[NCCDPHP] Sealant Efficiency Assessment for Locals and States (SEALS)

Forms and Documents

Document Name	Status
Form 0920-1289 Program Administration -Child Aggregate Screens (SSP Local Administrator) Form and Instruction	Modified
Form 0920-1289 Program Administration - Program Options and Cost Options (SSP Local Administrator) Form and Instruction	Modified
Form 0920-1289 SEALS Administration - Add User/Program/School (SSP Local Administrator) Form and Instruction	Modified
Form 0920-1289 Add Program and Add User - State Sealant Administrator Form and Instruction	Modified
SEALS SSB Final.docx Supporting Statement B	2019-11-18
SEALS SSA.101123.docx Supporting Statement A	2023-10-13
SEALS PIA Final.pdf Supplementary Document	2019-11-18
SEALS IRB Determination.pdf Supplementary Document	2023-10-13
2c. Sample Reports.xlsx Supplementary Document	2023-10-13
1_Legislation.pdf Supplementary Document	2023-10-13
3 SEALS 60dy published FRN.pdf Supplementary Document	2023-10-13

IC Document Collections

IC ID	Document Title	Status
238600	Program Administration -Child Aggregate Screens (SSP Local Administrator) Form and Instruction	Modified
238599	Program Administration - Program Options and Cost Options (SSP Local Administrator) Form and Instruction	Modified
238598	SEALS Administration - Add User/Program/School (SSP Local Administrator) Form and Instruction	Modified
238597	Add Program and Add User - State Sealant Administrator Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1289	ICR Reference No: 202309-0920-005
Status: Received in OIRA	Previous ICR Reference No: 201910-0920-011
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1289
Title: [NCCDPHP] Sealant Efficiency Assessment for Locals and States (SEALS)
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/31/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	3,582	0
Time Burden (Hours)	1,388	0
Cost Burden (Dollars)	0	0

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Abstract: By age 19, 67% of U.S. adolescents living in poverty have experienced tooth decay and 27% have at least one decayed tooth needing treatment. School sealant programs provide dental sealants, which protect against 80% of cavities for two years, and continue to protect against 50% of cavities for up to four years. CDC requests information from states regarding children's cavity risk, one-year sealant retention rate, sealant program services delivered, and school sealant program cost and quantity of resources used at each school event. This data will allow CDC and states to monitor the performance and efficiency of their school sealant programs, which will improve and extend program delivery to more children.

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Authorizing Statute(s): US Code: 42 USC 247b-14 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:
	88 FR 36583	06/05/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 72762	10/23/2023
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Add Program and Add User - State Sealant Administrator	0920-1289	SEALS Administration - Child Aggregate Screens
Program Administration - Program Options and Cost Options (SSP Local Administrator)	0920-1289	Program Administration - Program Options and Cost Options
Program Administration -Child Aggregate Screens (SSP Local Administrator)	0920-1289	Child Aggregate Screens - Add Event
SEALS Administration - Add User/Program/School (SSP Local Administrator)	0920-1289	SEALS State and Program Administrator Screens

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ICR Summary of Burden

	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	3,582	0	0	3,582	0	0
Annual Time Burden (Hours)	1,388	0	0	1,388	0	0
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: No

Burden Reduction Due to:

Short Statement: The change is the addition of collecting race/ethnicity data according to OMB standards. To advance health equity, addressing social determinants of health and improving diversity, equity, inclusion, accessibility, and belonging, the collection of race/ethnicity is crucial. Driving factors behind negative social determinants of health—such as economic policies and systems, social norms, systemic racism, and climate change—have negatively affected the health and health outcomes of groups including, but not limited to African American/Black, American Indian or Alaska Native, Asian, Hispanic, or Latino, and Native Hawaiian or other Pacific Islander people. The reinstatement request occurred because of delays by program to prepare the OMB package. There were no changes to burden.

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Annual Cost to Federal Government: $62,810

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: 10/31/2023

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