Rapid Response Suicide Investigation Data Collection

Forms and Documents

Document Name	Status
Form 0920-1243 Epi-Aid Investigation of an increase in suicide in Ohio, 2022 Form	New
Att. F PIA-18CV_Generic Suicide.pdf Supplementary Document	2021-01-05
Att. E Burden Memo Generic Suicide_30 day.docx Supplementary Document	2021-01-05
Att. D Investigation Protocol Template Generic Suicide_30 day.docx Supplementary Document	2021-01-13
Att. B_60 FRN OMB1243_Generic Suicide.pdf Supplementary Document	2021-01-05
Att. A_AuthLeg.docx Supplementary Document	2018-09-20
SSB_1243_Generic Suicide_Dec.2020.docx Supporting Statement B	2021-01-13
SSA_1243_Generic Suicide_01062021.docx Supporting Statement A	2021-01-13

IC Document Collections

IC ID	Document Title	Status
256406	Epi-Aid Investigation of an increase in suicide in Ohio, 2022 Form	New

ICR Details

OMB Control No: 0920-1243	ICR Reference No: 202101-0920-003
Status: Received in OIRA	Previous ICR Reference No: 201809-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1243
Title: Rapid Response Suicide Investigation Data Collection
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/29/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2021
Responses	6,000	6,000
Time Burden (Hours)	3,000	3,000
Cost Burden (Dollars)	73,020	73,020

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Abstract: The purpose of this ICR is to rapidly respond to urgent requests for CDC assistance to investigate an apparent and unexplained potential cluster or increase in suicidal behavior and to allow CDC to quickly investigate potential suicide clusters or increases in suicidal behavior for external partners who request urgent assistance in developing suicide prevention strategies.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: PHSA
  

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:
	85 FR 64477	10/13/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 7400	01/28/2021
Did the Agency receive public comments on this ICR? Yes

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

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ICR Summary of Burden

	Total Request	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	6,000	6,000	0	0	0	0
Annual Time Burden (Hours)	3,000	3,000	0	0	0	0
Annual Cost Burden (Dollars)	73,020	73,020	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: $248,250

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.     No

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? No

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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: 01/29/2021

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