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Federal forms, ICRs, and supporting documents

Information Collection Request

Who’s at Risk: From Hazards to Communities—An Approach for Operationalizing CDC Guidelines to Determine Risks, and Define, Locate and Reach At-Risk Populations in Public Health Emergencies

ICR 201803-0920-018 · OMB 0920-1221 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1221 Los Angeles County - Community Residents Form and Instruction Modified Repair queued
Form 0920-1221 Los Angeles County - Community Partner Stakeholders Form and Instruction Modified Available
Form 0920-1221 Los Angeles County - Public Health Center Guests Form and Instruction Modified Repair queued
Public Health and Medical Emergency Planners/Key Informants - Questionnaire Form and Instruction Unchanged Available
NonSubstantive Change Request 180322.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-03-30 Available
SSB-Who'sAtRisk20171016-clean.docx Supporting Statement B Uploaded 2017-11-08 Available
SSA-WhosAtRisk_13MAR2018.docx Supporting Statement A Uploaded 2018-03-14 Available
AttE-HumanResearchExemption-CDC.DOCX Supplementary Document Uploaded 2017-10-31 Available
AttE1-HumanResearchExemption-LAC.PDF Supplementary Document Uploaded 2017-10-31 Repair queued
AttB-60-DayFRN.PDF Supplementary Document Uploaded 2017-10-31 Available
AttA-AuthLeg.docx Supplementary Document Uploaded 2017-10-31 Available
IC Document Collections
IC IDCollectionTypeStatusForm
228845 Los Angeles County - Community Residents Form and Instruction Modified
228844 Los Angeles County - Community Partner Stakeholders Form and Instruction Modified
228843 Los Angeles County - Public Health Center Guests Form and Instruction Modified
228842 Public Health and Medical Emergency Planners/Key Informants - Questionnaire Form and Instruction Unchanged
ICR Details
0920-1221 201803-0920-018
Historical Active 201710-0920-011
HHS/CDC 0920-1221-18XE
Who’s at Risk: From Hazards to Communities—An Approach for Operationalizing CDC Guidelines to Determine Risks, and Define, Locate and Reach At-Risk Populations in Public Health Emergencies
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 04/05/2018
Retrieve Notice of Action (NOA) 03/30/2018
  Inventory as of this Action Requested Previously Approved
03/31/2020 03/31/2020 03/31/2020
1,600 0 1,600
220 0 226
0 0 0
CDC requests OMB Clearance to conduct participatory research to develop a comprehensive methodology and practical Tool(s) to empower local and state health agencies to identify, analyze, and depict health risks at the community level and develop emergency plans and response capabilities that improve emergency health outcomes. Key project outcomes: 1) Assess and develop risk formula and 2) Assess and develop risk assessment tool. Project includes 2 types of information collection: 1) 100 key informant interviews/focus groups; 2) Anonymous survey of ~1,500 individuals in Los Angeles County. This Non-Substantive Change Request aims to modify a single question (Sex: Female/Male) to address the sensitivity of the respondent to the current question as worded. Overall Burden will be reduced by 125 minutes.
US Code: 42 USC 241 Name of Law: U.S. Public Health Service Act
  
None
Not associated with rulemaking
  82 FR 22833 05/18/2017
82 FR 51842 11/08/2017
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 1,600 1,600 0 0 0 0
Annual Time Burden (Hours) 220 226 0 -6 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
Yes
Changing Forms
Submission of 0920-1221-18XE is a Non-Substantive Change Request to modify questions on the Community Emergency Preparedness Survey. Change Request results in a slight decrease in Burden Hours..
$540,038
No
    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.
03/30/2018