Information Collection Request

Colorectal Cancer Screening Program

ICR 201004-0920-014 · OMB 0920-0745 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 2 Cost Assessment Tool Form and Instruction Modified Available
Attachment 5. Annual Aggregate Data on Medically Ineligible Clients Form Form and Instruction Removed Repair queued
Attachment 4. Medical Complications Reporting Form and Instructions Form and Instruction Removed Available
Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs Form Removed Repair queued
Form 1 Clinical Data Elements (CCDE) Form and Instruction Modified Repair queued
ATTACHMENT 6 Data Consultants.doc Supplementary Document Uploaded 2010-04-08 Available
Attachment 2b. Public Comment and CDC Response.docx Supplementary Document Uploaded 2010-04-08 Available
ATTACHMENT 2a. 60-DAY FRN.pdf Supplementary Document Uploaded 2010-04-08 Available
Attachment 5b Cost Assessment Tool Users Manual.doc Supplementary Document Uploaded 2010-04-08 Repair queued
0920-05CJ ATTACHMENT 2b CRCSDP Data Users Manual (v101).pdf Supplementary Document Uploaded 2007-02-14 Available
ATTACHMENT 3c CCDE Comparison Table.pdf Supplementary Document Uploaded 2010-04-08 Available
ATTACHMENT 4abc Sample Feedback.doc Supplementary Document Uploaded 2010-04-08 Available
Attachment 3b CCDE Data Users Manual.docx Supplementary Document Uploaded 2010-04-08 Available
0920-0745_Supporting Statement_Part A 03.29.10.doc Supporting Statement A Uploaded 2010-04-08 Available
IC Document Collections
IC IDCollectionTypeStatusForm
179138 Cost Assessment Tool Form and Instruction Modified
179137 Attachment 5. Annual Aggregate Data on Medically Ineligible Clients Form Form and Instruction Removed
179136 Attachment 4. Medical Complications Reporting Form and Instructions Form and Instruction Removed
179135 Attachment 2a. Colorectal Cancer Clinical Data Elements for FOBT Programs Form Removed
179134 Clinical Data Elements (CCDE) Form and Instruction Modified
ICR Details
0920-0745 201004-0920-014
Historical Active 200703-0920-006
HHS/CDC
Colorectal Cancer Screening Program
Revision of a currently approved collection   No
Regular
Approved without change 06/03/2010
Retrieve Notice of Action (NOA) 04/28/2010
  Inventory as of this Action Requested Previously Approved
06/30/2013 36 Months From Approved 07/31/2010
9,776 0 3,520
3,010 0 1,270
0 0 0

CDC is expanding the Colorectal Cancer Screening Program, which provides screening services to individuals age 50 and older who have inadequate access to CRC screening services. Program grantees will report clinical data elements and cost information to CDC for purposes of program evaluation and improvement. The word "Demonstration" is being taken out of the previously approved title.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  75 FR 5086 02/01/2010
75 FR 17921 04/08/2010
Yes

  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 9,776 3,520 0 6,256 0 0
Annual Time Burden (Hours) 3,010 1,270 0 1,740 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Changing Forms
The term "Demonstration" will be deleted from the title of the information collection; the clinical data component will be simplified; and an activity-based economic data collection will replace the cost reimbursement data collection. The information collected from funded sites will be used to monitor and evaluate the CRC screening program. The overall estimated burden will increase due to the increase in the number of funded CRC screening sites.

$829,385
No
No
No
Uncollected
No
Uncollected
Petunia Gissendaner 4046390164

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/28/2010