View Information Collection Request (ICR) Package
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Common Form Info.
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View Information Collection (IC) List
View Supporting Statement and Other Documents
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:
0920-0978
ICR Reference No:
201612-0920-015
Status:
Historical Active
Previous ICR Reference No:
201603-0920-001
Agency/Subagency:
HHS/CDC
Agency Tracking No:
17IW
Title:
Emerging Infections Program
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:
01/03/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/30/2016
Terms of Clearance:
Previous terms continue: Approved consistent with the understanding that this consolidation will result in the modification and/or discontinuation of related CDC ICRs.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/28/2019
02/28/2019
02/28/2019
Responses
81,420
0
81,420
Time Burden (Hours)
22,806
0
22,806
Cost Burden (Dollars)
0
0
0
Abstract:
This Non-Substantive Change Request seeks to make minor changes to the following Forms: 1. HUS Surveillance 2. FoodNet Variable List 3. Clostridium difficile Infection (CDI) 4. Resistant Gram-Negative Bacilli Case Report Form 5. Methicillin-resistant Staphylococcus aureus (MRSA) HAIC Case Report Form The changes will have no impact on the burden of data collection
Authorizing Statute(s):
US Code:
42 USC 301
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:
80 FR 26051
05/06/2015
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 39780
07/10/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
25
IC Title
Form No.
Form Name
2015 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form
CDC 10-2015
2015 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form
ABCs Case Report Form
none, CDC 52.15A REV. 10-2015
ABCsCRF 2015
,
2016 Active Bacterial Core Surveillance (ABCs) CASE REPORT
ABCs Invasive Pneumococcal Disease in Children
none
Invasive Pneumococcal 2015
ABCs Neonatal Infection Expanded Tracking Form
none
Neonatal Tracking
ABCs Non Bacteremic Pneumococcal Disease
CDC, none
Non Bacteremic Pneumococcal 2015
,
2016 Surveillance for Non-Invasive Penumococcal Pneumonia (SNiPP)
CDI Case Report Form
CDC Rev 09-2016, CDC Rev.10-2015, NA
Clostridium Difficile Infection (CDI) Surveillance Emerging Infections Program Case Report
,
Clostridium Difficile Infection (CDI) Surveillance Emerging Infections Program Case Report
,
CLOSTRIDIUM DIFFICILE INFECTION (CDI) SURVEILLANCE EMERGING INFECTIONS PROGRAM CASE REPORT
CDI Screening Form
CDI Telephone Interview
CDI Treatment Form
NA
EIP CDI Surveillance: CDI Case Treatment Questionnaire
Campylobacter
Cryptosporidium
Cyclospora
FluSurv-NET Influenza Hospitalization Surveilance Project Case Report Form
CDC Rev 07-2015, none
FluSurv-NET Influenza Hospital Surveillance Project
,
2015-16 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form
FluSurv-Net Project Consent Form
none
Consent
Hemolytic Uremic Syndrome (HUS)
NA
FoodNet Hemolytic Uremic Syndrome (HUS) Surveillance
Influenza Hospitalization Surveillance Project Vaccination Telephone Survey
none
Vaccination Telephone Survey - English
Invasive Methicillin - Resistant - Staphylococcus aureus ABCs Case Report Form
CDC 52.15B Rev 09-2016, none, CDC 52.15B Rev 10-2015
Invasive Methicillin-Resistant Staph
,
Healthcare-Associated Infections Community Interface (HACI) Case Report -2016
,
Invasive Methicillin-Resistant Staphylococcus aureus HAIC Case Report - 2017
Legionellosis ABCs Case Report
none
Legionellosis Case Report
Listeria monocytogenes
Resistant Gram-Negative Bacilli Case Report Form
VERSION: 11/2017, VERSION:01-2016, NA
2015 Multi-site Gram-Negative Surveillance Initiative (MuGSI) Healthcare Associated Infection Community Interface (HAIC) Case Report
,
2016 Multi-site Gram Negative Surveillance Initiative (MuGSI) Healthcare Associated Infection Community Interface (HAIC) Case Report
,
2017 Multi-site Gram-Negative Surveillance Initiative (MuGSI) HAIC Case Report
Salmonella
Shiga toxin producing E. coli
Shigella
Vibrio
Yersinia
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
81,420
81,420
0
0
0
0
Annual Time Burden (Hours)
22,806
22,806
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:
$20,221,865
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:
Jeffrey Zirger 404 639-7118 wtj5@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:
12/30/2016
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