233 PCNASP Interview Guide - Coverdell Partners	Form and Instruction	Modified	Available
Form 0920-1233 PCNASP Interview Guides - Coverdell Partners	Form and Instruction	Modified	Repair queued
Data Analyst/Program Evaluator - Telephone Interview Protocol	Form and Instruction	Removed	Available
Data Analyst/Program Evaluator - Telephone Interview Protocol	Form and Instruction	Removed	Available
Form 0920-1233 PCNASP Interview Guide - Coverdell Quality Improvement Specialist	Form and Instruction	Modified	Available
Form 0920-1233 PCNASP Interview Guides - Coverdell Quality Improvement Specialist	Form and Instruction	Modified	Repair queued
Grantee Program Manager - Telephone Interview Protocol	Form and Instruction	Removed	Available
Grantee Program Manager - Telephone Interview Protocol	Form and Instruction	Removed	Repair queued
Form 0920-1233 PCNASP Interview Guide - Coverdell Program Director	Form and Instruction	Modified	Available
Form 0920-1233 PCNASP Interview Guide - Coverdell Program Director	Form and Instruction	Modified	Available
Form 0920-1233 Coverdell Cost Collection Tool	Form and Instruction	Modified	Available
Form 0920-1233 Coverdell- Cost Collection Tool (Program Manager)	Form and Instruction	Modified	Repair queued
A6. IRB Determination Memorandum.pdf	Supplementary Document	Uploaded 2022-11-01	Repair queued
A2-B3. Coverdell Cost Collection Tool_08-12-22.xlsx	Supplementary Document	Uploaded 2022-11-01	Repair queued
PCNASP OMB Statement B_110222.docx	Supporting Statement B	Uploaded 2022-11-02	Repair queued
PCNASP OMB Statement A_110122.docx	Supporting Statement A	Uploaded 2022-11-02	Repair queued
A3-B1. Introductory Email about Interviews.docx	Supplementary Document	Uploaded 2022-11-01	Repair queued
B4. Invitation and Reminder about Cost Data Collection_10-16-2022.docx	Supplementary Document	Uploaded 2022-11-01	Repair queued
A5. 0920-1233 60 day FRN May23-2022 (002).pdf	Supplementary Document	Uploaded 2022-11-01	Repair queued
A1. Public Health Service Act (42 U.S.C. 241).pdf	Supplementary Document	Uploaded 2022-11-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
231177	PCNASP Interview Guides - Coverdell Partners	Form and Instruction	Modified	PCNASP Interview Guide - Coverdell Partners
231177	PCNASP Interview Guides - Coverdell Partners	Form and Instruction	Modified
231176	Data Analyst/Program Evaluator - Telephone Interview Protocol	Form and Instruction	Removed	Data Analyst/Program Evaluator - Telephone Interview Protocol
231176	Data Analyst/Program Evaluator - Telephone Interview Protocol	Form and Instruction	Removed
231175	PCNASP Interview Guides - Coverdell Quality Improvement Specialist	Form and Instruction	Modified	PCNASP Interview Guide - Coverdell Quality Improvement Specialist
231175	PCNASP Interview Guides - Coverdell Quality Improvement Specialist	Form and Instruction	Modified
231174	Grantee Program Manager - Telephone Interview Protocol	Form and Instruction	Removed	Grantee Program Manager - Telephone Interview Protocol
231174	Grantee Program Manager - Telephone Interview Protocol	Form and Instruction	Removed
231173	PCNASP Interview Guide - Coverdell Program Director	Form and Instruction	Modified	PCNASP Interview Guide - Coverdell Program Director
231173	PCNASP Interview Guide - Coverdell Program Director	Form and Instruction	Modified
231172	Coverdell- Cost Collection Tool (Program Manager)	Form and Instruction	Modified	Coverdell Cost Collection Tool
231172	Coverdell- Cost Collection Tool (Program Manager)	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1233	ICR Reference No: 202209-0920-011
Status: Historical Active	Previous ICR Reference No: 201804-0920-010
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1233
Title: [NCCDPHP] Paul Coverdell National Acute Stroke Program (2015-2020) Assessment
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/05/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/28/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2025	24 Months From Approved
Responses	91	0	0
Time Burden (Hours)	117	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC and RTI International propose to collect information from all thirteen funded DP21-2102 Paul Coverdell National Acute Stroke Program (PCNASP) recipients and a sample of their partners to describe the implementation of PCNASP activities across the stroke system of care for the national and state levels and for the populations and subpopulations selected by recipients.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: U.S. PHSA
  

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:
	87 FR 31239	05/23/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 68695	11/16/2022
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Coverdell- Cost Collection Tool (Program Manager)	0920-1233	Coverdell Cost Collection Tool
Data Analyst/Program Evaluator - Telephone Interview Protocol	NA	Data Analyst/Program Evaluator - Telephone Interview Protocol
Grantee Program Manager - Telephone Interview Protocol	NA	Grantee Program Manager - Telephone Interview Protocol
PCNASP Interview Guide - Coverdell Program Director	0920-1233	PCNASP Interview Guide - Coverdell Program Director
PCNASP Interview Guides - Coverdell Partners	0920-1233	PCNASP Interview Guide - Coverdell Partners
PCNASP Interview Guides - Coverdell Quality Improvement Specialist	0920-1233	PCNASP Interview Guide - Coverdell Quality Improvement Specialist

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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	91	0	0	85	0	6
Annual Time Burden (Hours)	117	0	0	111	0	6
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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: CDC will implement the same two types of data collection as before: 1) program implementation cost data collection from recipients using a cost collection tool. The cost study will include the 13 respondents (once a year) for a total estimated burden to respondents of 52.0 hours (annualized burden of 26.0 hours). The telephone interviews will include 78 respondents (once a year) for a total estimated burden to respondents of 156 hours (annualized burden of 78 hours). Other changes include minor edits to the cost data collection tool and interview protocols to align with the PCNASP goals and strategies.

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Annual Cost to Federal Government: $90,310

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: 11/28/2022

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