OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Evaluation of Hospital Preparedness in a Mass Casualty Event

ICR 201409-0920-012 · OMB 0920-1042 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Survey Form New Repair queued
Supporting Statement A_OMBcomments_011315.docx Supporting Statement A Uploaded 2015-01-15 Available
Attachment H - Consent Form.doc Supplementary Document Uploaded 2014-09-25 Available
Attachment G - Public Comment.docx Supplementary Document Uploaded 2014-09-25 Repair queued
Attachment C - Invitation letters.docx Supplementary Document Uploaded 2014-09-25 Available
Attachment F - NCIPC Determination - Hospital Preparedness.pdf Supplementary Document Uploaded 2014-09-24 Available
Attachment B Published 60-day notice.pdf Supplementary Document Uploaded 2014-09-24 Available
Attachment A - Authorizing Legislation.doc Supplementary Document Uploaded 2014-09-24 Available
Supporting Statement B.docx Supporting Statement B Uploaded 2014-09-24 Available
IC Document Collections
IC IDCollectionTypeStatusForm
213247 Follow-up Phone Call to CEOs Other-Phone Call New
213237 Survey Form New
ICR Details
0920-1042 201409-0920-012
Historical Active
HHS/CDC 14QJ
Evaluation of Hospital Preparedness in a Mass Casualty Event
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 01/16/2015
Retrieve Notice of Action (NOA) 10/09/2014
  Inventory as of this Action Requested Previously Approved
01/31/2016 12 Months From Approved
720 0 0
740 0 0
0 0 0
The overarching goal of this data collection is to assess national capacity of trauma and non-trauma hospitals to respond to mass casualty incidents involving bombings or non-bombing explosions. Understanding the current capacities will allow the CDC's Division of Unintentional Injury Prevention (DUIP) to develop strategies that address major hospital preparedness gaps.
US Code: 42 USC 241 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  79 FR 24440 04/30/2014
79 FR 59270 10/01/2014
Yes
2
IC Title Form No. Form Name
Follow-up Phone Call to CEOs
Survey none Survey
  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 720 0 0 720 0 0
Annual Time Burden (Hours) 740 0 0 740 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection request.
$162,562
No
No
No
No
No
Uncollected
Carol Marsh 404 639-4773 [email protected]
  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.
10/09/2014