Community Transformation Grants: Use of System Dynamics Modeling and Economic Analysis in Select Communities

Forms and Documents

Document Name	Status
SS-Part B_CTG.SDM_022812 doc (2).docx Supporting Statement B	2012-03-01
Att 5_CTGEvaluationPlan.doc Supplementary Document	2012-03-02
Att 4_CTG Awardees.docx Supplementary Document	2012-03-02
Att 3_Strategic Directions.docx Supplementary Document	2012-03-02
Att 2_FRN.pdf Supplementary Document	2012-03-01
Att 1c_PHSAct.pdf Supplementary Document	2012-03-01
Att 1b_PL 111-148 ACA Section 4201 CTG.docx Supplementary Document	2012-03-01
Attachment 1a_ARRAAct.doc Supplementary Document	2012-03-01
CTG SDM_SS-Part A_041212.docx Supporting Statement A	2012-05-01

IC Document Collections

IC ID	Document Title	Status
201557	CTG Cost Study Instrument (CTG-CSI) Other-WORD	New

ICR Details

OMB Control No: 0920-0937	ICR Reference No: 201203-0920-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Community Transformation Grants: Use of System Dynamics Modeling and Economic Analysis in Select Communities
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/04/2012
	Date Received in OIRA: 03/14/2012
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	36 Months From Approved
Responses	480	0	0
Time Burden (Hours)	6,240	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: CDC plans to collect cost data from 30 Community Transformation Grant (CTG) awardees. Information will be analyzed to estimate the direct costs associated with particular community intervention approaches implemented with CTG funding.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 58 VIII Name of Law: American Recovery and Reinvestment Act
   PL: Pub.L. 111 - 148 4201 Name of Law: Patient Protection and Affordable Care 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 76976	12/09/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 13607	03/07/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
CTG Cost Study Instrument (CTG-CSI)

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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	480	0	0	480	0	0
Annual Time Burden (Hours)	6,240	0	0	6,240	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: This is a new collection request.

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Annual Cost to Federal Government: $166,211

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]? Yes

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)? Yes

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: 03/14/2012

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