Emergency Epidemic Investigations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Emergency Epidemic Investigations--Individual Households and Physcians	Form	Modified	Available
Form 2 Emergency Epidemic Investigations--State and Local Officials	Form	Modified	Available
Supporting Statement B Emergency Epidemic Investigations.doc	Supporting Statement B	Uploaded 2009-12-10	Available
ATTACHMENT G - Comment and Response 60-D FRN OMB 0920-0008.doc	Supplementary Document	Uploaded 2009-12-10	Available
ATTACHMENT F - IRB Determination for Emerg Epi Invest.pdf	Supplementary Document	Uploaded 2009-12-10	Available
ATTACHMENT C - Epidemic Investigation Case Records System Notice.doc	Supplementary Document	Uploaded 2009-12-10	Available
ATTACHMENT B - FRN 60 Day Notice Aug 19 09 Emerg Epi Investigations.pdf	Supplementary Document	Uploaded 2009-12-10	Available
ATTACHMENT A - Authorizing Legislation (Emerg Epi Invest).pdf	Supplementary Document	Uploaded 2009-12-10	Available
Supporting Statement A Emergency Epidemic Investigations.doc	Supporting Statement A	Uploaded 2009-12-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6601	Emergency Epidemic Investigations--Individual Households and Physcians	Form	Modified
46545	Emergency Epidemic Investigations--State and Local Officials	Form	Modified

ICR Details

OMB Control No: 0920-0008	ICR Reference No: 200912-0920-004
Status: Historical Active	Previous ICR Reference No: 200612-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Emergency Epidemic Investigations
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/12/2010
	Date Received in OIRA: 12/14/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2013	36 Months From Approved	03/31/2010
Responses	15,100	0	15,100
Time Burden (Hours)	3,775	0	3,775
Cost Burden (Dollars)	0	0	0

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Abstract: CDC receives requests from state and local health departments for scientific, medical and technical assistance in the event of an epidemic or medical emergency. This clearance package enables CDC scientists a means to collect data in the field. (Key words: health emergency medical services, disaster assistance, infectious disease surveys, health surveys, epidemic)

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Authorizing Statute(s): US Code: 42 USC 301[241] Name of Law: Public Health Services Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 41913	08/19/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 65537	12/10/2009
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Emergency Epidemic Investigations--Individual Households and Physcians	1	Emergency Epidemic Investigations--Individuals, Households, Physcians, etc.
Emergency Epidemic Investigations--State and Local Officials	2	State and Local Officials Questionnaire

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ICR Summary of Burden

table that charts list 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	15,100	15,100	0	0	0	0
Annual Time Burden (Hours)	3,775	3,775	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:

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Annual Cost to Federal Government: $350,000

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 12/14/2009

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