Information Collection for Tuberculosis Data from Referring Entities to CureTB

Forms and Documents

Document Name	Status
CureTB Partner Feedback (at completion of referred patient's treatment) Form and Instruction	New
CureTB Partner Feedback (at time of patient referral) Form and Instruction	New
Individual Followup with Tuberculosis (TB) Patients Referred by ICE Form and Instruction	Unchanged
Coordination with TB Treating Physician/Foreign Health Authority in New Country Form and Instruction	Unchanged
Cure TB Contact Source Investigation (CI/SI) Notification - LHD Form and Instruction	Unchanged
Individual Followup with Tuberculosis (TB) Patients Referred by LHD Form and Instruction	Unchanged
Cure TB Transnational Notification - Referral from Local Health Departments Form and Instruction	Unchanged
Nonsub Change Request_CureTB Assessment.docx Justification for No Material/Nonsubstantive Change	2022-03-17
Att. G 20200520 CureTB PIA Signed.pdf Supplementary Document	2020-06-15
SSA-CureTB06.15.2020-Final.docx Supporting Statement A	2020-06-15
Att. F - IRB Determination.pdf Supplementary Document	2020-06-08
Att. B - Published 60-day FRN-12.23.2019.pdf Supplementary Document	2020-06-08
Att. A5 - Section 311.pdf Supplementary Document	2020-06-08
Att. A4 - Section 301.pdf Supplementary Document	2020-06-08
Att. A3 - 42 CFR Part 71.pdf Supplementary Document	2020-06-08
Att. A2 - 42 CFR Part 70.pdf Supplementary Document	2020-06-08
Att. A1 - Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document	2020-06-08
SSB-CureTB5.29.2020-Final.docx Supporting Statement B	2020-06-08

IC Document Collections

IC ID	Document Title	Status
252225	CureTB Partner Feedback (at completion of referred patient's treatment) Form and Instruction	New
252223	CureTB Partner Feedback (at time of patient referral) Form and Instruction	New
242057	Individual Followup with Tuberculosis (TB) Patients Referred by ICE Form and Instruction	Unchanged
226739	Coordination with TB Treating Physician/Foreign Health Authority in New Country Form and Instruction	Unchanged
226738	Cure TB Contact Source Investigation (CI/SI) Notification - LHD Form and Instruction	Unchanged
226737	Individual Followup with Tuberculosis (TB) Patients Referred by LHD Form and Instruction	Unchanged
226736	Cure TB Transnational Notification - Referral from Local Health Departments Form and Instruction	Unchanged

ICR Details

OMB Control No: 0920-1186	ICR Reference No: 202203-0920-003
Status: Received in OIRA	Previous ICR Reference No: 202004-0920-019
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-22DH
Title: Information Collection for Tuberculosis Data from Referring Entities to CureTB
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 03/17/2022

	Requested	Previously Approved
Expiration Date	02/29/2024	02/29/2024
Responses	3,914	3,764
Time Burden (Hours)	1,103	1,081
Cost Burden (Dollars)	31,105	30,139

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Abstract: The objective of this information collection is to facilitate CDC coordinating of the continuity of care for individuals affected by TB who enter US jurisdictions from foreign nations who or who leave US jurisdictions bound for foreign nations.

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Authorizing Statute(s): US Code: 42 USC Code of Federal Regulations Name of Law: Public Health Service Act
   US Code: 42 USC Code of Federal Regulations Name of Law: Part 70 Interstate Quarantine
   US Code: 42 USC Code of Federal Regulations Name of Law: Part 71 Foreign Quarantine
  

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 70555	12/23/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 36211	06/15/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

IC Title	Form No.	Form Name
Coordination with TB Treating Physician/Foreign Health Authority in New Country	n/a	Telephone Script for Clinician/Foreign Health Authority Referral Follow-up
Cure TB Contact Source Investigation (CI/SI) Notification - LHD	n/a	CureTB Contact/Source Investigation (CI/SI) Notification
Cure TB Transnational Notification - Referral from Local Health Departments	n/a	CureTB Transnational Notification
CureTB Partner Feedback (at completion of referred patient's treatment)	n/a	CureTB Partner Feedback
CureTB Partner Feedback (at time of patient referral)	n/a	CureTB Partner Feedback
Individual Followup with Tuberculosis (TB) Patients Referred by ICE	n/a	CureTB Transnational Notificaiton
Individual Followup with Tuberculosis (TB) Patients Referred by LHD	n/a	CureTB Transnational Notification

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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	3,914	3,764	0	150	0	0
Annual Time Burden (Hours)	1,103	1,081	0	22	0	0
Annual Cost Burden (Dollars)	31,105	30,139	0	966	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: Two short partner feedback surveys (ICs) are being added to assess/improve CDC support and treatment information provided by CDC to public health partners.

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Annual Cost to Federal Government: $234,343

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? 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: 03/17/2022

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