State and Local Area Integrated Telephone Survey (SLAITS)

Forms and Documents

Document Name	Status
Test document to be recognized as generic IC.doc Justification for No Material/Nonsubstantive Change	2007-06-12

IC Document Collections

IC ID	Document Title	Status

ICR Details

OMB Control No: 0920-0406	ICR Reference No: 200706-0920-004
Status: Historical Active	Previous ICR Reference No: 200605-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: State and Local Area Integrated Telephone Survey (SLAITS)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/12/2007
	Date Received in OIRA: 06/12/2007
Terms of Clearance: We understand that this study is considered a pilot for identifing target areas for improvement in future followback modules. Please provide OMB with a copy of the report that explains experience with locating individuals - we are looking for something that we can share with other agencies as they address similar problems.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2007	11/30/2007	11/30/2007
Responses	620,325	0	620,325
Time Burden (Hours)	55,190	0	55,190
Cost Burden (Dollars)	0	0	0

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Abstract: The State and Local Area Integrated Telephone Survey (SLAITS) will provide state level estimates on a wide range of health, health insurance, and welfare related topcis to help track and monitor changs in health and welfare outcomes. SLAITS can provide both general purpose health statistics and targeted population statistics for special studies.

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Authorizing Statute(s): None

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 0

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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	620,325	620,325	0	0	0	0
Annual Time Burden (Hours)	55,190	55,190	0	0	0	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: $0

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]? Uncollected

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)? Uncollected

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: 06/12/2007

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