Assessment of Chemical Exposures (ACE) Investigations

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Appx H Decision Tree for ACE Invstig .docx	Supplementary Document	Uploaded 2018-01-04	Available
Appx G VetChartAbstrct Form SAMPLE.docx	Supplementary Document	Uploaded 2018-01-04	Available
Appx F MedChartAbstrct Form SAMPLE.docx	Supplementary Document	Uploaded 2018-01-04	Available
Appx E HospSurvey SAMPLE.docx	Supplementary Document	Uploaded 2018-01-04	Repair queued
Appx D HHSurvey SAMPLE.docx	Supplementary Document	Uploaded 2018-01-04	Available
Appx C ACE Short Form SAMPLE.docx	Supplementary Document	Uploaded 2018-01-04	Available
Appx B GenSurvey SAMPLE.docx	Supplementary Document	Uploaded 2018-01-04	Available
Appx A Summary of ACE Invstgns.docx	Supplementary Document	Uploaded 2018-01-04	Available
Att 9 NCEH-ATSDR RDF-OSSigned.pdf	Supplementary Document	Uploaded 2018-01-04	Available
Att 8 ACE Rash Report.pdf	Supplementary Document	Uploaded 2018-01-04	Available
Att 7 ACE Consent Forms.docx	Supplementary Document	Uploaded 2018-01-04	Available
Att 6 Steps for Using Gnric Clrnce ACE Inv .docx	Supplementary Document	Uploaded 2018-01-04	Available
Att 5 ACE Burden Memo ACE Invs.docx	Supplementary Document	Uploaded 2018-01-04	Available
Att 4 ACE Investigation GenIC Advnc Ntfictn.docx	Supplementary Document	Uploaded 2018-01-04	Repair queued
Att 3 Request ACE Investsgtn Frm.docx	Supplementary Document	Uploaded 2018-01-04	Available
Att 2 60 Day FRN ACE Invstgtns.pdf	Supplementary Document	Uploaded 2018-01-04	Available
Att 1 AuthLegisl-Cmbnd ACE Inv.docx	Supplementary Document	Uploaded 2018-01-04	Available
ACE SSB .docx	Supporting Statement B	Uploaded 2018-01-04	Available
ACE SSA Clean.docx	Supporting Statement A	Uploaded 2018-01-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form

ICR Details

OMB Control No: 0923-0051	ICR Reference No: 201801-0923-001
Status: Active	Previous ICR Reference No: 201607-0923-002
Agency/Subagency: HHS/TSDR	Agency Tracking No: 0923-0051
Title: Assessment of Chemical Exposures (ACE) Investigations
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/13/2018
	Date Received in OIRA: 01/09/2018
Terms of Clearance: Previous terms continue: CDC will submit a Part B for each Gen IC submission, and provide a justification for any ICs longer than 30 minutes. If a short approval time is requested (24- or 72-hrs), CDC will also provide a justification based on a public health need.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2021	36 Months From Approved	03/31/2018
Responses	3,870	0	3,870
Time Burden (Hours)	1,773	0	1,773
Cost Burden (Dollars)	0	0	0

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Abstract: The ACE Investigations focus on performing rapid epidemiological assessments to assist state, regional, local, or tribal health departments (the requesting agencies) to respond to or prepare for acute chemical releases. States use the information to 1. Characterize exposure and acute health effects of respondents exposed, 2. Identify needs (i.e. medical and basic) of those exposed during the releases to aid in planning interventions in the community, 3. Assess the impact of the incidents on health services use and share lessons learned for use in planning for chemical incidents. For an ACE investigation to occur, the following criteria must be met: 1) ACE investigations are undertaken at the request of, and in collaboration with, the state, regional, local, or tribal health department where the release occurred. 2) ACE investigations are carried out in the event of an acute chemical release of toxic substances. 3) ACE investigations are non-research public health responses designed to prevent or control disease or injury and improve public health 4) ACE investigations are restricted to domestic incidents. 5) ACE investigations are completed within 180 days after OMB approval. Revisions include deletion of insurance related questions and change of form title.

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Authorizing Statute(s): US Code: 42 USC 9604 Name of Law: Comprehensive Environmental Response, Compensation and Liability Act of 1980
   US Code: 42 USC 9626 Name of Law: Superfund Amendments and Reauthorization Act of 1986
   US Code: 42 USC 241 Name of Law: Public Health 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:
	82 FR 41263	08/30/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 814	01/08/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 0

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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	3,870	3,870	0	0	0	0
Annual Time Burden (Hours)	1,773	1,773	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $41,196

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.     No

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: 01/09/2018

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