Information Collection Request

Poison Center Collaborations for Public Health Emergencies

ICR 202001-0920-012 · OMB 0920-1166 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-1166 Identifying Sources of and Risk Factors for Harmful Algal Bloom Exposures through Poison Control Center Follow-up Questionnaires – United States, 2019 Form Unchanged Available
HABs Consent and Assent Forms.docx Supplementary Document Uploaded 2020-01-23 Available
Att4 HABs GenIC Questionnaire - Parent-Child.docx Supplementary Document Uploaded 2020-01-23 Repair queued
Att3 HABs GenIC Questionnaire - Adolescent.docx Supplementary Document Uploaded 2020-01-23 Available
Att2 HABs GenIC Questionnaire - Adult.docx Supplementary Document Uploaded 2020-01-23 Available
2019 Poison Center Burden Memo HABs.docx Supplementary Document Uploaded 2020-01-23 Available
0920-1166 Change Request Justification FY2020 Q1.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-01-23 Available
Att14 Smpl Dtst for Qstnnr PCCPHE.xlsx Supplementary Document Uploaded 2016-09-07 Available
Att13 NCEH-ATSDR RDF PCCPHE.pdf Supplementary Document Uploaded 2016-09-07 Available
Att12 Burden Memo PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att11 Sample Questionnaire Parent PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att10 Sample Questionnaire Adolescent PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Repair queued
Att9 Sample Questionnaire Adult PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att8 Sample Consent and Assent Forms PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att7 GenIC Rqst Apprvl Form PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att6 Advncd Ntifictn Emil for OMB PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att5 Step-by-StepHowtoUsetheGenericClrnce PCCPHE.docx Supplementary Document Uploaded 2016-09-07 Available
Att4 CDC-AAPCC DataLicAgremt 2016_signed.pdf Supplementary Document Uploaded 2016-09-07 Available
Att3 Map of US Poison Centers.pdf Supplementary Document Uploaded 2016-09-07 Repair queued
Att2 60-day FRN PCCPHE.pdf Supplementary Document Uploaded 2016-09-07 Available
Att1 Authorizing Legislation.pdf Supplementary Document Uploaded 2016-09-07 Available
SSB PPCCPHE.docx Supporting Statement B Uploaded 2016-09-07 Available
SSA PPCCPHE Clean.docx Supporting Statement A Uploaded 2017-02-14 Available
ICR Details
0920-1166 202001-0920-012
Historical Active 201609-0920-003
HHS/CDC 0920-1166-20GH
Poison Center Collaborations for Public Health Emergencies
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 01/27/2020
Retrieve Notice of Action (NOA) 01/23/2020
Previous terms continue: Approved consistent with the understanding that GenICs under this generic will be limited to follow-up activities in response to acute public health emergencies that may be causing adverse health outcomes. Data collection for investigations conducted under this generic will not exceed 60 days. Investigations conducted for the primary purpose of program evaluation, surveillance, needs assessment, or research (e.g., to contribute to generalizable knowledge) are excluded from this generic pathway. Al GenICs submitted under this generic will include all information collection instruments and an abbreviated supporting statement part A.
  Inventory as of this Action Requested Previously Approved
02/29/2020 02/29/2020 02/29/2020
900 0 900
600 0 600
12,696 0 12,696

The goal of this generic collection is to create a timely mechanism to allow poison centers, supported by CDC, to obtain critical exposure and health information during a public health emergency. For selected events, poison center staff with CDC collaboration will conduct a call-back questionnaire to include questions not asked during initial poison center calls but are important for public health response to reduce mortality and morbidity. This change request reports the quarterly burden used.

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

Not associated with rulemaking

  81 FR 40698 06/22/2016
81 FR 62740 09/12/2016
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 900 900 0 0 0 0
Annual Time Burden (Hours) 600 600 0 0 0 0
Annual Cost Burden (Dollars) 12,696 12,696 0 0 0 0
No
No
This is a new generic clearance request.

$122,784
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [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.
01/23/2020