GenIC Request

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0920-1026)

TITLE OF INFORMATION COLLECTION: Flu on Call^TM National Network of Telephone Triage Lines Demonstration Pilot

PURPOSE:

Flu on Call™ is a CDC-led initiative, developed in collaboration with its partners including Association of State and Territorial Health Officials (ASTHO), National Association of County and City Health Officials (NACCHO), Council of State and Territorial Epidemiologists (CSTE), and Public Health Management Corporation (PHMC), designed to establish a national network of telephone triage lines staffed by information specialists, from United Way 2-1-1 Call Centers, and clinicians, from Poison Control Centers, for use during a severe influenza pandemic. CDC’s initiative to develop a coordinated network of triage lines was largely inspired by the success of an effort implemented in Minnesota during the 2009 – 2010 H1N1 pandemic influenza response. The goal of the Flu on Call™ network is to help reduce the pressure on traditional sources of medical care during emergency events and to improve access to medicines.

This is a specific request to pilot the functionality of the Flu on Call™ network during the 2016 influenza season. The goal is to test the usability of the Flu on Call™ platform and refine and improve operational plans, procedures and collection instruments if needed. CDC has contracted with United Way World Wide (UWW) and they have subcontracted with 2-1-1 and Poison Control Centers (PCC) to develop the Flu on Call™ Demonstration Project. United Way will create a hotline number that will be used during this demonstration. Communication plans to increase awareness of the hotline include print and broadcast media; outdoor advertising; and strategic ad placement in movie theaters and community gathering places.

2-1-1 call centers are used in communities across the U.S. to support every day needs or in times of emergency. Trained information specialists provide information to the public at no charge. Poison Control Centers offer free, confidential medical advice 24 hours a day, seven days a week to those with poison exposures as part of their everyday role in the community. The Poison Information Specialists are registered nurses and pharmacists with special training in toxicology, are nationally certified as specialists in poison information, and work under the direction of a medical toxicologist. These health professional Specialists are trained in medical triage to safely direct persons to needed care.

Individuals who contact Flu on Call™ will provide information (Attachment A) to the 2-1-1 information specialist. 211 Call Centers have standard intake screens that are used on a day to day basis for calls received as standard operating procedures. For the Flu on Call™ demonstration, CDC has modified the standard 211 Call Center intake screen to include additional questions to ensure the information specialists ask if the caller is sick or caring for someone who is sick as well as identify who is sick: self, child, spouse/partner, parent, other. Remaining questions on the intake screen have not been modified and remain the standard, already developed, questions under 211 United Way operating procedures. The intake screens at the 2-1-1 call centers are proprietary and it is not appropriate for the OMB Control No. to appear during this usability testing.

Depending on needs, the 2-1-1 information specialist will provide the caller with website addresses or other public-health informational resources about influenza. If a caller is ill, the 2-1-1 Specialist will transfer the caller to a Poison Information Specialists, working under an established protocol (Attachment B), who can provide the caller with information and medical advice. Telephony infrastructure at the 2-1-1 call centers allows the 2-1-1- specialist to route the call automatically to the Poison Control Center.

In a future pandemic, the Poison Control Specialists can provide access to medications over the phone; however, access to medication will not be provided during this usability test. Callers whose symptoms represent an emergency will be transferred or directed to 911 services as appropriate. The standard intake screens that the PCCs use daily have not been modified for the Flu on Call™ demonstration. However, the protocol which functions as a management document will be referenced during the call to determine if there is an emergency, influenza like illness (ILI) and screening for high risk medical conditions when ILI symptoms are present. The information obtained via the protocol will be entered into the notes/narrative section on the standard PCC intake screen.

CDC will receive de-identified aggregated data from UWW who will compile data from each participating center at the end of the usability test and submit to CDC in an aggregated, de-identified format. Data on the number of calls received, number of dropped calls, length of calls, numbers of calls escalated, hold times, total number of patients who are clinically ill, and total number of callers by age or gender. The data will be downloaded from the 2-1-1 and PCC center’s system to UWW, who will aggregate data and send via email to CDC as an excel spreadsheet. Anticipated use of the data gathered from this demonstration will be to inform the next operational exercise for Flu on Call™, to help refine the operations manual for Flu on Call™, and to assess the overall feasibility and acceptability of the system. Public dissemination of results is not intended.

DESCRIPTION OF RESPONDENTS:

Two jurisdictions have been identified participate in the 2015-2016 influenza season usability test:

1. Milwaukee, WI

2. Three Rivers, Nebraska

Flu on Call™ will be tested for six weeks in Milwaukee, WI, and in the “Three Rivers” jurisdiction in Nebraska, which includes Washington, Dodge, and Saunders counties. The Milwaukee 2-1-1 Call Center and the Wisconsin Poison Control Center will provide services for Milwaukee, WI. The Nebraska Poison Control Center in Omaha, Nebraska and the 2-1-1 Call Center in St. Louis, Missouri will provide services for callers from the three counties in Nebraska.

Each center (211 and PCC) will be staffed to support the projected call volume. Call volume has been estimated according to a simulation exercise. In Milwaukee, a total of 5 specialists are projected to staff this demonstration, with 3 United Way 2-1-1 Call Center information specialists and 2 Poison Information Specialists. In Nebraska, a total of 4 specialists will support this demonstration, with 2 United Way 2-1-1 Call Center information specialists (located in St. Louis, MO) and 2 Poison Information Specialists. The total number of 2-1-1 incoming calls from the general public are estimated at 3600. The number of calls that are estimated to be transferred to the Poison Control Centers are 900.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[X] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other:

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Lisa M. Koonin DrPH MN MPH; [email protected]

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X] Yes [ ] No

2. If Yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

3. If Applicable, has a System or Records Notice been published? []Yes [X]No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Individuals calling 2-1-1	3600	2/60	120
Individuals transferred to Poison Control Centers	900	5/60	75
Totals

FEDERAL COST: The estimated annual cost to the Federal government is $1,600,000.

If you are conducting a focus group, survey, or plan to employ statistical methods, Please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

The Flu on Call™ Demonstration Project will be tested in two jurisdictions, Milwaukee, WI and Three Rivers, Nebraska. These jurisdictions confirmed interest and have the capability to support the project. The 2-11 United Way Center and the Poison Control Centers dedicated to those jurisdictions will participate. Additionally, the residents of these jurisdictions will have the opportunity to voluntarily call the Flu on Call™ line when activated.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[X] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [X ] Yes [ ] No

Attachments:

Attachment A_United Way 211 Information Specialist Intake Screen_Flu OnCall

Attachment B_ Management Guidelines for Adults (≥18 years) or Children (2-17 years) with Possible Influenza-Like Illness

4