Monitoring and Coordinating Personal Protective Equipment (PPE) in Healthcare to Enhance Domestic Preparedness for Ebola Response

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Crisis Survey	Form and Instruction	New	Available
Emergency Survey	Form and Instruction	New	Repair queued
Quarterly Survey	Form and Instruction	New	Available
Annual Survey	Form and Instruction	New	Available
Baseline Survey	Form and Instruction	New	Available
SSB_PPE 02JUN2016.docx	Supporting Statement B	Uploaded 2016-06-13	Available
SSA_PPE 02JUN2016.docx	Supporting Statement A	Uploaded 2016-06-13	Available
ATT D HSRB.docx	Supplementary Document	Uploaded 2016-06-08	Available
Att F Analysis Plan.docx	Supplementary Document	Uploaded 2016-05-06	Available
Att C Hospital Consent.pdf	Supplementary Document	Uploaded 2016-05-06	Available
Att B 60 day.pdf	Supplementary Document	Uploaded 2016-05-06	Available
Att A Authorizing Leg.docx	Supplementary Document	Uploaded 2016-05-06	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
221901	Crisis Survey	Form and Instruction	New
221845	Emergency Survey	Form and Instruction	New
221844	Quarterly Survey	Form and Instruction	New
221843	Annual Survey	Form and Instruction	New
221842	Baseline Survey	Form and Instruction	New

ICR Details

OMB Control No: 0920-1131	ICR Reference No: 201605-0920-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16KA
Title: Monitoring and Coordinating Personal Protective Equipment (PPE) in Healthcare to Enhance Domestic Preparedness for Ebola Response
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2016
	Date Received in OIRA: 06/14/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2019	36 Months From Approved
Responses	137	0	0
Time Burden (Hours)	230	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The request for a New ICR is to garner a better understanding of the particular PPE needs of healthcare workers to ensure the health and safety of this workforce during emergencies, and an urgent need to monitor and assess PPE needs for the Ebola response. Infection control is a key strategy in stopping the spread of Ebola as well as identifying and managing patients with the Ebola virus. The study intends to answer the following: (1) “What is the best way to optimize the PPE supply chain in real time?” and (2) “How can predictive modeling assist in resource allocation?” Additionally, the information to be collected will aid in improving the health and safety of healthcare workers by assessing PPE training and supply management.

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Authorizing Statute(s): US Code: 29 USC 671 Name of Law: National Institute for Occupational Safety and Health
  

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:
	81 FR 3421	01/21/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 36920	06/08/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Baseline Survey	NA	Web-Based Survey - Baseline
Annual Survey	NA	Web-Based Survey - Annual
Quarterly Survey	NA	Web-Based Survey - Quarterly
Emergency Survey	NA	Web-Based Survey - Emergency
Crisis Survey	NA	Web-Based Survey - Crisis

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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	137	0	0	137	0	0
Annual Time Burden (Hours)	230	0	0	230	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: Submission of 0920-16KA is a New ICR.

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Annual Cost to Federal Government: $75,351

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: 06/14/2016

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