[NCEH] Environmental Public Health Tracking Network (Tracking Network)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1175 PA/PHA Impact Followup	Form and Instruction	Unchanged	Available
Form 0920-1175 PHA Impact Follow Up - (RedCap form) (New form)	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Performance Measurses - Unique	Form and Instruction	Unchanged	Available
Form 0920-1175 Performance Measures- Unique	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Standardized Web Statistics - Codebook	Form and Instruction	Unchanged	Available
Form 0920-1175 Standardized Web Statistics - Codebook	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Data Dictionary- State Biomonitoring Data	Form and Instruction	Modified	Available
Form 0920-1175 Data Dictionary- State Biomonitoring Data	Form and Instruction	Modified	Repair queued
Form 0920-1175 Outreach & Communication Plan Template with Instructions	Form and Instruction	Unchanged	Available
Form 0920-1175 Outreach & Communication Plan Template with Instructions	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Program Accomplishments & Public Health Actions	Form and Instruction	Unchanged	Available
Form 0920-1175 Publilc Health Action Report - Existing Awardees	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Modernizing Environmental Public Health Tracking to Advance Enviromental Health Surveillance Work Plan Template	Form and Instruction	Unchanged	Available
Form 0920-1175 Environmental Public Health Tracking Work Plan Template	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Metadata Sample Content	Form and Instruction	Unchanged	Available
Form 0920-1175 Metadata Sample Content	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Radon Testing Form	Form and Instruction	Unchanged	Available
Form 0920-1175 Data Dictionary for Data Submission -- Labs Radon Data	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Data Dictionary- Hospitalizations	Form and Instruction	Modified	Available
Form 0920-1175 Data Dictionary- Hospitalizations	Form and Instruction	Modified	Available
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits	Form and Instruction	Modified	Available
Form 0920-1175 Data Dictionary - Emergency Department (ED) Visits	Form and Instruction	Modified	Repair queued
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction	Unchanged	Available
Form 0920-1175 Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Environmental Public Health Tracking - CHILDHOOD BLOOD LEAD POISONING	Form and Instruction	Unchanged	Available
Form 0920-1175 Environment Public Health Tracking -- Childhood Blood Lead Poisoning	Form and Instruction	Unchanged	Repair queued
Form 0920-1175 Data Dictionary -- Birth Defects(Prevalence)	Form and Instruction	Modified	Available
Form 0920-1175 Data Dictionary – Birth Defects (Prevelance) Form	Form and Instruction	Modified	Repair queued
0920-1175 Change Request Memo - EO14168.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-06	Available
0920-1175 Change Request Memo - EO14168.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-03-06	Repair queued
Att6 CDC-RFA-EH17-1702.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att6 CDC-RFA-EH17-1702.pdf	Supplementary Document	Uploaded 2023-07-06	Repair queued
Att10 Data Management Processes.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att10 Data Management Processes.pdf	Supplementary Document	Uploaded 2023-07-06	Repair queued
Att9 NCDM Requirements.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att9 NCDM Requirements.pdf	Supplementary Document	Uploaded 2023-07-06	Repair queued
Att8 Funding Determination.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att8 Funding Determination.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att7 Environ PH Trckg 2023 Revision PIA.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att7 Environ PH Trckg 2023 Revision PIA.pdf	Supplementary Document	Uploaded 2023-07-06	Repair queued
Att3 NOFO CDC-RFA-EH22-2202.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att3 NOFO CDC-RFA-EH22-2202.pdf	Supplementary Document	Uploaded 2023-07-06	Repair queued
Att2 Environ PH Trckg 60 day FRN publication.pdf	Supplementary Document	Uploaded 2023-07-06	Available
Att2 Environ PH Trckg 60 day FRN publication.pdf	Supplementary Document	Uploaded 2023-07-06	Repair queued
Att1_PHSA Section 243&247.docx	Supplementary Document	Uploaded 2020-04-27	Available
Att1_PHSA Section 243&247.docx	Supplementary Document	Uploaded 2020-04-27	Repair queued
0 - Environ PH Trckg 2023 Revision SSB.docx	Supporting Statement B	Uploaded 2023-07-06	Available
0 - Environ PH Trckg 2023 Revision SSB.docx	Supporting Statement B	Uploaded 2023-07-06	Repair queued
0 - Environ PH Trckg 2023 (REV) SSA.docx	Supporting Statement A	Uploaded 2023-07-17	Available
0 - Environ PH Trckg 2023 (REV) SSA.docx	Supporting Statement A	Uploaded 2023-07-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260973	PHA Impact Follow Up - (RedCap form) (New form)	Form and Instruction	Unchanged	PA/PHA Impact Followup
260973	PHA Impact Follow Up - (RedCap form) (New form)	Form and Instruction	Unchanged
241554	Performance Measures- Unique	Form and Instruction	Unchanged	Performance Measurses - Unique
241554	Performance Measures- Unique	Form and Instruction	Unchanged
222657	Standardized Web Statistics - Codebook	Form and Instruction	Unchanged	Standardized Web Statistics - Codebook
222657	Standardized Web Statistics - Codebook	Form and Instruction	Unchanged
222656	Data Dictionary- State Biomonitoring Data	Form and Instruction	Modified	Data Dictionary- State Biomonitoring Data
222656	Data Dictionary- State Biomonitoring Data	Form and Instruction	Modified
222654	Outreach & Communication Plan Template with Instructions	Form and Instruction	Unchanged	Outreach & Communication Plan Template with Instructions
222654	Outreach & Communication Plan Template with Instructions	Form and Instruction	Unchanged
222652	Publilc Health Action Report - Existing Awardees	Form and Instruction	Unchanged	Program Accomplishments & Public Health Actions
222652	Publilc Health Action Report - Existing Awardees	Form and Instruction	Unchanged
222650	Environmental Public Health Tracking Work Plan Template	Form and Instruction	Unchanged	Modernizing Environmental Public Health Tracking to Advance Enviromental Health Surveillance Work Plan Template
222650	Environmental Public Health Tracking Work Plan Template	Form and Instruction	Unchanged
222649	Metadata Sample Content	Form and Instruction	Unchanged	Metadata Sample Content
222649	Metadata Sample Content	Form and Instruction	Unchanged
222648	Data Dictionary for Data Submission -- Labs Radon Data	Form and Instruction	Unchanged	Radon Testing Form
222648	Data Dictionary for Data Submission -- Labs Radon Data	Form and Instruction	Unchanged
222646	Data Dictionary- Hospitalizations	Form and Instruction	Modified	Data Dictionary- Hospitalizations
222646	Data Dictionary- Hospitalizations	Form and Instruction	Modified
222533	Data Dictionary - Emergency Department (ED) Visits	Form and Instruction	Modified	Data Dictionary - Emergency Department (ED) Visits
222533	Data Dictionary - Emergency Department (ED) Visits	Form and Instruction	Modified
222532	Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction	Unchanged	Data Dictionary – Drinking Water (Community Monitoring)
222532	Data Dictionary – Drinking Water (Community Monitoring)	Form and Instruction	Unchanged
222531	Environment Public Health Tracking -- Childhood Blood Lead Poisoning	Form and Instruction	Unchanged	Environmental Public Health Tracking - CHILDHOOD BLOOD LEAD POISONING
222531	Environment Public Health Tracking -- Childhood Blood Lead Poisoning	Form and Instruction	Unchanged
222530	Data Dictionary – Birth Defects (Prevelance) Form	Form and Instruction	Modified	Data Dictionary -- Birth Defects(Prevalence)
222530	Data Dictionary – Birth Defects (Prevelance) Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1175	ICR Reference No: 202503-0920-007
Status: Active	Previous ICR Reference No: 202306-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-25-0034
Title: [NCEH] Environmental Public Health Tracking Network (Tracking Network)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/01/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 03/28/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2026	08/31/2026	08/31/2026
Responses	635	0	635
Time Burden (Hours)	14,384	0	14,384
Cost Burden (Dollars)	0	0	0

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Abstract: CDC's Tracking Program collects, integrates, analyzes, and disseminates data on health, exposure, environmental hazards, and populations in order to drive public health actions that mitigate or prevent the effects of environmental factors on the health of communities. Respondents include 26 funded grantees and unfunded state and local health departments (SLHD). These data are used to describe trends, identify populations at risk, generate hypotheses, and inform public health actions for SLHD. Additional program information collected quarterly or annually are used to evaluate and assess program performance is collected using 6 forms. This change request is to adhere to current executive orders.

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Authorizing Statute(s): US Code: 42 USC 247 Name of Law: Public Health Service Act
  

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 77840	12/20/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 41630	06/27/2023
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 14

table that charts list of burden

IC Title	Form No.	Form Name
Data Dictionary - Emergency Department (ED) Visits	0920-1175	Data Dictionary - Emergency Department (ED) Visits
Data Dictionary for Data Submission -- Labs Radon Data	0920-1175	Radon Testing Form
Data Dictionary – Birth Defects (Prevelance) Form	0920-1175	Data Dictionary -- Birth Defects(Prevalence)
Data Dictionary – Drinking Water (Community Monitoring)	0920-1175	Data Dictionary – Drinking Water (Community Monitoring)
Data Dictionary- Hospitalizations	0920-1175	Data Dictionary- Hospitalizations
Data Dictionary- State Biomonitoring Data	0920-1175	Data Dictionary- State Biomonitoring Data
Environment Public Health Tracking -- Childhood Blood Lead Poisoning	0920-1175	Environmental Public Health Tracking - CHILDHOOD BLOOD LEAD POISONING
Environmental Public Health Tracking Work Plan Template	0920-1175	Modernizing Environmental Public Health Tracking to Advance Enviromental Health Surveillance Work Plan Template
Metadata Sample Content	0920-1175	Metadata Sample Content
Outreach & Communication Plan Template with Instructions	0920-1175	Outreach & Communication Plan Template with Instructions
PHA Impact Follow Up - (RedCap form) (New form)	0920-1175	PA/PHA Impact Followup
Performance Measures- Unique	0920-1175	Performance Measurses - Unique
Publilc Health Action Report - Existing Awardees	0920-1175	Program Accomplishments & Public Health Actions
Standardized Web Statistics - Codebook	0920-1175	Standardized Web Statistics - Codebook

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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	635	635	0	0	0	0
Annual Time Burden (Hours)	14,384	14,384	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The program data will increase the number of respondents from 26 to 37 to incorporate the 7 new recipients funded under CDC-RFA-EH22-2202, potential future funding of new SLHD, and to collect voluntary responses from unfunded SLHD. Based on the above changes, we are requesting to increase the annualized number of responses from 599 to 635 (due to an increased number of recipients) but decrease the annualized time burden from 21,860 to 14,384 hours.

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Annual Cost to Federal Government: $21,571,142

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: 03/28/2025

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