CDC Emergency Operations Center: Zika Related Clinical Inquiries

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Zika Clinical Inquiries Data - Clinicians and Other Providers	Form and Instruction	New	Available
Zika Clinical Inquiries Database - State/Local Health Department	Form and Instruction	New	Available
SSB-EOC Clinical Inquiries Database 072116.docx	Supporting Statement B	Uploaded 2017-01-27	Available
SSA-EOC Clinical Inquiries Databasev 27JAN2017.docx	Supporting Statement A	Uploaded 2017-01-27	Available
Att. D - IRB Approval - EOC Call Center.pdf	Supplementary Document	Uploaded 2016-08-03	Available
Att. E - Public Comments.pdf	Supplementary Document	Uploaded 2016-08-03	Available
Att. A - Authorizing Legislation.pdf	Supplementary Document	Uploaded 2016-08-03	Available
60-Day-CDC-2016-0040-0001.pdf	Supplementary Document	Uploaded 2016-08-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222839	Zika Clinical Inquiries Data - Clinicians and Other Providers	Form and Instruction	New
222837	Zika Clinical Inquiries Database - State/Local Health Department	Form and Instruction	New

ICR Details

OMB Control No: 0920-1159	ICR Reference No: 201608-0920-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16AFR
Title: CDC Emergency Operations Center: Zika Related Clinical Inquiries
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 with change	Conclusion Date: 01/30/2017
	Date Received in OIRA: 08/22/2016
Terms of Clearance: Approved consistent with the understanding that information is reported voluntarily to the EOC by inquiring members of the general public and clinicians, and not all zika cases that occur domestically may result in a call to the EOC. As a result--this collection is not intended to result in generalizable conclusions or to directly inform health policy.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved
Responses	1,220	0	0
Time Burden (Hours)	305	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The goal of this information collection is to document and track clinical inquiries made to the CDC EOC call center related to Zika virus illness, as well as to systematically collect standardized clinical/demographic/epidemiologic information about suspected cases of Zika virus illness, so that clinical inquiries can inform future policy.

---

Authorizing Statute(s): US Code: 42 USC 247 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:
	81 FR 26231	05/02/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 52694	08/09/2016
Did the Agency receive public comments on this ICR? Yes

---

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

table that charts list of burden

IC Title	Form No.	Form Name
Zika Clinical Inquiries Data - Clinicians and Other Providers	NA	2016 Zika Virus Inquiry Log
Zika Clinical Inquiries Database - State/Local Health Department	NA	2016 Zika Virus Inquiry Log

---

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	1,220	0	0	1,220	0	0
Annual Time Burden (Hours)	305	0	0	305	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: 0920-16AFR is a New ICR submitted to continue collection of information under a previously approved Emergency Clearance.

---

Annual Cost to Federal Government: $108,700

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

---

Common Form ICR:  No

---

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: 08/22/2016

---