Pulmonary Function Testing Course Approval Program

Forms and Documents

Document Name	Status
Annual Report Form	Modified
One-Time Customer Satisfaction Survey Form	New
Refresher Course Application Form	Modified
Initial Course Application Form	Modified
Renewal Application Form	Modified
0920-0138 Part B.docx Supporting Statement B	2014-02-26
Attachment 1a.docx Supplementary Document	2014-02-24
Attachment 1.docx Supplementary Document	2014-02-24
Attachment 9.pdf Supplementary Document	2014-02-19
Attachment 2.pdf Supplementary Document	2014-02-19
Sec A 0920-0138 2.24.14.docx Supporting Statement A	2014-02-26

IC Document Collections

IC ID	Document Title	Status
6649	Annual Report Form	Modified
210765	One-Time Customer Satisfaction Survey Form	New
184872	Request for Course Change (Example) Other-Email	Modified
184871	Refresher Course Application Form	Modified
184870	Initial Course Application Form	Modified
184869	Renewal Application Form	Modified

ICR Details

OMB Control No: 0920-0138	ICR Reference No: 201403-0920-007
Status: Historical Active	Previous ICR Reference No: 201107-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No: 21461
Title: Pulmonary Function Testing Course Approval Program
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: 04/21/2014
	Date Received in OIRA: 03/18/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2017	36 Months From Approved	08/31/2014
Responses	96	0	73
Time Burden (Hours)	201	0	196
Cost Burden (Dollars)	0	0	0

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Abstract: The National Institute for Occupational Safety and Health (NIOSH) has responsibility for approving courses for training technicians in pulmonary function testing. NIOSH is revising this data collection to include a one-time customer satisfaction survey to evaluate service to stakeholders, the effectiveness of program changes implemented since 2005, and the usefulness of potential program enhancements.

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Authorizing Statute(s): US Code: 29 USC 1910.1043 Name of Law: Cotton Dust Standard
   PL: Pub.L. 91 - 596 20 Name of Law: Occupational Safety and Health Act of 1970
  

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:
	78 FR 77468	12/23/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 13057	03/07/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
One-Time Customer Satisfaction Survey	none	Customer Survey
Annual Report	none	Annual Report
Renewal Application	none	Renewal Application
Initial Course Application	none	Initial Course Application
Refresher Course Application	none	Refresher Course Application
Request for Course Change (Example)

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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	96	73	0	23	0	0
Annual Time Burden (Hours)	201	196	0	5	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 revision is requesting the addition of one new form which increases burden.

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Annual Cost to Federal Government: $8,041

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]? 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: 03/18/2014

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