Information Collection for Tuberculosis Data from Panel Physicians

Forms and Documents

Document Name	Status
TB Indicator Reporting Form Form	Modified
Attachment E PIA Signed.pdf Supplementary Document	2021-08-26
Attachment D TB Indicators IRB Form.pdf Supplementary Document	2021-08-26
Attachment F Published Federal Register 0920-1102.pdf Supplementary Document	2021-08-26
Attachment A3 - 42 CFR Part 34.pdf Supplementary Document	2021-08-26
Attachment A2 - Public Health Service Act 42 USC 252.docx Supplementary Document	2021-08-26
Attachment A1-Immigration and Nationality Act 8 U.S.C. § 1182.pdf Supplementary Document	2021-08-26
SupSta B 0920-1102 TB Indicators Revision.docx Supporting Statement B	2021-08-26
SupSta A 0920-1102 TB Indicators Revision_final.docx Supporting Statement A	2021-08-26

IC Document Collections

IC ID	Document Title	Status
218237	TB Indicator Reporting Form Form	Modified

ICR Details

OMB Control No: 0920-1102	ICR Reference No: 202108-0920-011
Status: Received in OIRA	Previous ICR Reference No: 201808-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1102
Title: Information Collection for Tuberculosis Data from Panel Physicians
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/30/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2021
Responses	333	336
Time Burden (Hours)	999	1,008
Cost Burden (Dollars)	105,115	104,459

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Abstract: More than 760 panel physicians perform overseas pre-departure medical examinations at 336 panel sites. Screening for tuberculosis is an important part of the medical exam in order to diagnose active TB disease prior to arrival in the U.S. The goal of the data collection is to determine TB rates in immigrant and refugee populations migrating to the US. Data are used to improve the quality of TB screening overseas and assess the impact of CDC's TB Technical Instructions. This Revision has minor adjustments.

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Authorizing Statute(s): US Code: 8 USC 1182 Name of Law: Immigration and Nationality Act
   US Code: 42 USC 241 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:
	86 FR 28356	05/26/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 48144	08/27/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
TB Indicator Reporting Form	none	TB Indicator Data Reporting Form

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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	333	336	0	-3	0	0
Annual Time Burden (Hours)	999	1,008	0	-9	0	0
Annual Cost Burden (Dollars)	105,115	104,459	0	656	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The decrease is due to a slight adjustment to the number of respondents.

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Annual Cost to Federal Government: $29,123

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: 08/30/2021

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