Information Collection for Tuberculosis Data from Panel Physicians

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
TB Indicator Spreadsheet	Form and Instruction	Modified	Available
0920-1102 Non Sub Change 04112018.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-04-12	Available
Attachment D TB Indicators IRB Form.pdf	Supplementary Document	Uploaded 2015-09-17	Available
Attachment 2A - 8 USC 1182.pdf	Supplementary Document	Uploaded 2015-09-17	Available
Attachment 1A 42 CFR Part 34 Medical Examination of Aliens.pdf	Supplementary Document	Uploaded 2015-09-17	Available
60 day published.pdf	Supplementary Document	Uploaded 2015-09-17	Available
SupSta B TB Indicators 22FEB2016_OMB_DGMQ.docx	Supporting Statement B	Uploaded 2016-02-22	Available
SupSta A TB Indicators 22FEB2016_OMB_DGMQ.docx	Supporting Statement A	Uploaded 2016-02-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218237	TB Indicator Spreadsheet	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1102	ICR Reference No: 201804-0920-009
Status: Historical Active	Previous ICR Reference No: 201509-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1102-18AAW
Title: Information Collection for Tuberculosis Data from Panel Physicians
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/19/2018
	Date Received in OIRA: 04/12/2018
Terms of Clearance: Previous terms continue: Because TB Indicator data is not obtained from a national surveillance system, the database is representative only of TB incidence rates among U.S. migrant populations and not intended to develop country-wide prevalence estimates. This collection is approved with the understanding that when disseminating any data gathered from this collection, CDC will compare the characteristics of the population covered in the database to that of the population to whom they intend to generalize, and clearly caveat the likelihood of over or under-estimates of TB burden.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	02/28/2019	02/28/2019
Responses	353	0	353
Time Burden (Hours)	2,648	0	2,648
Cost Burden (Dollars)	0	0	0

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Abstract: More than 760 panel physicians perform overseas pre-departure medical examinations at 353 panel sites. Screening for tuberculosis is an important part of the medical exam in order to diagnose active TB disease prior to arrival in the U.S. CDC needs to collect TB indicator data to have a more accurate system to collect information on immigrants. CDC requests minor changes to some data fields related to moving the collection time frame from January to March.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act
   US Code: 8 USC 1182 Name of Law: Immigration and Nationality 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:
	80 FR 44355	07/27/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 59154	10/01/2015
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
TB Indicator Spreadsheet	none	TB Indicator Data Reporting 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	353	353	0	0	0	0
Annual Time Burden (Hours)	2,648	2,648	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: $25,050

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: 04/12/2018

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