School Associated Violent Deaths Surveillance System

Forms and Documents

Document Name	Status
30dy160604.docx Supplementary Document	2016-01-12
Att N_NCIPC Research Determination Form.pdf Supplementary Document	2016-01-12
Att K_Summary of Proposed Changes to Interview Tools.docx Supplementary Document	2016-01-12
Att C_CDC IRB Approval.doc Supplementary Document	2016-01-05
SSB_0604_SAVD_110215.docx Supporting Statement B	2016-01-12
Att J_Parental Consent Form.doc Supplementary Document	2016-01-12
Att M_Crosswalk for SAVD Survey Tools School Official.xlsx Supplementary Document	2016-01-12
Att L_Crosswalk for SAVD Survey Tools Law Enforcement.xlsx Supplementary Document	2016-01-12
Att H_Assurance of Confidentiality - CDC Approval for 308d Protection.doc Supplementary Document	2016-01-12
Att G_List of Selected Publications.doc Supplementary Document	2016-01-12
Att B_60dy Publi-0604 SAVD.pdf Supplementary Document	2016-01-05
Att A Authorizing Legislation.doc Supplementary Document	2016-01-05
SSA_0604_SAVD 120315.docx Supporting Statement A	2016-01-12

IC Document Collections

IC ID	Document Title	Status
7069	Att E_School Officials (Interviews) Other-CATI	Modified
191865	Att D_ Law Enforcement Officials (Interview) Other-CATI	Modified

ICR Details

OMB Control No: 0920-0604	ICR Reference No: 201601-0920-004
Status: Historical Active	Previous ICR Reference No: 201302-0920-018
Agency/Subagency: HHS/CDC	Agency Tracking No: 0604
Title: School Associated Violent Deaths Surveillance System
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: 05/26/2016
	Date Received in OIRA: 01/13/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2019	36 Months From Approved	05/31/2016
Responses	70	0	70
Time Burden (Hours)	76	0	70
Cost Burden (Dollars)	0	0	0

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Abstract: To continue the surveillance of school-associated homicides and suicides. The system relies on existing public records and interviews with law enforcement officials and school officials. The purpose of the system is to (1) estimate the rate of school-associated violent death in the United States and (2) identify common features of school-associated violent deaths. The system will contribute to the understanding of fatal violence associated with schools, guide further research in the area, and help direct ongoing and future prevention programs. SAVD is an ongoing surveillance system that draws cases from the entire USA in attempting to capture all cases of school-associated violent deaths that have occurred.

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Authorizing Statute(s): US Code: 42 USC 391 Name of Law: Public Health Service Act
   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:
	80 FR 51272	08/24/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 1189	01/11/2016
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Att D_ Law Enforcement Officials (Interview)
Att E_School Officials (Interviews)

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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	70	70	0	0	0	0
Annual Time Burden (Hours)	76	70	0	6	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: Changes included item eliminations, item revisions, and addition of completely new items. Changes reflect recent advancements and developments in research addressing violence in school settings.

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Annual Cost to Federal Government: $159,566

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: 01/13/2016

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