Privacy Narrative Form

Date
09/14/2021

Information Collection Request - Privacy Narrative

Synopsis of State Oral Health Programs
Title: ______________________________________________________________________________________
Lorena Espinoza ([email protected])
Point of Contact: _____________________________________________________________________________

Description

This privacy narrative supports an activity that is an existing collection in use without an OMB Control
number. Compared to previous versions of the questionnaire, the 2022 Synopses questionnaire no
longer collects protected or identifiable information i.e., dental director's name, degrees/credentials,
and race/ethnicity.
Data, submitted by the states via email to ASTDD or via SurveyMonkey, is entered/transferred into an
Access database which is stored on ASTDD's secure server. ASTDD's secure server, along with the
State Synopses database, are password protected and only the Executive Director, Grants Manager, and
Data Consultants have access. The database will be stored on ASTDD's server for 10 years.
Once data is submitted and analyzed, ASTDD shares free public access to aggregate data. ASTDD also
allows restricted access of state-specific data to members of ASTDD. ASTDD does not release state
specific information on overall budget. State specific data for all variables except dental director's
name, dental director's degrees/credentials, and overall budget are available as a PDF on the member's
only section of ASTDD's website, which requires special log in credentials (www.astdd.org). If an
individual or organization requests additional state specific information, ASTDD provides that
information as an Excel spreadsheet with a data dictionary and a copy of the questionnaire used to
collect the information, as appropriate.
ASTDD sends the full State Synopsis dataset to the DOH annually. Data sent to DOH are stored in a
password protected shared drive accessible by the DOH Data Manager. Data will be retained and
archived according to CDC's Records Management Policy. CDC will store and maintain the data set as
long as the data is being used for surveillance and program needs or other research. Within one year of
data collection, a subset of state-specific State Synopses data, including information on leadership,
policies, programs, and staffing, is publicly available on CDC's Oral Health Data portal.
Does this ICR request any PII?

Yes

✔ No

If yes, describe: _____________________________________

Does this ICR include a form that requires a Privacy Act Statement?
Does this ICR require a PIA?

Yes

✔

No

Yes

✔

No

If yes, does a signed PIA already exist?

C/I/O Approval
Associate Director for Science

Joan Redmondleonard -S
Comments:

Digitally signed by Joan
Redmond-leonard -S
Date: 2022.07.05
21:35:00 -04'00'

Information Systems Security Officer

Cynthia
Allen -S

Digitally signed by
Cynthia Allen -S
Date: 2022.07.06
11:05:56 -04'00'

Yes

✔

No