Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form DD-2990 Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas	Form and Instruction	Modified	Available
SS-A_0720-0056_OIMReview.docx	Supporting Statement A	Uploaded 2018-05-30	Available
SSN Justification_Ebola Risk Exposure_DD2990 2991 PCLO_5.22.2018_Final.pdf	Supplementary Document	Uploaded 2018-05-30	Available
DMSS_DD2930_PIA_DRAFT_5.24.2018.pdf	Supplementary Document	Uploaded 2018-05-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
213534	Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas	Form and Instruction	Modified

ICR Details

OMB Control No: 0720-0056	ICR Reference No: 201805-0720-002
Status: Active	Previous ICR Reference No: 201502-0720-001
Agency/Subagency: DOD/DODOASHA	Agency Tracking No:
Title: Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas
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: 08/24/2018
	Date Received in OIRA: 05/30/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved	08/31/2018
Responses	2,400	0	2,400
Time Burden (Hours)	480	0	480
Cost Burden (Dollars)	11,928	0	14,438

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Abstract: The DD-2990 and DD-2991 forms are used to ensure DoD personnel deployed in support of Operation United Assistance are promptly evaluated for exposure(s) to the Ebola virus within 12 hours prior to departing an Ebola outbreak country or region (West Africa). Ebola is a Quarantinable Communicable Disease as named in Executive Order 13295 and may necessitate quarantine and isolation to protect the individual and the health of the public.

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Authorizing Statute(s): EO: EO 13295 Name/Subject of EO: Ordering the Selected Reserve and Certain Individual Ready Reserve Members of the Armed Forces to Ac
   US Code: 10 USC 136 Name of Law: Under Secretary of Defense for Personnel and Readiness
   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:
	83 FR 11188	03/14/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 24750	05/30/2018
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
Screening and Monitoring of DoD Personnel Deployed to Ebola Outbreak Areas	DD-2990, DD-2991	Ebola Virus Disease Exposure Risk Evaluation (In Theater Use Only) ,   Ebola Virus Disease Redeployment Risk Assessment and Medical Clearance

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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	2,400	2,400	0	0	0	0
Annual Time Burden (Hours)	480	480	0	0	0	0
Annual Cost Burden (Dollars)	11,928	14,438	0	-2,510	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: $97,496

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

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.     Yes

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: 05/30/2018

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