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:
0920-0009
ICR Reference No:
201901-0920-013
Status:
Historical Active
Previous ICR Reference No:
201708-0920-015
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-0009-19RH
Title:
National Disease Surveillance 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:
02/05/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
02/01/2019
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2019
06/30/2019
06/30/2019
Responses
630
0
630
Time Burden (Hours)
190
0
173
Cost Burden (Dollars)
0
0
0
Abstract:
Acute flaccid myelitis (AFM) is a rare but serious condition that affects the nervous system, specifically the spinal cord, which can cause the muscles and reflexes in the body not to work normally. CDC does not yet know the cause of these AFM cases and it is unclear what pathogen or immune response is causing the weakness and paralysis. CDC has not yet determined who is at higher risk for developing AFM, or the reasons why they may be at higher risk. Information about cases is collected from state health departments, in consultation with clinicians, using a national case report form. CDC will use this information to describe the illness, identify etiology, modes of transmission, risk factors, and geographic distribution of the neurologic illness. The data will also help inform the baseline rate of AFM in the United States, which is currently unknown. For this ICR CDC is requesting minor changes to a few questions which will cause a minor burden change.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: Research and Investigations Generally
US Code:
42 USC 301
Name of Law: General Powers and Duties of Public Health Service
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 56997
09/21/2015
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 78737
12/17/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Att D-1_CJD
Att D-3_Reye Syndrome
Att D-4_Acute Flaccid Myelitis
0920-0009
AFM: Patient Summary Form 2019 update
Att D2_Kawasaki Syndrome
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
630
630
0
0
0
0
Annual Time Burden (Hours)
190
173
0
17
0
0
Annual Cost Burden (Dollars)
0
0
0
0
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:
The burden increased slightly because of an increase in the estimation of the time it takes to fill out the AFM instrument.
Annual Cost to Federal Government:
$10,000
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.
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.
Yes
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:
Kevin Joyce 404 639-1944 kdj7@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:
02/01/2019
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