OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

ASSESSING THE INFRASTRUCTURE FOR PUBLIC STD PREVENTION SERVICES

ICR 201706-0920-006 · OMB 0920-1210 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
SHD Survey Form and Instruction New Available
LHD Survey Form and Instruction New Available
SSB.docx Supporting Statement B Uploaded 2017-08-14 Available
SSA 0920-17NS Assessing Infrastructure 14AUG2017.docx Supporting Statement A Uploaded 2017-08-14 Available
Att 10_web survey reminders - LHD and SHD.docx Supplementary Document Uploaded 2017-06-13 Available
Att 9_Web Survey Invite LHD and SHD.docx Supplementary Document Uploaded 2017-06-13 Available
Att 2_60-Day FRN.pdf Supplementary Document Uploaded 2017-06-13 Available
Att 8_ProjectDeterminationForm.pdf Supplementary Document Uploaded 2017-06-13 Available
Att 7_Definitions for Survey Terms.docx Supplementary Document Uploaded 2017-06-13 Available
Att 1_Sect 301 PHSA.doc Supplementary Document Uploaded 2017-06-13 Available
IC Document Collections
IC IDCollectionTypeStatusForm
227898 SHD Survey Form and Instruction New
227897 LHD Survey Form and Instruction New
ICR Details
0920-1210 201706-0920-006
Historical Active
HHS/CDC 0920-17NS
ASSESSING THE INFRASTRUCTURE FOR PUBLIC STD PREVENTION SERVICES
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 12/22/2017
Retrieve Notice of Action (NOA) 08/17/2017
  Inventory as of this Action Requested Previously Approved
12/31/2020 36 Months From Approved
378 0 0
146 0 0
0 0 0
The goal of this study is to monitor STD preventive and clinical treatment services provided by local and state health departments. Web surveys will be sent to a sample of 668 local health departments & all 50 state health departments. Reminders will be sent to non-responders in order to reach the target of 334 completed local health department & 44 state health departments. Data will be used to help CDC assess the delivery of timely public STD preventive and clinical services to reduce the number of newly acquired STDs and prevent STD-related sequelae.
US Code: 42 USC 241 Name of Law: U.S. PHSA
  
None
Not associated with rulemaking
  82 FR 12357 03/02/2017
82 FR 37860 08/14/2017
Yes
2
IC Title Form No. Form Name
LHD Survey NA Local Health Department Survey
SHD Survey NA State Health Department 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 378 0 0 378 0 0
Annual Time Burden (Hours) 146 0 0 146 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Submission of 0920-17NS - ASSESSING THE INFRASTRUCTURE FOR PUBLIC STD PREVENTION SERVICES is a New ICR.
$151,026
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [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.
08/17/2017