SUPPORTING STATEMENT - PART A
Personnel Accountability and Assessment Notification for COVID-19 Exposure – 0720-XXXX
1. Need for the Information Collection
The principal purpose of the DD form 3112, “Personnel Accountability and Assessment Notification for a Public Health Emergency,” is to collect information used to protect the health and safety of individuals working in, residing on, or assigned to DoD installations, facilities, field operations, and commands, and to protect the DoD mission. When authorized by DoD, this form may be used to provide information about individuals who are infected or otherwise impacted by the COVID-19 pandemic. The collection of this information is necessary to support the DoD in protecting the health and safety of DoD-affiliated individuals and maintain the DoD mission.
The information collected via the DD-3112 will be used to make informed decisions about the status of the DoD facility and office space that subject individuals exposed to COVID-19 have entered. This information may be used to make Health Protection Condition (HPCON) level decisions. It may also be used to notify other individuals who may have been in contact with the subject individual(s).
The collection of this information is authorized by the following authorities:
10 U.S.C. 113, Secretary of Defense
10 U.S.C. 136, Under Secretary of Defense for Personnel and Readiness
10 U.S.C. 7013, Secretary of the Army
10 U.S.C. 8013, Secretary of the Navy
10 U.S.C. 9013, Secretary of the Air Force
10 U.S.C. 2672, Protection of Buildings, Grounds, Property, and Persons
DoD Instruction 3001.02, Personnel Accountability in Conjunction with Natural or Manmade Disasters
DoD Instruction 6200.03, Public Health Emergency Management (PHEM) Within the DoD
DoD Instruction 6055.17, and DoD Emergency Management (EM) Program
2. Use of the Information
The public respondents of the DD-3112 include government contractors, Contracting Officer Representatives, DoD employee dependents, as well as any other residents or visitors to DoD facilities. Respondents (or their sponsoring DoD employee) complete the form in the event that the respondent has potentially been exposed to COVID-19.
The DD-3112 will be widely disseminated to DoD employees for use at the component and proponent level. The form will be accessible at https://www.esd.whs.mil/Directives/forms/. Once completed, respondents submit the form to the appropriate office within their DoD component via email (respondents also have the option to submit their responses by telephone, however this submission method is not expected to be widely utilized.. The information collected will allow for informed decisions to be made by installation commanders, public health emergency officers, senior DoD officials, military housing/ facilities managers and supervisors about the status of the DoD facility and office space that the exposed respondent has entered.
3. Use of Information Technology
99% of responses will be collected electronically.
4. Non-duplication
The information obtained through this collection is unique and is not already available for use or adaptation from another cleared source.
5. Burden on Small Businesses
This information collection does not impose a significant economic impact on a substantial number of small businesses or entities.
6. Less Frequent Collection
This information is collected upon the occasion a DoD-affiliated individual or recent facility visitor is potentially exposed COVID-19. Should this information be collected less frequently, the health and safety of individuals working in, residing on, or assigned to DoD installations, facilities, field operations, and commands may be put at risk, and also result in a public health issue.
7. Paperwork Reduction Act Guidelines
This collection of information does not require collection to be conducted in a manner inconsistent with the guidelines delineated in 5 CFR 1320.5(d)(2).
8. Consultation and Public Comments
This collection is being submitted to OMB for an emergency approval as it is imperative the Department collect this information immediately. Solicitation for public comments on the collection through the Federal Register will be sought at a later date.
9. Gifts or Payment
No payments or gifts are being offered to respondents as an incentive to participate in the collection.
10. Confidentiality
A Privacy Act Statement (PAS) is required for this collection. The PAS is provided on page 3 of the form.
A System of Record Notice (SORN) is required for this collection. The SORN, DPR 39 DoD, “DoD Personnel Accountability and Assessment System” is available at https://dpcld.defense.gov/Portals/49/Documents/Privacy/SORNs/OSDJS/DPR-39-DoD.pdf.
The Military Departments, Joint Chiefs of Staff and OSD all retain in accordance with their individual Records and Information Management retention schedules.
11. Sensitive Questions
No questions considered sensitive are being asked in this collection.
12. Respondent Burden and its Labor Costs
Part A: ESTIMATION OF RESPONDENT BURDEN
DD-3112
Number of Respondents: 100,000
Number of Responses Per Respondent: 1
Number of Total Annual Responses: 100,000
Response Time: 5 minutes
Respondent Burden Hours: 8,333.3 hours
Total Submission Burden
Total Number of Respondents: 100,000
Total Number of Annual Responses: 100,000
Total Respondent Burden Hours: 8,333.3 hours
The generous public burden estimates are based on data provided by the Emergency Operations Center of 540 responses in a month. However, based on the scope of the pandemic or a similar situation, the burden estimate will vary. The burden estimate will be revised as needed upon future submissions for OMB extensions of this collection.
Part B: LABOR COST OF RESPONDENT BURDEN
DD-3112
Number of Total Annual Responses:100,000
Response Time: 5 minutes
Respondent Hourly Wage: $7.25
Labor Burden per Response: $0.60
Total Labor Burden: $60,416.67
Overall Labor Burden
Total Number of Annual Responses: 100,000
Total Labor Burden: $60,416.67
The Respondent hourly wage was determined by using the Department of Labor Wage Website ([http://www.dol.gov/dol/topic/wages/index.htm]).
13. Respondent Costs Other Than Burden Hour Costs
There are no annualized costs to respondents other than the labor burden costs addressed in Section 12 of this document to complete this collection.
14. Cost to the Federal Government
Part A: LABOR COST TO THE FEDERAL GOVERNMENT
DD-3112
Number of Total Annual Responses: 100,000
Processing Time per Response: 15 minutes
Hourly Wage of Worker(s) Processing Responses : $40.82*
Cost to Process Each Response: $10.21
Total Cost to Process Responses: $1,020,500.00
Overall Labor Burden to the Federal Government
Total Number of Annual Responses: 100,000
Total Labor Burden: $1,020,500.00
*https://www.opm.gov/policy-data-oversight/data-analysis-documentation/federal-employment-reports/reports-publications/profile-of-federal-civilian-non-postal-employees/
Part B: OPERATIONAL AND MAINTENANCE COSTS
Cost Categories
Equipment: $0.00
Printing: $0.00
Postage: $0.00
Software Purchases: $0.00
Licensing Costs: $0.00
Other: $0.00
Total Operational and Maintenance Cost: $0.00
Part C: TOTAL COST TO THE FEDERAL GOVERNMENT
Total Labor Cost to the Federal Government: $1,020,500.00
Total Operational and Maintenance Costs: $0.00
Total Cost to the Federal Government: $1,020,500.00
15. Reasons for Change in Burden
This is a new collection with a new associated burden.
16. Publication of Results
The results of this information collection will not be published.
17. Non-Display of OMB Expiration Date
We are not seeking approval to omit the display of the expiration date of the OMB approval on the collection instrument.
18. Exceptions to “Certification for Paperwork Reduction Submissions”
We are not requesting any exemptions to the provisions stated in 5 CFR 1320.9.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Kaitlin Chiarelli |
| File Modified | 0000-00-00 |
| File Created | 2021-01-13 |