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 Generic ICR - OIRA Conclusion
OMB Control No:
0920-1011
ICR Reference No:
202201-0920-010
Status:
Historical Active
Previous ICR Reference No:
202110-0920-009
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-1011-22BV
Title:
Emergency Epidemic Investigation Data Collections- -Expedited Review (Y3Q4)
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:
01/18/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/13/2022
Terms of Clearance:
Previous terms continue: Approved consistent with the understanding that GenICs under this generic will be limited to acute public health emergencies resulting from outbreaks or events with undetermined agent, source, mode of transmission, or risk factors. Data collection for investigations conducted under this generic will not exceed 90 days. Investigations conducted for the primary purpose of program evaluation, surveillance, needs assessment, or research (e.g., to contribute to generalizable knowledge) are excluded from this generic pathway.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2023
01/31/2023
01/31/2023
Responses
805,759
0
805,759
Time Burden (Hours)
402,874
0
402,874
Cost Burden (Dollars)
0
0
0
Abstract:
This non-substantive change request is submitted to comply with the stated procedures in the approved EEI Generic ICR package (as specified in point 5 under Special Circumstances Relating to the Guidelines of 5 CFR 1320.5), “CDC maintains a library of data collection instruments that includes all final data collection instruments conducted under this generic ICR. This library and the updated burden numbers based on data collected via the “Burden Memo” are submitted to OMB quarterly as a non-substantive change to the generic ICR.” In this quarter there were no EEIs to report, so this non-substantive change request has zero burden to report from July 1, 2021 to September 30, 2021.
Authorizing Statute(s):
US Code:
42 USC 301
Name of Law: PHSA
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:
84 FR 46535
09/04/2019
30-day Notice:
Federal Register Citation:
Citation Date:
84 FR 66908
12/06/2019
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
7
IC Title
Form No.
Form Name
2022_Monkeypox Response
0920-1011
2022 Case Report Form_MPX
Pediatric Brain Abscesses, Epidural Empyemas, and Subdural Empyemas Associated with Streptococcal Species
0920-1011
CDC Pediatric Brain Abscess Case Reporting Form
Undetermined agent for hepatitis among children <10 years of age – United States, 2022
0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011
Appendix 1: Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form (CRF)
,
Appendix 2: Pediatric Hepatitis of Unknown Etiology- Exposures Questionnaire (Parental Interview)
,
Appendix 3: Domestic Hepatitis-Adenovirus Investigation Consent
,
Appendix 4: Pediatric Hepatitis of Unknown Etiology Medical Record Abstraction Form: Controls (CRF)
,
Appendix 5: Pediatric Hepatitis of Unknown Etiology- Exposures Questionnaire: Controls (Parental Interview)
,
Appendix 6: Domestic Hepatitis-Adenovirus Investigation Consent: Controls (residual blood)
,
Appendix 7: Pediatric Hepatitis of Unknown Etiology- Exposures Questionnaire (Parental Interview) - SPANISH
,
Appendix 8: Domestic Hepatitis-Adenovirus Investigation Consent - SPANISH
Undetermined agent for hepatitis among children <10 years of age – United States, 2022
0920-1011, 0920-1011, 0920-1011
Pediatric Hepatitis of Unknown Etiology Case Report Form
,
Pediatric Hepatitis of Unknown Etiology Exposures Questionnaire
,
Consent Form
Undetermined risk factor for highly pathogenic avian influenza H5N1 among individuals exposed to infected birds – United States, 2022
0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011, 0920-1011
Aggregate counts of persons exposed to HPAI
,
HPAI H5 Consent Form (English)
,
HPAI H5 Consent Form (Spanish)
,
Avian Influenza Initial Case Investigation Form (English)
,
Avian Influenza Initial Case Investigation Form (Spanish)
,
Highly Pathogenic Avian Influenza A (H5N1) Exposure Questionnaire (English)
,
Highly Pathogenic Avian Influenza A (H5N1) Exposure Questionnaire (Spanish)
,
HPAI H5 Self Swab Instructions (English)
,
HPAI H5 Self Swab Instructions (Spanish)
,
Human Sera Collection Guidelines for Flu Serology
Undetermined risk factor for highly pathogenic avian influenza H5N1 among individuals exposed to infected birds – United States, 2022
0920-1011
Aggregate counts of persons exposed to highly pathogenic avian influenza (HPAI)
Undetermined risk factor for highly pathogenic avian influenza H5N1 among individuals exposed to infected birds – United States, 2022
0920-1011
Aggregate counts of persons exposed to highly pathogenic avian influenza (HPAI)
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
805,759
805,759
0
0
0
0
Annual Time Burden (Hours)
402,874
402,874
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:
This non-substantive change request includes reporting for data collection completed from July 1, 2020 to September 30, 2020. The actual burden for the one investigation completed during this quarter was 1,414 respondents and 1,081 burden hours.
Annual Cost to Federal Government:
$1,586,352
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.
No
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?
Yes
Agency Contact:
Thelma Sims 4046394771
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:
01/13/2022