[NCCDPHP] National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities

Forms and Documents

Document Name	Status
Form 0920-1046 Minimum Data Elements (MDE) Data Definition Table Form and Instruction	Modified
Form 0920-1046 NBCCEDP Service Delivery Projection Worksheet Form and Instruction	Modified
Form 0920-1046 NBCCEDP Quarterly Program Update Form and Instruction	Modified
Form 0920-1046 NBCCEDP Clinic-Level Data Instrument (Cervical) Form and Instruction	Modified
Form 0920-1046 NBCCEDP Clinic-Level Data Collection Instruments Form and Instruction	Modified
Form 0920-1046 Annual NBCCEDP Survey Form and Instruction	Modified
0920-1046_PIA final.pdf Supplementary Document	2025-01-13
Att 11 - 60 Day Federal Register Notice.pdf Supplementary Document	2025-01-13
Att 10 - Institutional Review Board Approval.pdf Supplementary Document	2025-01-13
Att 7d - NBCCEDP Quarterly Program Update Reminder Email.docx Supplementary Document	2025-01-13
Att 7c - NBCCEDP Quarterly Program Update Administration Email.docx Supplementary Document	2025-01-13
Att 7b - NBCCEDP Quarterly Program Update Pre-Administration Email.docx Supplementary Document	2025-01-13
Att 6c - NBCCEDP Clinic-Level Data Collection Reminder Email.docx Supplementary Document	2025-01-13
Att 6b - NBCCEDP Clinic-Level Data Collection Introductory Email.docx Supplementary Document	2025-01-13
Att 5c - Annual NBCCEDP Survey Reminder Email_v2.docx Supplementary Document	2025-01-13
Att 5b - Annual NBCCEDP Survey Introductory Email_v2.docx Supplementary Document	2025-01-13
Att 4 - NBCCEDP Data Collection Revision Matrix.docx Supplementary Document	2025-01-08
Att 3 - DP22-2202 NBCCEDP Logic Model.pdf Supplementary Document	2025-01-08
Att 2 - Breast and Cervical Cancer Mortality Prevention Act of 1990.pdf Supplementary Document	2025-01-08
Att 1 - Authorizing Legislation.pdf Supplementary Document	2025-01-08
0920-1046 SS Part B_Revision.docx Supporting Statement B	2025-01-08
0920-1046 SS Part A Revision_rev_final.docx Supporting Statement A	2025-01-13

IC Document Collections

IC ID	Document Title	Status
250030	Minimum Data Elements (MDE) Data Definition Table Form and Instruction	Modified
250027	NBCCEDP Service Delivery Projection Worksheet Form and Instruction	Modified
250010	NBCCEDP Quarterly Program Update Form and Instruction	Modified
233708	NBCCEDP Clinic-Level Data Instrument (Cervical) Form and Instruction	Modified
233707	NBCCEDP Clinic-Level Data Collection Instruments Form and Instruction	Modified
233706	Annual NBCCEDP Survey Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1046	ICR Reference No: 202501-0920-002
Status: Received in OIRA	Previous ICR Reference No: 202111-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1046
Title: [NCCDPHP] National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Monitoring Activities
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 01/13/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved	03/31/2025
Responses	1,420	1,400
Time Burden (Hours)	1,162	1,228
Cost Burden (Dollars)	0	38,976

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Abstract: This project will systematically collect information about implementation, including delivery of screening and follow-up clinical services, and outcomes of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), which funds 71 recipients. In this Revision, CDC proposed use of three revised instruments - the annual NBCCEDP survey, clinic-level data collection, and quarterly program update (QPU) - and continued use of two instruments - the Service Delivery Projection Worksheet and MDEs - with no changes. The estimated burden will decrease from 1,220 to 1,162.

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Authorizing Statute(s): PL: Pub.L. 101 - 354 2 Name of Law: Breast and Cervical Cancer Prevention and Treatment Act of 2000
   US Code: 42 USC 300k Name of Law: Breast and Cervical Cancer Mortality Prevention Act of 1990
  

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:
	89 FR 79922	10/01/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 1492	01/08/2025
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
NBCCEDP Clinic-Level Data Instrument (Cervical)	0920-1046	NBCCEDP Clinic-Level Data Collection Instruments (Cervical)
Annual NBCCEDP Survey	0920-1046	Annual National Breast and Cervical Early Detection Program (NBCCEDP) Survey
Minimum Data Elements (MDE) Data Definition Table	0920-1046	Minimum Data Elements (MDE) Data Definition Table
NBCCEDP Clinic-Level Data Collection Instruments	0920-1046	NBCCEDP Clinic-Level Data Collection Instruments
NBCCEDP Quarterly Program Update	0920-1046	NBCCEDP Quarterly Program Update
NBCCEDP Service Delivery Projection Worksheet	0920-1046	NBCCEDP Service Delivery Projections

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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	1,420	1,400	0	20	0	0
Annual Time Burden (Hours)	1,162	1,228	0	-66	0	0
Annual Cost Burden (Dollars)	0	38,976	0	-38,976	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden decreased slightly because of modified burden times even though there was one extra respondent added per instrument.

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Annual Cost to Federal Government: $711,171

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]? 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: 01/13/2025

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