View Information Collection Request (ICR) Package
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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0004
ICR Reference No:
201412-0920-014
Status:
Historical Active
Previous ICR Reference No:
201407-0920-012
Agency/Subagency:
HHS/CDC
Agency Tracking No:
15IH
Title:
National Disease Surveillance Program - II. Disease Summaries
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
12/30/2014
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/23/2014
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
10/31/2017
10/31/2017
10/31/2017
Responses
175,180
0
175,180
Time Burden (Hours)
31,921
0
31,921
Cost Burden (Dollars)
0
0
0
Abstract:
CDC requests approval for changes to 4 forms including adding, deleting, and reformatting some questions. There is no change in burden or respondents.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
79 FR 37
02/25/2014
30-day Notice:
Federal Register Citation:
Citation Date:
79 FR 46828
08/11/2014
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
24
IC Title
Form No.
Form Name
Att K Human Infection with Novel Influenza A Virus Case Report Form
none, None
Human Infection with Novel Influenza A Virus Case Report Form
,
Human Infection with Novel Influenza A Virus Case Report Form
Att AA_ Influenza Virus Electronic year round - PHLIP_HL7 Messaging Data Elements
Att BB_ Influenza Virus Electronic year round PHIN-MS
Att D_Foodborne Disease Transmission Person-to-Person_Animal Contact
CDC 52.13
Foodborne Disease Transmission, Person-to-Person, Animal Contact
Att E_WHO Collaborating Center for Influenza Virus Surveillance Internet Year Round
CDC 55.31
WHO Collaborating Center for Influenza Virus Surveillance (Internet: Year Round)
Att F US WHO Colloborating Laboratories Influenza Testing Methods Assessment
CDC 55.31A
US WHO Collaborating Laboratories Flu Testing Methods Assessment
Att G US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly
CDC 55.20
US Outpatient Influenza-like Illness Surveillance Network (ILINet) Weekly
Att I_ US Outpatient Influenza-like Illiness Surveillance Network (ILINet) Daily Reports
None
US Outpatient Influenza like Illness Surveillance Network (ILINet) Daily Reports
Att J_Influenza Associated Pediatric Mortality Case Report Form
none
Influenza-Associated Pediatric Mortality Case Report
Att L Human Infection with Novel Influenza A Virus with Suspected Avian Source
None
Human Infection with Novel Influenza A Virus with Suspected Avian Source
Att M Human Infections with Novel Influenza A Virus Severe Outcomes
None
Human Infection with Novel Influenza A Virus Severe Outcomes
Att N Novel Influenza A Virus Infection Contact Tracing Form
None
Novel Influenza A Virus Infection Contact Tracing Form
Att O_Novel Influenza A Virus Status Case Status Summary
None
Novel Influenza A Virus Case Status Summary
Att P Novel Influenza A Virus Case Screening Form
None
Novel Influenza A Virus Case Screening Form
Att Q_122 CMRS - City Health Officer or Vital Statistics Registrars Daily Mortality Report
CDC 43.50
122 CMRS -City Health Officers or Vital Statistics Registrars Daily Mortality Report
Att R_CMRS - City Health Officer or Vital Statistics Registrars Weekly Mortality Report
CDC 43.5, none
CMRS Weekly
,
122 CMRS-City Health Officers or Vital Statistics Registrars Weekly Mortality Report
Att S_Aggregate Hospitalization and Death Reporting Activity Weekly Report Form
none
Aggregate Hospital
Att T Antiviral Resistant Influenza Infection Case Report Form
none
Antiviral-Resistant Influenza Infection Case Report
Att U_National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment
CDC 55.83A, CDC 55.83D, CDC 55.83, CDC 55.83B
National Respiratory and Enteric Virus Surveillance System (NREVSS) Laboratory Assessment
,
NREVSS Antigen Detection Worksheet
,
NREVSS Polymerase Chain Reaction (PCR) Worksheet
,
NREVSS Virus Isolation (culture) Worksheet
Att V_ National Enterovirus Surveillance Report 55.9
CDC 55.90
Enterovirus Surveillance System Report Form
Att W Adenovirus Typing Report Form
None
Adenovirus Typing Report Form
Att X Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form
None
Middle East Respiratory Syndrome Coronavirus (MERS) Patient Under Investigation (PUI) Form
Att Y_ Form for Submitting Specimens from Suspected Norovirus Outbreak
None
Form for Submitting Specimens from Suspected Norovirus Outbreaks
Att Z_ Waterborne Diseases Transmission
CDC 52.12
Waterborne Disease Transmission
ICR Summary of Burden
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
175,180
175,180
0
0
0
0
Annual Time Burden (Hours)
31,921
31,921
0
0
0
0
Annual Cost Burden (Dollars)
0
0
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:
Annual Cost to Federal Government:
$51,000
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
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?
Uncollected
Agency Contact:
Shari Steinberg 404 639-4942 sxw2@cdc.gov
Common Form ICR:
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:
(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:
12/23/2014
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