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:
0920-1396
ICR Reference No:
202604-0920-002
Status:
Active
Previous ICR Reference No:
202212-0920-001
Agency/Subagency:
HHS/CDC
Agency Tracking No:
0920-26-0182
Title:
[NCEZID] School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren: Phase-2 of the National Roll-Out
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
Yes
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
06/11/2026
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/28/2026
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2029
36 Months From Approved
06/30/2026
Responses
238
0
238
Time Burden (Hours)
951
0
631
Cost Burden (Dollars)
0
0
0
Abstract:
ME/CFS is a complex, debilitating, chronic disease that involves several body systems and is hypothesized to contribute to chronic school absenteeism. The condition is characterized by reduced ability to perform pre-illness activities that lasts for more than six months and is accompanied by profound fatigue, which is not improved by rest. Data collection activities associated with the School-Based Active Surveillance (SBAS) of Myalgic Encephalomyelitis/Chronic Fatigue Syndrome Among Schoolchildren are designed to test and refine an approach for school-based active surveillance (SBAS) of myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) by building on and improving ongoing active surveillance of chronic conditions associated with absenteeism and school withdrawal among US schoolchildren (grades kindergarten through twelve, K-12). This Revision request is submitted to renew the data collection for an additional three years and continue activities associated with Phase-4 which consists of four main components: 1) engage and educate nursing professionals including school nurses, 2) maintain and enhance the electronic data platform for the active surveillance, 3) increase nurse workforce to help ensure students’ health and data collection for the surveillance, and 4) assess burden of ME/CFS using data from Phase-4 for the school-based active surveillance. The Electronic Platform: Quarterly Chronic Absenteeism Data Reporting Form has been revised to account for additional states that have been added over time. There is an increase in burden hours from the previously approved burden estimate.
Authorizing Statute(s):
US Code:
42 USC 241
Name of Law: U.S. 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:
91 FR 6219
02/11/2026
30-day Notice:
Federal Register Citation:
Citation Date:
91 FR 22821
04/28/2026
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
6
IC Title
Form No.
Form Name
Demographic Data Collection Points
0920-22HN
Attachment B_SBAS_Demographic Data Collection Points
Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form
0920-1396
Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form 08JUN2026
Question Guide for Face-to-Face Evaluation Interviews
0920-22HN
Question Guide for Face-to-Face Evaluation Interviews
School District Feedback Form
0920-22HN
School District Feedback Form
Site Baseline Survey
0920-22HN
Attachment C_SBAS_Site Baseline Survey
Webinar 1 Feedback Form
920-22HN
Webinar 1 Feedback Form
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
238
238
0
0
0
0
Annual Time Burden (Hours)
951
631
0
320
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:
Revision submitted for 0920-1396 involves modified Electronic Platform Quarterly Chronic Absenteeism Data Reporting Form and increase in burden to 951 burden hours
Annual Cost to Federal Government:
$348,384
Does this IC contain surveys, censuses, or employ statistical methods?
No
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?
No
Agency Contact:
Jeffrey Zirger 404 639-7118 wtj5@cdc.gov
Common Form ICR:
Yes
Description/Changes for Common Form Usage:
There are no Common Forms associated with this data collection
Approved RCFs using this ICR
Agency/Sub Agency
RCF ID
RCF Title
RCF Status
IC Title
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:
04/28/2026
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