COVID Vaccine Registration Supporting Statement

COVID Vaccine Registration Supporting Statement.docx

KSC COVID-19 Vaccine Scheduling Application

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KSC COVID-19 Vaccine Scheduling application

SUPPORTING STATEMENT

OMB Control number 2700-XXXX


INFORMATION COLLECTION TYPE: New


A. JUSTIFICATION


1. NECESSITY FOR INFORMATION COLLECTION

Kennedy Space Center (KSC) has been tasked by National Aeronautics and Space Administration (NASA) to prepare to provide COVID-19 vaccines to a prioritized set of employees. These vaccines could be provided to KSC by either the State of Florida Department of Health (via the Florida State Health Online Tracking System (SHOTS) program) or directly by the Federal Government.


Employee data, including Personally Identifiable Information (PII) such as Name, Date of Birth (DOB), Address, Sex, Race, and other medical data related to the vaccination, is required by the State of Florida to be uploaded to the Florida SHOTS website within 24 hours of vaccination. This data is also required by NASA to be entered into the Agency’s CORITY electronic health records system, and subsequently be provide to the Centers for Disease Control and Prevention (CDC).


Eventbrite will be used to gather a subset of this data electronically directly from the employee during registration in lieu of manual entry based on a completed paper form.

2. USES OF INFORMATION

The information will be initially collected via an electronic process using Eventbrite. Only those employees identified as meeting the NASA Tier 1 vaccination priority criteria will be requested to enter data and schedule their vaccination appointment.


The data will be used to inform the State of Florida, NASA, and CDC on when and who was vaccinated for COVID-19 at the Kennedy Space Center.


This data will become part of the employee medical record and retained in accordance with NASA Records Retention Schedule NRRS 1441.1, AFS 01, Item 127.0.A.01.B Employee Health Records. 30 DAYS AFTER SEPARATION TRANSFER TO NATIONAL PERSONNEL RECORDS CENTER (NPRC), ST. LOUIS, MO. NPRC WILL DESTROY 75 YEARS AFTER BIRTH DATE, 60 YEARS AFTER DATE OF THE EARLIEST DOCUMENT IN THE FOLDER IF THE DATE OF BIRTH CANNOT BE ASCERTAINED, OR 30 YEARS AFTER LATEST SEPARATION, WHICHEVER IS LATER. [GRS 2.7-060]


3. CONSIDERATIONS OF USING IMPROVED TECHNOLOGY

This data can be collected manually using Florida Department of Health COVID-19 vaccination forms available on the Florida SHOTS website.


The use of Eventbrite will allow respondents to use an electronic process to submit information and facilitate transfer of the data to other systems identified above.

4. Efforts to Identify Duplication

Employee demographic data contained in NASA IdMax/NASA Access Management System or KSC Health Unit Management System (HUMS) (e.g., home address and telephone number) may not be current. Up to date employee data needs to be collected for input to Florida Department of Health, NASA and CDC.

5. Efforts to Minimize Burden on Small Business

There is no collection of information from any small business or other small entities. Hence, there is no impact on small business or other small entities.

6. Consequences of Less Frequent Data Collection

If the information is not collected, NASA cannot update the Florida Department of Health within the required 24 hours after vaccination, nor accurately update CORITY or CDC.


This PII and vaccine information is a legal requirement of the CDC COVID-19 Vaccination Program Provider Agreement.

7. Special Circumstances

There are no special circumstances as identified above, associated with this information collection.

8. Federal Register Announcement and Consultation Outside the Agency

60-day FRN: As this is an emergency clearance, a 60-day FRN was not published.

30-day FRN: Federal Register Volume 86, Number 102, on 5/28/2021.

9. Payment or Gifts to Respondents

Respondents will not receive payment or gifts.

10. Assurance of Confidentiality

The information collection instruments were reviewed by the KSC Coronavirus Executive Integration Team, including representation from the KSC Procurement Office, Human Resources Office, and the Office of the Chief Counsel. This collection is covered under System of Record NASA 10HIMS and a privacy statement is included on applicable forms.

11. Justification for Sensitive Questions

Employee data, including Personally Identifiable Information (PII) such as Name, DOB, Address, Sex, Race, and other medical data related to the vaccination, is required by the State of Florida to be uploaded to the Florida SHOTS website within 24 hours of vaccination. This data is also required by NASA to be entered into the Agency’s CORITY electronic health records system, KSCs Health Record System (HUMS), and subsequently be provided to the CDC.

12. Estimate of Respondent Burden


RESPONDENT CATEGORY

NUMBER OF RESPONDENTS

ESTIMATED COMPLETION TIME

ANNUAL BURDEN

Contractor

2874

5 minutes

238.625 hours

Civil Servant

462

5 minutes

38.346 hours

TOTAL

3336


276.971 hours


13. Cost Burden to Respondents

The primary burden to the applicants is the time needed to complete the application as there are no other costs associated. We estimate it will take each respondent five minutes to complete the form.


For Contractors, this cost is based on the average annual salary of a full-time Aerospace contractor paid $78,1001 per year, or $37.55 per hour. For five minutes of time, at that rate, the cost burden is $3.12 per Contractor. The total annual cost burden for Contractor registrants will be $3.12 x 2,874 = $8,966.88


For Civil Servants, this cost is based on the average annual salary of a full-time Civil Servant paid $114,6412 per year, or $54.93 per hour. For five minutes of time, at that rate, the cost burden is $4.56 per Civil Servant. The total annual cost burden for Civil Servant registrants will be $4.56 x 462 = $2,106.72.


Therefore; the total estimated annual cost burden for all registrants is approximately $11,073.60.

14. Cost Burden to Federal Government

The estimated annualized cost burden to the Federal government is approximately $1,126.50, for administration activities associated with analyzing the data. The employee demographic data that originated in Eventbrite, must be validated, input into separate spreadsheets, and uploaded to the KSC HUMS database, the NASA CORITY database, and the State of Florida SHOTS database. This amount is based on two personnel with an average hourly wage of $37.55 x 3 hours daily, processing data for 5 days.

15. Reason for Change in Burden

There have been no program changes. This is a new information collection.

16. Schedule for Information Collection and Publication

This data is required by NASA to be entered into the Agency’s CORITY electronic health records system, KSC’s Health Record System (HUMS), and will subsequently be provided to the CDC.


Information gathered is not collected for external publication and will not be tabulated.

17. Display of OMB Expiration Date

The OMB Expiration Date will be displayed on every data collection instrument.

18. Exception to the Certificate Statement
NASA does not take exception to the certification statements.


Name, title, and organization of NASA Information Collection Sponsor certifying statements above:


NAME: David A. Tipton, M.D.


TITLE: KSC Chief Medical Officer


ORG: Spaceport Integration & Services Directorate


1 Based on 2019 Florida Occupational Employment and Wage Rates from the U.S. Bureau of Labor Statistics: https://www.bls.gov/oes/current/oes_fl.htm

2 Based on data from the NASA Organizational Profile System

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleSupporting Statement for Paperwork Reduction Act Submission
AuthorODIN/KSC
File Modified0000-00-00
File Created2021-06-02

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