Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV, Coordinated School Health and Asthma Management for Adolescent and School Health Programs

Forms and Documents

Document Name	Status
SS Part B 033011.doc Supporting Statement B	2011-04-01
Att H_Desc of Chgs to Questionnaires.doc Supplementary Document	2011-04-01
Att G_Funded partners list.doc Supplementary Document	2011-04-01
Attachment B 60-day FRN.pdf Supplementary Document	2011-04-01
Attachment A Authorizing Legislation.pdf Supplementary Document	2011-04-01
684 Form.pdf Supplementary Document	2011-04-01
0920-0672 SupSta A. 1 (FY10-12) 0411.doc Supporting Statement A	2011-04-01

IC Document Collections

IC ID	Document Title	Status
7140	Att D - Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007) Other-WORD	Modified
184578	Att F - Indicators for School Health Programs: Asthma Management (LEA) Other-WORD	Modified
184577	Att E - Indicators for School Health Programs: Coordinated School Health Programs Other-WORD	Modified
184576	Indicators for School Health Programs: HIV Prevention (for State Education Agencies) Other-WORD	Modified

ICR Details

OMB Control No: 0920-0672	ICR Reference No: 201104-0920-008
Status: Historical Active	Previous ICR Reference No: 200804-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV, Coordinated School Health and Asthma Management for Adolescent and School Health Programs
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/04/2011
	Date Received in OIRA: 04/12/2011
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2014	36 Months From Approved	06/30/2011
Responses	106	0	102
Time Burden (Hours)	811	0	783
Cost Burden (Dollars)	0	0	0

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Abstract: CDC requests OMB clearance for a 3-year continue annual web based collection of Indicators of the Performance of Local, State, Territorial, and Tribal Education Agencies in HIV Prevention, Coordinated School Health Program, and Asthma Management Activities in local, state, territorial, and tribal education agencies.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 1618	01/11/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 19363	04/07/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Att D - Indicators for School Health Programs: HIV Prevention, Local Education Agencies (FY2007)
Indicators for School Health Programs: HIV Prevention (for State Education Agencies)
Att E - Indicators for School Health Programs: Coordinated School Health Programs
Att F - Indicators for School Health Programs: Asthma Management (LEA)

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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	106	102	0	0	4	0
Annual Time Burden (Hours)	811	783	0	0	28	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $110,975

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? Yes

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]? No

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

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 04/12/2011

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