Early Hearing Detection and Intervention Hearing Screening and Follow-up survey

Forms and Documents

Document Name	Status
Supp_Statement_B_ EHDI_OMB_2010_Renewal_SC_4_23.doc Supporting Statement B	2010-05-05
30dyFRN2010-10587.pdf Supplementary Document	2010-05-05
Attach_14.docx Supplementary Document	2010-05-05
Attach_13.docx Supplementary Document	2010-05-05
Attach_12.docx Supplementary Document	2010-05-05
Attach_11.docx Supplementary Document	2010-05-05
Attach_10.docx Supplementary Document	2010-05-05
Attach_9.docx Supplementary Document	2010-05-05
Attach_7.docx Supplementary Document	2010-05-05
Attach_6.docx Supplementary Document	2010-05-05
Attach_3.docx Supplementary Document	2010-05-05
Attach_5.docx Supplementary Document	2010-05-05
Attach_8.docx Supplementary Document	2010-05-05
Attach_2.docx Supplementary Document	2010-05-05
Attach_1.docx Supplementary Document	2010-05-05
Supp_Statement_A_EHDI_OMB_2010_Renewal_SC_4_23.docm Supporting Statement A	2010-05-05

IC Document Collections

IC ID	Document Title	Status
43622	Early Hearing Detecton and Intervention Hearing Screening and Follow-up survey Instruction	Modified
192922	CDC EHDI Hearing Screening and Followup Survey (HSFS) Instruction	New

ICR Details

OMB Control No: 0920-0733	ICR Reference No: 201005-0920-004
Status: Historical Active	Previous ICR Reference No: 200607-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Early Hearing Detection and Intervention Hearing Screening and Follow-up survey
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/21/2010
	Date Received in OIRA: 05/18/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2013	36 Months From Approved
Responses	107	0	0
Time Burden (Hours)	210	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: Federal support for identifying children with hearing loss began with the Children's Health Act of 2000, which authorized federal programs to support EHDI activities at the state level. Since then, funds have been distributed to states via cooperative agreements from the CDC and grants from the Health Resources and Services Administration (HRSA). States are using these federal monies to enhance EHDI programs and develop corresponding tracking and surveillance systems. These systems are intended to help EHDI programs ensure infants and children are receiving recommended hearing screening, follow-up, and intervention services. The purpose of the revised survey is to obtain annual state data on the performance indicators in a consistent manner, which is needed to assess progress towards meeting the National EHDI Goals. In addition, the availability of these data will better enable the CDC-EHDI team to provide technical assistance to states and respond to questions by the general public, policy makers, and Healthy People 2010 officials.

---

Authorizing Statute(s): PL: Pub.L. 42 - 241 301 Name of Law: Public Health Service Act
   PL: Pub.L. 42 - 247 399 Name of Law: Children's Health Act of 2000
   PL: Pub.L. 42 - 247 317 Name of Law: Children's Health Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 21809	05/11/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 24704	05/05/2010
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Early Hearing Detecton and Intervention Hearing Screening and Follow-up survey
CDC EHDI Hearing Screening and Followup Survey (HSFS)	2	CDC EHDI Hearing Screening and Follow-up Survey (HSFS)

---

ICR Summary of Burden

	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	107	0	0	107	0	0
Annual Time Burden (Hours)	210	0	0	210	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Minor changes are proposed to the original ICR that was approved by OMB in October 2006 (0920-0733). These proposed changes for the revised ICR have been made in response to feedback from respondents and requests for additional information from state and national partners. These minor changes are intended to make the ICR easier to complete and further improve the quality of the data that is collected. These changes include revising the wording of some questions, splitting the previously combined questions about the number of infants that died and parents refused into two separate questions, adding a question about how many infants with hearing loss are receiving only monitoring services, simplifying the table for reporting type and severity of hearing loss data, and expanding the demographics section to include additional data items. These proposed changes for the revised ICR are explained in more detail below.

---

Annual Cost to Federal Government: $5,053

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/18/2010

---