Maternal Mortality Review Information Application (MMRIA)

Forms and Documents

Document Name	Status
Form 0920-19BDE Committee Decision Form and Instruction	New
Form 0920-19BDE Data Abstraction Form and Instruction	New
Attachment 9. MMRIA Request for Determination of Research Status.pdf Supplementary Document	2019-12-19
Attachment 8. Estimates of pregnancy related deaths.xlsx Supplementary Document	2019-12-19
Attachment 7. Memorandum of Understanding.docx Supplementary Document	2019-12-19
Attachment 6. Privacy Impact Assessment.pdf Supplementary Document	2019-12-19
Attachment 5a 60 DAY FRN.pdf Supplementary Document	2019-12-19
Attachment 4. Authorization to Operate.pdf Supplementary Document	2019-12-19
Attachment 3b. Case Narrative MMRIA Screenshots.pdf Supplementary Document	2019-12-19
Attachment 2. Data Flow Diagram.pptx Supplementary Document	2019-12-19
Attachment 1b. Preventing Maternal Deaths Act.pdf Supplementary Document	2019-12-19
Attachment 1a. Section 301 of the Public Health Service Act (42 U.S.C. 241).docx Supplementary Document	2019-12-19
MMRIA SSB_10 28 2019 final.docx Supporting Statement B	2019-12-19
MMRIA SSA_30 day 12 02 2019_sc.docx Supporting Statement A	2019-12-19

IC Document Collections

IC ID	Document Title	Status
239003	Committee Decision Form and Instruction	New
238999	Data Abstraction Form and Instruction	New

ICR Details

OMB Control No: 0920-1294	ICR Reference No: 201912-0920-002
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-19BDE
Title: Maternal Mortality Review Information Application (MMRIA)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/29/2020
	Date Received in OIRA: 12/23/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved
Responses	1,500	0	0
Time Burden (Hours)	11,550	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Maternal Mortality Review Committees (MMRCs) review cases of pregnancy-associated deaths in their jurisdiction to determine and understand pregnancy-relatedness. MMRIA is a comprehensive and standardized data collection system for abstracting data from clinical and nonclinical sources and documenting MMRC decisions. MMRIA will provide comprehensive, timely, and accurate data surrounding these deaths to inform future prevention efforts.

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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:
	84 FR 28819	06/20/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 70554	12/23/2019
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Data Abstraction	0920-19BDE	Data Abstraction
Committee Decision	0920-19BDE	Committee Decision

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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	1,500	0	0	1,500	0	0
Annual Time Burden (Hours)	11,550	0	0	11,550	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 is a New Collection.

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Annual Cost to Federal Government: $9,449,493

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? 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: 12/23/2019

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