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:
0920-1287
ICR Reference No:
202003-0920-007
Status:
Historical Active
Previous ICR Reference No:
202001-0920-020
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-20HF
Title:
2019 Novel Coronavirus Airport Entry Questionnaires
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Emergency
Approval Requested By:
03/11/2020
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/16/2020
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/16/2020
Terms of Clearance:
Previous terms continue: Approved consistent with the understanding that CDC will work with its desk officer to determine the appropriate pathway, should the agency request approval to revise or extend the collection beyond the approved period under this action. CDC will submit a request for any revisions to collection instruments, burden, or respondent population.The Agency will include the OMB control number, expiration date, and public burden statement on all instruments and instructions associated with this collection.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2020
09/30/2020
09/30/2020
Responses
14,195,850
0
955,000
Time Burden (Hours)
2,349,475
0
136,667
Cost Burden (Dollars)
0
0
0
Abstract:
CDC has been tasked with conducting public health assessments at U.S. airports of travelers coming from areas experiencing an outbreak of a novel (new) coronavirus (named “2019-nCoV”) in order to detect ill individuals or individuals at risk of being ill with 2019-nCoV. The goal of this information collection is to 1) accurately assess risk for infection or exposure to 2019-nCoV in travelers coming to the United States from locations experiencing an outbreak of 2019-nCoV, and 2) assist states in facilitating public health follow-up of contacts in the event of a confirmed case on an aircraft. The information will be used to determine if individuals meet risk thresholds for further medical evaluation or public health follow-up according to guidance developed by the CDC, and to assist health departments in facilitating public health follow-up, as appropriate. The Non-Substantive Change Request described here is being submitted to adjust the burden for travelers coming to this country from England/Ireland.
Emergency Justfication:
Pursuant to the Office of Management and Budget (OMB) procedures established at 5 CFR 1320, Controlling Paperwork Burdens on the Public, CDC requests that the following collection of information, 2019 Novel Coronavirus Airport Entry Questionnaires and Aircraft Contact Investigations Information Collection, be processed in accordance with section 1320.13 Emergency Processing. CDC has determined that this information must be collected prior to the expiration of time periods established under Part 1320, and that this information is essential to the CDC’s ability to effectively address the potential international public health crisis emanating from Wuhan City, Hubei Province, China, and which continues to expand. There is currently a lack of information concerning the risk of spread posed by the Novel (new) Coronavirus (“2019-nCoV”); however, thousands of cases have been identified in China, including outside of Hubei Province and infections are also being reported in a growing number of international locations, including the United States. This suggests there is a risk of international spread. To combat this, CDC, along with the Department of Homeland Security, will implement an enhanced risk assessment program at U.S airports for travelers from Wuhan, China. CDC may also require that travelers from additional countries be assessed for risk in the event that those locations represent a risk of spread to the United States.
Authorizing Statute(s):
Statute at Large:
42 Stat. 71
Name of Statute: Foreign Quarantine
US Code:
42 USC 264
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
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
8
IC Title
Form No.
Form Name
COVID-2019 Air Traveler Illness and Death Investigation Form
0920-20HF
Air Traveler Illness or Death Investigation Form
COVID-2019 Referral Slip
0920-20HF
Referral Slip
Daily Sympton Check
Preboarding Health Screen
0920-20HF
Preboarding Health Screen
Supplemental 2019 Questionnaire
0920-20HF
Supplemental Questionnaire
United States Travel Health Declaration for Repatriation
0920-20HF
US Traveler Health Declaration for Repatriation
United States Travel Health Declaration for Repatriation from Ship
0920-20HF
US Traveler Health Declaration Repatriation from Ship
United States Traveler Health Declaration
0920-20HF, 0920-20HF, 0920-20HF, 0920-1287, 0920-1287
US Traveler health Declaration Web
,
US Traveler Health Declaration Fillable PDF
,
US Traveler Health Declaration Paper
,
U.S. Traveler Health Declaration England/Ireland Paper
,
U.S. Traveler Health Declaration England/Ireland Fillable PDF
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
14,195,850
955,000
0
13,240,850
0
0
Annual Time Burden (Hours)
2,349,475
136,667
0
2,212,808
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:
Changes to ICR and Burden result from requirement that additional travelers from United Kingdom and Ireland complete the information collection,
Annual Cost to Federal Government:
$17,500,000
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.
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:
03/16/2020
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