Information Collection on Cause-Specific Absenteeism in Schools

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Household Members - Household Study Form	Form	New	Available
Parents - Household Study Form	Form	New	Available
Parents - Acute Respiratory Infection and Influenza Surveillance Form	Form	Modified	Repair queued
Parents - ORCHARDS Telephone Screen	Form and Instruction	Modified	Available
Att. C3a - Household Members_consent_assent forms.docx	Supplementary Document	Uploaded 2017-10-27	Available
Att. C3 - consent_assent forms.docx	Supplementary Document	Uploaded 2017-10-27	Available
Att. C1 - School District Approval Letter.pdf	Supplementary Document	Uploaded 2017-10-27	Repair queued
Att. D4 - orchards newspaper ad.pdf	Supplementary Document	Uploaded 2017-10-27	Repair queued
Att. D2 - Recruitment Flyer_teenager_10 22 13.docx	Supplementary Document	Uploaded 2017-10-27	Available
Att. D3 - Recruitment Flyer_kid_10 22 13.docx	Supplementary Document	Uploaded 2017-10-27	Available
Att. D1 - participant packet.pdf	Supplementary Document	Uploaded 2017-10-27	Available
Att. C5 - IRB Approval.pdf	Supplementary Document	Uploaded 2017-10-27	Available
Att. C6 - CDC IRB Deferral.docx	Supplementary Document	Uploaded 2017-10-27	Repair queued
Att. B2 - Public Comment.pdf	Supplementary Document	Uploaded 2017-10-27	Repair queued
Att. B1 - Public Comment.pdf	Supplementary Document	Uploaded 2017-10-27	Available
Att. B - 60-day FRN.pdf	Supplementary Document	Uploaded 2017-10-27	Available
Non-Substantive Change 0920-1039 ARI and Influenze Survillance Form.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2015-12-28	Available
SupStaA_WI School Absenteeism_revised_2018_3_2.docx	Supporting Statement A	Uploaded 2018-03-12	Available
Att A3- Sec 301 PHSA (42 USC 241).pdf	Supplementary Document	Uploaded 2014-07-21	Repair queued
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_WI School Absenteeism_08.01.17.docx	Supporting Statement B	Uploaded 2017-10-27	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
228818	Household Members - Household Study Form	Form	New
228817	Student - Biospecimen Collection	Instruction	New
228816	Parents - Household Study Form	Form	New
212417	Parents - Acute Respiratory Infection and Influenza Surveillance Form	Form	Modified
212402	Parents - ORCHARDS Telephone Screen	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1039	ICR Reference No: 201710-0920-016
Status: Active	Previous ICR Reference No: 201512-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1039
Title: Information Collection on Cause-Specific Absenteeism in Schools
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/12/2018
	Date Received in OIRA: 11/13/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved	03/31/2018
Responses	2,985	0	12,000
Time Burden (Hours)	419	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 revision adds household transmission component to the ongoing approved information collection

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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:
	82 FR 19373	04/27/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 51838	11/08/2017
Did the Agency receive public comments on this ICR? Yes

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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
Parents - Acute Respiratory Infection and Influenza Surveillance Form	NA	Acute Respiratory Infection and Influenza Surveillance Form
Parents - ORCHARDS Telephone Screen	NA	ORCHARDS Screening Form
Parents - Household Study Form	NA	ORCHARDS - Household Study Form
Student - Biospecimen Collection
Household Members - Household Study Form	NA	ORCHARDS - Household Study Form

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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	2,985	12,000	0	-9,015	0	0
Annual Time Burden (Hours)	419	3,500	0	-3,081	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The submission of Revision for 0920-1039 - Information Collection on Cause-Specific Absenteeism in Schools results in addition of a Household Form, and a reduction in the number of students participating and responses per Respondent.

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Annual Cost to Federal Government: $608,479

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 11/13/2017

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