OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Promoting Adolescent Health through School-based HIV/STD Prevention

ICR 201710-0920-008 · OMB 0920-1049 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
NGO Exemplary Sexual Health Education Measures Form Modified Repair queued
NGO Safe and Supportive Environment Measures Form Modified Available
NGO Sexual Health Services Measures Form Modified Repair queued
Local Education Agency Exemplary Sexual Health Education Measures Form Modified Repair queued
Local Education Agency Sexual Health Services Measures Form Modified Available
Local Education Agency Safe and Supportive Environment Measures Form Modified Available
State Education Agency Exemplary Sexual Health Education Measures Form Modified Available
State Education Agency Sexual Health Services Measures Form Modified Available
State Education Agency Safe and Supportive Environment Measures Form Modified Available
Att 11 Eval Framework.pdf Supplementary Document Uploaded 2017-10-17 Available
Att 10 Analysis of Alternatives.doc Supplementary Document Uploaded 2017-10-17 Available
Att 7 Funded Agencies Providing Feedback.docx Supplementary Document Uploaded 2017-10-17 Available
Att 6 List of Funded Agencies.docx Supplementary Document Uploaded 2017-10-17 Repair queued
Supporting Statement A 17OCT2017.docx Supporting Statement A Uploaded 2017-10-17 Available
Att 2 60 FRN.pdf Supplementary Document Uploaded 2017-10-17 Available
Att 1 Public Health Service Act Legislation.pdf Supplementary Document Uploaded 2017-10-17 Available
Att 9c SSE Rationale.pdf Supplementary Document Uploaded 2014-09-04 Available
Att 9b SHS Rationale.pdf Supplementary Document Uploaded 2014-09-04 Available
Att 9a ESHE Rationale.pdf Supplementary Document Uploaded 2014-09-04 Available
Supporting Statement B 17OCT2017.docx Supporting Statement B Uploaded 2017-10-17 Available
IC Document Collections
IC IDCollectionTypeStatusForm
212973 NGO Exemplary Sexual Health Education Measures Form Modified
212972 NGO Safe and Supportive Environment Measures Form Modified
212971 NGO Sexual Health Services Measures Form Modified
212970 Local Education Agency Exemplary Sexual Health Education Measures Form Modified
212969 Local Education Agency Sexual Health Services Measures Form Modified
212968 Local Education Agency Safe and Supportive Environment Measures Form Modified
212967 State Education Agency Exemplary Sexual Health Education Measures Form Modified
212966 State Education Agency Sexual Health Services Measures Form Modified
212965 State Education Agency Safe and Supportive Environment Measures Form Modified
ICR Details
0920-1049 201710-0920-008
Historical Active 201409-0920-004
HHS/CDC 0920-1049
Promoting Adolescent Health through School-based HIV/STD Prevention
Extension without change of a currently approved collection   No
Regular
Approved without change 01/16/2018
Retrieve Notice of Action (NOA) 10/24/2017
  Inventory as of this Action Requested Previously Approved
01/31/2019 12 Months From Approved 02/28/2018
222 0 228
804 0 820
0 0 0
The purpose of this request is to obtain a one-year extension for data collection using a Web-based program evaluation and monitoring system that will use Web-based questionnaires to organize, plan, and track PS13-1308 funded agency activities conducted to meet the performance and process measures established by the Centers for Disease Control and Prevention (CDC), National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Adolescent and School Health, (DASH). The system will provide access to data and reports for DASH and its funded agencies (state and local education agencies and non-governmental organizations), which allows areas for improvement to be identified and addressed efficiently. These questionnaires will include performance and process measures to be used for program monitoring, evaluation, and quality improvement for HIV/STD prevention activities.
US Code: 42 USC 241 Name of Law: PHSA
  
None
Not associated with rulemaking
  82 FR 16833 04/06/2017
82 FR 48814 10/20/2017
No
  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 222 228 0 -6 0 0
Annual Time Burden (Hours) 804 820 0 -16 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Miscellaneous Actions
Submission of 0920-1049 is an Extension ICR. Decrease in Burden Hours is due to State Education Agencies dropping out of the previously approved information collection process.
$498,851
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.
10/24/2017