Contact Investigation Outcome Reporting Forms

ICR 201808-0920-021

OMB: 0920-0900

Federal Form Document

ICR Details
0920-0900 201808-0920-021
Active 201802-0920-005
HHS/CDC 0920-18AXV
Contact Investigation Outcome Reporting Forms
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 08/29/2018
Retrieve Notice of Action (NOA) 08/29/2018
  Inventory as of this Action Requested Previously Approved
05/31/2021 05/31/2021 05/31/2021
1,036 0 1,036
109 0 109
4,055 0 4,055

The purpose of this information collection is to obtain sufficient information on the results of contact investigations carried out by state and local public health professionals or maritime medical crews to assess the impact of a confirmed communicable disease of public health concern in a traveler. Information is used to assess the impact in terms of spread and health outcomes and to determine if further public health intervention is appropriate. Communicable diseases of interest include clinically active tuberculosis (TB), varicella, influenza-like illness, measles, and rubella. The purpose of this non-substantive Change Request (submitted August 2018) is to clarify the wording of selected questions on the ILI Outbreak Enhanced Data Collection Form.

US Code: 42 USC 70-71 Name of Law: Quarantine, Inspection, Licensing
   US Code: 42 USC 264 Name of Law: The Public Health and Welfare
  
None

Not associated with rulemaking

  82 FR 47743 10/13/2017
83 FR 17418 04/19/2018
No

  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 1,036 1,036 0 0 0 0
Annual Time Burden (Hours) 109 109 0 0 0 0
Annual Cost Burden (Dollars) 4,055 4,055 0 0 0 0
No
No

$221,716
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
Uncollected
Renita Macaluso 770 488-6458 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/29/2018


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