CDC Diabetes Prevention Recognition Program (DPRP)

Forms and Documents

Document Name	Status
Form 0920-0909 Evaluation data for private-sector organizations Form and Instruction	Modified
Form 0920-0909 Evaluation data for public-sector organizations Form and Instruction	Modified
Form 0920-0909 Application data for private-sector organizations Form and Instruction	Modified
Form 0920-0909 Application data for public-sector organizations Form and Instruction	Modified
SS Part A (DPRP) 27NOV2017_FINAL (002)_OMB (002) (002).docx Supporting Statement A	2018-02-13
Att 7 Data Transition Letter.docx Supplementary Document	2017-11-27
Att 8 IRB Exemption from Human Subjects Research.pdf Supplementary Document	2017-11-27
Att 5D(7) Notification of Achievement of Full Recognition.docx Supplementary Document	2017-11-27
Att 5D(6) Loss of Recognition (Failure to Meet Standards).docx Supplementary Document	2017-11-27
Att 5D(5) Evaluation Report (determonation of Full Recognition).docx Supplementary Document	2017-11-27
Att 5D(4) Progress Report.docx Supplementary Document	2017-11-27
Att 5D(3) Loss of rcognition Email (Failure to Send in any Data 18 Months).docx Supplementary Document	2017-11-27
Att 5D(2) Data Reminder email (2 weeks past due).docx Supplementary Document	2017-11-27
Att 5D(1) Data Reminder Email (4 weeks prior to due date).docx Supplementary Document	2017-11-27
Att 5C DPRP Data Web Application (screenshot).docx Supplementary Document	2017-11-27
Att 5B Data Dictionary_Evaluation Data Elements (Previously Approved by OMB 2015).docx Supplementary Document	2017-11-27
Att 4F DPRP Application Rejection Email.docx Supplementary Document	2017-11-27
Att 4E DPRP Application Acceptance Email.docx Supplementary Document	2017-11-27
Att 4D DPRP Confirmation Email.docx Supplementary Document	2017-11-27
Att 4C DPRP Conformation Page (screenshot).docx Supplementary Document	2017-11-27
Att 4B DPRP Homepage (screenshot).docx Supplementary Document	2017-11-27
Att 6 Overview of Changes_FINAL_01-19-18.docx Supplementary Document	2018-02-13
Att 3 DPRP Standards 2018.docx Supplementary Document	2017-11-27
SS Part B (DPRP).docx Supporting Statement B	2017-11-27
Att 2B Summary of Public Comments.pdf Supplementary Document	2017-11-27
Att 2A 60-day FRN_DPRP_Standards.pdf Supplementary Document	2017-11-27
Attachment 1B PHSA.pdf Supplementary Document	2014-09-18
Attachment 1A Public Law 111 148.pdf Supplementary Document	2014-09-18

IC Document Collections

IC ID	Document Title	Status
199192	Evaluation data for private-sector organizations Form and Instruction	Modified
199191	Evaluation data for public-sector organizations Form and Instruction	Modified
199190	Application data for private-sector organizations Form and Instruction	Modified
199189	Application data for public-sector organizations Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0909	ICR Reference No: 201711-0920-011
Status: Active	Previous ICR Reference No: 201409-0920-010
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0909
Title: CDC Diabetes Prevention Recognition Program (DPRP)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/20/2018
	Date Received in OIRA: 11/28/2017
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved	02/28/2018
Responses	4,088	0	1,550
Time Burden (Hours)	7,676	0	1,550
Cost Burden (Dollars)	0	0	0

---

Abstract: CDC established a national diabetes prevention program and criteria for recognizing organizations that deliver evidence-based diabetes prevention programs to individuals with pre-diabetes. Information will be collected to monitor, evaluate and provide technical assistance to organizations that apply for recognition through the Diabetes Prevention Recognition Program. CDC is increasing the total estimated annualized number of applicants to 500. The distribution of those applicants is predicted to be 70% (350) from the private sector and 30% (150) from the public sector, based on current DPRP data and projections. This change is based on an anticipated increase in the number of healthcare organizations applying for CDC recognition to deliver the lifestyle change program due to the MDPP Expanded Model and its promotion by CMS and the American Medical Association in healthcare settings.

---

Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
   PL: Pub.L. 111 - 148 399-V Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 32549	07/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 56026	11/27/2017
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
Application data for public-sector organizations	0920-0909	DPRP Application Form
Application data for private-sector organizations	0920-0909	DPRP Application Form
Evaluation data for public-sector organizations	0920-0909	Evaluation Data Form
Evaluation data for private-sector organizations	0920-0909	Evaluation Data Form

---

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	4,088	1,550	0	2,538	0	0
Annual Time Burden (Hours)	7,676	1,550	0	6,126	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: Submission of 0920-0909 is a Revision. CDC is increasing the total estimated annualized number of applicants.

---

Annual Cost to Federal Government: $2,031,300

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

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)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 11/28/2017

---