Information Collection on Cause-Specific Absenteeism in Schools

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Acute Respiratory Infection and Influenza Surveillance Form	Form	Modified	Available
Non-Substantive Change 0920-1039 ARI and Influenze Survillance Form.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-12-28	Available
SupStaA_12102014 WI School Absenteeism.docx	Supplementary Document	Uploaded 2014-12-15	Available
SupStaB_12102014 WI School Absenteeism.docx	Supplementary Document	Uploaded 2014-12-15	Available
SupStaA_12102014 WI School Absenteeism.docx	Supporting Statement A	Uploaded 2014-12-15	Available
Att C3- Univ of Wisconsin - consent_assent forms.docx	Supplementary Document	Uploaded 2014-07-24	Available
Att D FRN comment.docx	Supplementary Document	Uploaded 2014-07-24	Repair queued
Att C7- Univ of Wisconsin - CDC IRB deferral notice.docx	Supplementary Document	Uploaded 2014-07-21	Available
Att C6- Univ of Wisconsin - IRB approval letter.pdf	Supplementary Document	Uploaded 2014-07-21	Available
Att B- 60d FRN.pdf	Supplementary Document	Uploaded 2014-07-21	Available
Att A3- Sec 301 PHSA (42 USC 241).pdf	Supplementary Document	Uploaded 2014-07-21	Available
Att A2- CFR part 70.pdf	Supplementary Document	Uploaded 2014-07-21	Available
Att A1- Sec 361 PHSA (42 USC 264).pdf	Supplementary Document	Uploaded 2014-07-21	Available
SupStaB_12102014 WI School Absenteeism.docx	Supporting Statement B	Uploaded 2014-12-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212417	Acute Respiratory Infection and Influenza Surveillance Form	Form	Modified
212402	ORCHARDS Phone Screening	Other-WORD	Unchanged

ICR Details

OMB Control No: 0920-1039	ICR Reference No: 201512-0920-009
Status: Historical Active	Previous ICR Reference No: 201407-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 16HT
Title: Information Collection on Cause-Specific Absenteeism in Schools
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: 01/21/2016
	Date Received in OIRA: 01/19/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2017	12/31/2017	12/31/2017
Responses	12,000	0	12,000
Time Burden (Hours)	3,500	0	3,500
Cost Burden (Dollars)	0	0	0

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Abstract: The Centers for Disease Control and Prevention (CDC), National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Global Migration and Quarantine (DGMQ), requests approval of a new information collection on Cause-Specific Absenteeism in Schools. This information collection aims to improve our understanding of the role of cause-specific absenteeism in schools in predicting community-wide influenza transmission, and will be used to strengthen the evidence-base of CDC's Pre-Pandemic Guidance prior to next pandemic. This request is to add four questions to the currently approved Acute Respiratory Infection and Influenza Surveillance Form. No significant change in Burden is expected.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Research and Investigations Generally
   US Code: 42 USC SubChapter F Name of Law: Quarantine, Inspection, Licensing
   US Code: 42 USC 264 Name of Law: Regulations to Control Communicable Diseases
  

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:
	79 FR 27617	05/14/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 42327	07/21/2014
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
Acute Respiratory Infection and Influenza Surveillance Form	NA	Acute Respiratory Infection and Influenza Surveillance Form 28DEC2015
ORCHARDS Phone Screening

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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	12,000	12,000	0	0	0	0
Annual Time Burden (Hours)	3,500	3,500	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: $536,000

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]? 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

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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: 01/19/2016

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