OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments

ICR 202111-0920-016 · OMB 0920-1353 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-21EE Acute Viral Hepatitis Case Reporting Form Unchanged Repair queued
Form 0920-21EE Outbreak Summary Report Form Form and Instruction Unchanged Repair queued
Form 0920-21EE Initial Outbreak Report Form Form and Instruction Unchanged Repair queued
Form 0920-21EE Component 3: Special Projects Form Modified Available
Form 0920-22AV Core Viral Hepatitis Outbreak Prevention Activities Form Modified Repair queued
Form 0920-22AV Core Viral Hepatitis Outbreak Response and Surveillance Activities Form Modified Repair queued
Non-subs change request_0920-1353_11-16-2021.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-11-18 Repair queued
Att 4c_Comp 3 instructions_11-5-2021.docx Supplementary Document Uploaded 2021-11-18 Repair queued
Att 4c_Comp 3 instructions_11-5-2021.docx Supplementary Document Uploaded 2021-11-16 Missing upstream
Att 4b_Comp 2 instructions_11-5-2021.docx Supplementary Document Uploaded 2021-11-16 Repair queued
Att 4a_Comp 1 instructions_11-5-2021.docx Supplementary Document Uploaded 2021-11-16 Repair queued
Att 1_ Authorizing Legislation.pdf Supplementary Document Uploaded 2021-08-02 Repair queued
SSA_7-12-2021_rev_10.28.2021.docx Supporting Statement A Uploaded 2021-11-03 Repair queued
Att 10_PCSIDataSecurityGuidelines.pdf Supplementary Document Uploaded 2021-08-02 Missing upstream
Att 9_2019HepSurveillanceRpt.pdf Supplementary Document Uploaded 2021-08-02 Repair queued
Att 8_IRB Project Determination.pdf Supplementary Document Uploaded 2021-08-02 Repair queued
Att 6_GuidelinesVHSurveillance.pdf Supplementary Document Uploaded 2021-08-02 Missing upstream
Att 4c_Comp 3 instructions_5-18-2021.docx Supplementary Document Uploaded 2021-08-02 Repair queued
Att 5_HepatitisCaseRprtForm.pdf Supplementary Document Uploaded 2021-08-02 Missing upstream
Att 4b_Comp 2 instructions_5-28-2021.docx Supplementary Document Uploaded 2021-08-02 Repair queued
Att 4a_Comp 1 instructions_5-18-2021.docx Supplementary Document Uploaded 2021-08-02 Repair queued
SSB_6-9-2021.docx Supporting Statement B Uploaded 2021-08-02 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
248662 Acute Viral Hepatitis Case Reporting Form Unchanged
248661 Outbreak Summary Report Form Form and Instruction Unchanged
248660 Initial Outbreak Report Form Form and Instruction Unchanged
248659 Component 3: Special Projects Form Modified
248657 Core Viral Hepatitis Outbreak Prevention Activities Form Modified
248655 Core Viral Hepatitis Outbreak Response and Surveillance Activities Form Modified
ICR Details
0920-1353 202111-0920-016
Received in OIRA 202108-0920-001
HHS/CDC 0920-22AV
Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments
No material or nonsubstantive change to a currently approved collection   Yes
Regular 11/22/2021
  Requested Previously Approved
11/30/2024 11/30/2024
427 427
239 239
0 0
Tools exist to prevent new cases of hepatitis A, B, and C, to treat people living with hepatitis B, and to cure people living with hepatitis C. Yet new cases of viral hepatitis (VH) continue to rise, many people infected with VH remain undiagnosed, and far too many VH-related deaths occur in the US each year. This project will enable states to collect data to evaluate disease burden and trends and to analyze and disseminate that data to develop or refine recommendations, policies, and practices that will ultimately reduce the burden of VH in their jurisdictions.
None
None
Not associated with rulemaking
  86 FR 20161 04/16/2021
86 FR 41472 08/02/2021
Yes
  Total Request 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 427 427 0 0 0 0
Annual Time Burden (Hours) 239 239 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$22,445,790
No
    No
    No
No
No
No
No
Odion Clunis 770 488-0045 [email protected]
  Yes
  Changes requested to the Integrated Viral Hepatitis Surveillance and Prevention Funding for Health Departments Information Collection Request package (OMB No. 0920-1353) are intended to improve clarity, readability, flow, and efficiency for recipients.
Agency/Sub Agency RCF ID RCF Title RCF Status IC Title
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.
11/22/2021