Report of Verified Case of Tuberculosis (RVCT)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Report of Verified Case of Tuberculosis (RVCT)	Form	Modified	Available
SSA.doc	Supporting Statement A	Uploaded 2016-10-27	Available
Att 5 IRB Evaluaiton.pdf	Supplementary Document	Uploaded 2016-10-27	Available
Att 4_RVCT Instructions.pdf	Supplementary Document	Uploaded 2016-10-27	Available
Att 2 60 Day FRN.pdf	Supplementary Document	Uploaded 2016-10-27	Available
Att 1 Authorizing Legislation.docx	Supplementary Document	Uploaded 2016-10-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
6627	Report of Verified Case of Tuberculosis (RVCT)	Form	Modified

ICR Details

OMB Control No: 0920-0026	ICR Reference No: 201610-0920-012
Status: Historical Active	Previous ICR Reference No: 201402-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0026
Title: Report of Verified Case of Tuberculosis (RVCT)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/21/2016
	Date Received in OIRA: 10/31/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2019	36 Months From Approved	03/31/2017
Responses	9,420	0	9,960
Time Burden (Hours)	5,495	0	5,810
Cost Burden (Dollars)	0	0	0

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Abstract: CDC is requesting OMB approval for 3-year extension of the data collection form called Report of Verified Case of Tuberculosis (RVCT) for the national tuberculosis (TB) surveillance system. The previously approved Information Collection Request is OMB No. 0920-0026. This request reflects extension without changes to the currently approved RVCT. Respondents to the collection remain as before, territorial, state, and local public health departments in 60 reporting areas (50 states, the District of Columbia, New York City, Puerto Rico, and 7 jurisdictions in the Pacific and Caribbean). National TB surveillance system data assist federal, state, and local public health officials and policy makers in program planning, evaluation, and resource allocation. CDC publishes summarized data on TB in the United States annually, which is disseminated to TB control officers, pulmonary and infectious disease experts, and others interested in TB control.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Service Act
  

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 57588	08/23/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 74805	10/27/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Report of Verified Case of Tuberculosis (RVCT)	NA	Report of Verified Case of Tuberculosis

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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	9,420	9,960	0	-540	0	0
Annual Time Burden (Hours)	5,495	5,810	0	-315	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Reduction in Burden Hours is the result of having fewer TB cases reported in the United States as we continue progress towards TB elimination.

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Annual Cost to Federal Government: $1,479,347

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 10/31/2016

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