Privacy Act Checklist

Privacy Act Checklist

Preventative Health and Health Services Block Grant (OMB Control No. 0920-0106, Exp. 02/29/2024) – EXTENSION - National Center for State, Tribal, Local, and Territorial Public Health Infrastructure and Workforce (NCSTLTPHIW), Centers for Disease Control and Prevention (CDC).

• CDC is requesting a three-year approval for an information collection request extension to collect information from the 61 PHHS Block Grant recipients during the period of performance to: a) account for funds in accordance with legislative mandates; b) monitor recipient’s progress; c) identify activities and personnel supported with Block Grant funding; d) conduct compliance reviews; and e) promote the use of evidence-based guidelines and interventions.

• The Privacy Act does not apply. No personal identifying information will be collected, aligns with the PHHS Block Grant program reporting requirements, and in accordance with legislative mandates. All identifying information will be kept secure, stored in a password protected file, and will only be accessible to the project team. No identifiable information describing respondents will be included in the analyzed data and aggregate reports. No sensitive information is being collected. This data collection is not research involving human subjects.