School Dismissal Monitoring System

Forms and Documents

Document Name	Status
School Dismissal Monitoring System (Reporting Form) Form	Modified
School Dismissal Monitoring System 0920-0849 B 041521013.docx Supporting Statement B	2013-04-16
School Dismissal Monitoring System 0920-0849 B_03 18 13.docx Supplementary Document	2013-04-02
IRB determination.pdf Supplementary Document	2013-04-02
Attachment 1 USC-2011-title42-chap6A-subchapII-partA-sec241.pdf Supplementary Document	2013-04-02
Attachment 3 CDC School Guidance.pdf Supplementary Document	2010-02-24
School Dismissal Monitoring System 0920-0849 A_03 18 13.doc Supporting Statement A	2013-04-02

IC Document Collections

IC ID	Document Title	Status
192337	School Dismissal Monitoring System (Reporting Form) Form	Modified

ICR Details

OMB Control No: 0920-0849	ICR Reference No: 201304-0920-009
Status: Historical Active	Previous ICR Reference No: 201003-0920-012
Agency/Subagency: HHS/CDC	Agency Tracking No: 19225
Title: School Dismissal Monitoring 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: 05/22/2013
	Date Received in OIRA: 04/17/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2016	36 Months From Approved	05/31/2013
Responses	2,500	0	500
Time Burden (Hours)	208	0	42
Cost Burden (Dollars)	0	0	0

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Abstract: The data collected by the School Dismissal Monitoring System are necessary to fulfill CDC's public health mission to prevent the spread of infectious diseases and evaluate consequences of public health emergencies in communities in the U.S.

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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:
	77 FR 71797	12/04/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 18598	03/27/2013
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
School Dismissal Monitoring System (Reporting Form)	None	School Dismissal Monitoring Sysem

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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	2,500	500	0	2,000	0	0
Annual Time Burden (Hours)	208	42	0	166	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: CDC is requesting a revision to a currently approved information collection. During the 2009 H1N1 pandemic influenza response, there was considerable interest in the reasons why dismissals were occurring. This revision requests the addition of a field for the reason for dismissal into the existing data collection form, and an increase of 166 burden hours due to a revised estimate of respondent burden given lessons learned during the response to the 2009 H1N1 pandemic influenza.

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Annual Cost to Federal Government: $610,878

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: 04/17/2013

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