OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Emergency Epidemic Investigation Data Collections - Expedited Reviews

ICR 201311-0920-016 · OMB 0920-1011 · Historical Active

Forms and Documents
Document
Name
Status
Form
 New
Form
 New
Form and Instruction
 New
Form and Instruction
 New
Form
 New
Form
 New
Form
 New
Form
 New
Form and Instruction
 New
Form
 New
Form
 New
Form
 New
Form
 New
Supporting Statement B
2014-03-25
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supplementary Document
2014-03-25
Supplementary Document
2014-03-25
Supplementary Document
2014-03-25
Supplementary Document
2013-11-20
Supplementary Document
2013-11-20
Supporting Statement A
2014-03-25
IC Document Collections
IC ID
Document
Title
Status
213737 New
213373 New
213323 New
213274 New
213233 New
213189 New
213101 New
212908 New
212644 New
212395 New
212348 New
212320 New
212266 New
212227
New
212127 New
211951 New
211894 New
211760 New
211705 New
211702 New
211682 New
ICR Details
0920-1011 201311-0920-016
Historical Active
HHS/CDC 20989
Emergency Epidemic Investigation Data Collections - Expedited Reviews
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/27/2014
Retrieve Notice of Action (NOA) 11/25/2013
Approved consistent with the understanding that GenICs under this generic will be limited to acute public health emergencies resulting from outbreaks or events with undetermined agent, source, mode of transmission, or risk factors. Because of the time sensitivity of these investigations, OMB approval will generally be granted within 72 hours of the request. Existing OMB control number 0920-0008 will be discontinued once this generic is approved and active.
  Inventory as of this Action Requested Previously Approved
03/31/2017 36 Months From Approved
36,000 0 0
18,000 0 0
0 0 0
CDC requests approval of a generic ICR to conduct Emergency Epidemic Investigations in response to acute public health emergencies resulting from outbreaks or events with undetermined agent, source, mode of transmission, or risk factors. This will replace 0920-0008 (exp 7/31/14) which applied specifically to information collections down under the Epi-Aid mechanism which will not be renewed after expiration.
US Code: 42 USC 301 Name of Law: PHSA
  
None
Not associated with rulemaking
  78 FR 41930 07/12/2013
78 FR 69854 11/21/2013
Yes
21
IC Title Form No. Form Name
2014009-XXX_Chikungunya_US Service Org Volunteers
Pediatric cluster of neurologic symptoms - Colorado none, none Medical Chart Abstraction ,   Family Interview Questionnaire
2014010-XXX Ebola_Guinea 0920-1011, 0920-1011 Appendix 1- Case Investigation Form ,   Appendix 2- Contact Tracing Form
Ebola_TX None, None Appendix 2 - Ebola Case Contact Questionnaire ,   Appendix 1 - Ebola Case Investigation Form
2014004XXX_Legionnaires' Disease_Alabama 2014 none, none Record Abstraction ,   Interview Questionnaire
BSI_CA none, none, none Chart Abstraction ,   Outpatient Dialysis Practices Survey ,   Reprocessing Observation Checklist
Ebola_West Africa_2014 none, none, none Observation Guide ,   Field Guide ,   Focus Group Guide
Pseudomonas NICU_CA
2014E003XXX_MERS-CoV_GA none, none Questionnaire for Passengers and Crew ,   Follow-up Questionnaire for Asymptomatic Passengers and Crew
2014012-XXX Resp Illness UC_CA
2014005XXX_DiarrhealDisease_AS none, none Medical Abstraction Form ,   Case Questionnaire
20140006XXX Measles FSM
2014016-XXX_Ebola_DRC
2014015-XXX_Parechovirus_Multi none, none Chart Abstraction ,   Family interview
CCRF_Georgia none, none, none KAP Survey ,   Case Investigation ,   Consent
Chikungunya_USVI CDC 56.31 A REV. 06/2006 Dengue Case Investigation Report
2014008-XXX Chikungunya_PR none, none, none, none Household Questionnaire ,   Individual Questionnaire ,   Case Report (English) ,   Case Report (Spanish)
2014014-XXX Ebola_Sierra Leone
Suicide _VA none, none Interview Guide ,   Focus Group Guide
2014011-XXX Ebola_Liberia none, none Case Report Form ,   Contact Listing Form
2014013-XXX_Resp Illness UAC_Multi
  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 36,000 0 0 36,000 0 0
Annual Time Burden (Hours) 18,000 0 0 18,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new generic information collection request.
$1,510,099
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 sxw2@cdc.gov
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
11/25/2013