Aggregate Reports for Tuberculosis Program Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Follow-up and Treatment of Contacts to Tuberculosis Case Form	Form and Instruction	Modified	Available
Targeted Testing and Treatment for Latent TB Infection - Program Managers- (manual)	Form and Instruction	Modified	Available
Targeted Testing and Treatment for Latent TB Infection - data clerks - (manual)	Form and Instruction	Modified	Available
Targeted Testing and Treatment for Latent Tuberculosis Infection - Electronic (Data Clerks & Program Managers)	Form and Instruction	Modified	Available
0920-0457 - Follow-up and Treatment for Contacts to TB Cases - Program Managers- (Manual)	Form and Instruction	Modified	Available
0920-0457 - Follow-up and Treatment for Contacts to TB Cases - data clerks - manual	Form and Instruction	Modified	Available
Att 5 arpes_manual.pdf	Supplementary Document	Uploaded 2016-09-22	Available
Att 4 Project Determination.pdf	Supplementary Document	Uploaded 2016-09-22	Available
Att 2 60 Day FRN.pdf	Supplementary Document	Uploaded 2016-09-22	Available
SSB.docx	Supporting Statement B	Uploaded 2016-09-22	Available
Att 1_Legislative Authority.pdf	Supplementary Document	Uploaded 2016-09-22	Available
SSA.docx	Supporting Statement A	Uploaded 2016-09-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6884	Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)	Form and Instruction	Modified	Follow-up and Treatment of Contacts to Tuberculosis Case Form
178821	0920-0457 Targeted Testing and Treatment for Latent TB Infection - prog. manag. - manual	Form and Instruction	Modified	Targeted Testing and Treatment for Latent TB Infection - Program Managers- (manual)
178819	Targeted Testing and Treatment for Latent TB Infection - data clerks - (manual)	Form and Instruction	Modified	Targeted Testing and Treatment for Latent TB Infection - data clerks - (manual)
178818	Targeted Testing and Treatment for Latent Tuberculosis Infection - Electronic (Data Clerks & Program Managers)	Form and Instruction	Modified	Targeted Testing and Treatment for Latent Tuberculosis Infection - Electronic (Data Clerks & Program Managers)
178817	Follow-up and Treatment for Contacts to TB Cases - Managers- manual	Form and Instruction	Modified	0920-0457 - Follow-up and Treatment for Contacts to TB Cases - Program Managers- (Manual)
178815	0920-0457 - Follow-up and Treatment for Contacts to TB Cases - data clerks - manual	Form and Instruction	Modified	0920-0457 - Follow-up and Treatment for Contacts to TB Cases - data clerks - manual

ICR Details

OMB Control No: 0920-0457	ICR Reference No: 201609-0920-016
Status: Historical Active	Previous ICR Reference No: 201307-0920-007
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0457
Title: Aggregate Reports for Tuberculosis Program Evaluation
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/17/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/27/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2020	36 Months From Approved
Responses	272	0	0
Time Burden (Hours)	226	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is a request for extension of OMB approval of a previously approved collection. The Division of Tuberculosis Elimination (DTBE)/ (NCHHSTP)/CDC is submitting two public health report forms representing (1) denominator-based outcome measurements, (2) technology for data storage and transmission, and (3) the primary public health strategies for tuberculosis (TB) control. The respondents for the reports are the 68 state and local health departments having federal TB cooperative agreements.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service - Research and Investigations generally
  

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 43203	07/01/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 66030	09/26/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
0920-0457 - Follow-up and Treatment for Contacts to TB Cases - data clerks - manual	None	0920-0457 - Follow-up and Treatment for Contacts to TB Cases - data clerks - manual
0920-0457 Targeted Testing and Treatment for Latent TB Infection - prog. manag. - manual	None	Targeted Testing and Treatment for Latent TB Infection - Program Managers- (manual)
Follow-up and Treatment for Contacts to TB Cases - Managers- manual	None	0920-0457 - Follow-up and Treatment for Contacts to TB Cases - Program Managers- (Manual)
Follow-up and Treatment of Contacts to Tuberculosis Case Form - Electronic (Data Clerks and Program Managers)	None	Follow-up and Treatment of Contacts to Tuberculosis Case Form
Targeted Testing and Treatment for Latent TB Infection - data clerks - (manual)	None	Targeted Testing and Treatment for Latent TB Infection - data clerks - (manual)
Targeted Testing and Treatment for Latent Tuberculosis Infection - Electronic (Data Clerks & Program Managers)	None	Targeted Testing and Treatment for Latent Tuberculosis Infection - Electronic (Data Clerks & Program Managers)

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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	272	0	0	272	0	0
Annual Time Burden (Hours)	226	0	0	226	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: There are no program changes or adjustments. The burden has not changed from the burden shown in the current inventory.

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Annual Cost to Federal Government: $75,040

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: 09/27/2016

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