Information Collection for Tuberculosis Data from Panel Physicians

Forms and Documents

Document Name	Status
TB Indicator Reporting Form Form	Modified
Attachment E - PIA.pdf Supplementary Document	2018-08-06
Attachment D TB Indicators IRB Form.pdf Supplementary Document	2018-08-06
Attachment B - 60-day FRN.pdf Supplementary Document	2018-08-06
Attachment A3 - 42 CFR Part 34.pdf Supplementary Document	2018-08-06
Attachment A2 - Public Health Service Act 42 U.S.C. § 252.pdf Supplementary Document	2018-08-06
Attachment A1 - Immigration and Nationality Act 8 U.S.C. § 1182.pdf Supplementary Document	2018-08-06
SupSta B TB Indicators Revision 2019_OPRA_MRH2.docx Supporting Statement B	2018-08-06
SupSta A TB Indicators 2019 Revision_OPRA_MRH2.docx Supporting Statement A	2018-08-31

IC Document Collections

IC ID	Document Title	Status
218237	TB Indicator Reporting Form Form	Modified

ICR Details

OMB Control No: 0920-1102	ICR Reference No: 201808-0920-002
Status: Active	Previous ICR Reference No: 201804-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1102
Title: Information Collection for Tuberculosis Data from Panel Physicians
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: 09/28/2018
	Date Received in OIRA: 08/29/2018
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.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	36 Months From Approved	02/28/2019
Responses	336	0	353
Time Burden (Hours)	1,008	0	2,648
Cost Burden (Dollars)	104,459	0	0

---

Abstract: More than 760 panel physicians perform overseas pre-departure medical examinations at 336 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. The goal of the data collection is to determine TB rates in immigrant and refugee populations migrating to the US. Data are used to improve the quality of TB screening overseas and assess the impact of CDC's TB Technical Instructions.

---

Authorizing Statute(s): US Code: 8 USC 1182 Name of Law: Immigration and Nationality Act
   US Code: 42 USC 241 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 24476	05/29/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 43875	08/28/2018
Did the Agency receive public comments on this ICR? Yes

---

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

IC Title	Form No.	Form Name
TB Indicator Reporting Form	none	TB Indicator Data Reporting Form

---

ICR Summary 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	336	353	0	-17	0	0
Annual Time Burden (Hours)	1,008	2,648	0	-1,640	0	0
Annual Cost Burden (Dollars)	104,459	0	0	104,459	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: The estimated burden has been reduced due to most panel physicians having established electronic tracking systems, and removal of four variables, and a reduction in the number of respondents.

---

Annual Cost to Federal Government: $27,489

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

---

Common Form ICR:  No

---

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: 08/29/2018

---