Emergency Justification Letter to OMB

UNITED STATES DEPARTMENT OF COMMERCE
Office of the Acting Chief Financial Officer and
Assistant Secretary for Administration
Washington, D.C. 20230

March 23, 2023
Richard Revesz
Office of Information and Regulatory Affairs
Office of Management and Budget
Dear Administrator Revesz,
The Department of Commerce requests Office of Management and Budget (OMB) emergency
processing, pursuant to 5 C.F.R. 1320.13, of the Eligibility Questionnaire for HAVANA Act
Payments.
On October 8, 2021, the President signed the "Helping American Victims Afflicted by
Neurological Attacks" (HAVANA) Act of 2021 (Public Law 117-46). In this statute, Congress
authorized federal government agencies to make payments to affected current employees, former
employees, and their dependents for qualifying injuries to the brain. The Department must
collect certain information from individuals seeking such a payment to ensure that they have an
injury that would make them eligible for payment and to determine the amount of payment. The
use of normal Paperwork Reduction Act (PRA) clearance procedures would unduly delay the
Department’s ability to obtain this information in a timely manner and ultimately make payments
expeditiously to affected persons who have established that they have suffered from a qualifying
injury. In light of the foregoing, the Department of Commerce requests OMB's formal
emergency review and approval of this information collection by March 31. The Department
submitted a draft interim final rule (IFR) to OMB for formal review, which will fulfill the
mandate of the HAVANA Act, define "qualifying injury to the brain" and provide procedures for
affected individuals to submit claims.
Pursuant to the procedures outlined in the IFR, a board-certified physician will review a potential
claimant's file and complete the Eligibility Questionnaire for HAVANA Act Payments (CD350), which will provide the required medical substantiation for any claims filed pursuant to the
Department's implementation of the HAVANA Act. This form requires approval under the PRA.
Justification:
1. This collection is necessary without allowing for the time period normally associated
with a routine submission for review under the provisions of the PRA. It is crucial that
individuals experiencing qualifying injuries to the brain be examined and, if appropriate,
submit their claims under the Act and receive payment for qualifying injuries as soon as
possible. In addition, Congress mandated a deadline for these procedures be in place,
which, although it has passed, indicated the urgency for providing payments; therefore, it
is critical that the form be ready for the public to use as soon as the IFR is published.

2. This collection is essential to the mission of the Department of Commerce, which is
committed to protecting its employees and their dependents from injury; and, to the
extent possible, making a payment to them pursuant to the HAVANA Act for qualifying
injuries to the brain incurred in connection with war, terrorist activity, or other incidents
designated by the Secretary of State, and which were not the result of the willful
misconduct of the covered individual. The purpose of this collection is to provide
required documentation from a board-certified physician regarding the claimant's
injuries.

Sincerely,

JEREMY
PELTER

Digitally signed by
JEREMY PELTER
Date: 2023.03.23
19:09:25 -04'00'

Jeremy Pelter
Anomalous Health Incidents Coordinator
Acting Chief Financial Officer &
Assistant Secretary for Administration