[NCEZID] US Tuberculosis Follow-up Worksheet for Newly Admitted Persons with Overseas Tuberculosis Classifications

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-1238 EDN TB Follow-up Worksheet	Form	Modified	Available
Non-Substantive Change Memo for TB Follow-up Worksheet.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-10-12	Available
Att 3a_Detailed Chart of Revisions on the 2021 EDN TB Follow-Up Worksheet.docx	Supplementary Document	Uploaded 2022-05-17	Available
Att 5_CDC Non-Research Determination.pdf	Supplementary Document	Uploaded 2022-05-17	Available
Att 4-EDN_PIA_2014-12-23.pdf	Supplementary Document	Uploaded 2022-05-17	Repair queued
Att 2 FRN Published 031921.pdf	Supplementary Document	Uploaded 2022-05-17	Repair queued
Att 1C- 42 CFR Part 34.pdf	Supplementary Document	Uploaded 2022-05-17	Repair queued
Att 1B-Public Health Service Act 42 U.S.C. 252.pdf	Supplementary Document	Uploaded 2022-05-17	Available
Att 1A-Immigration and Nationality Act 8 U.S.C. § 1182.pdf	Supplementary Document	Uploaded 2022-05-17	Available
SSB-TB Follow up Worksheet_revised.docx	Supporting Statement B	Uploaded 2022-05-17	Repair queued
SSA-TB Follow up Worksheet_revised.docx	Supporting Statement A	Uploaded 2022-05-17	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
231229	EDN TB Follow-up Worksheet	Form	Modified

ICR Details

OMB Control No: 0920-1238	ICR Reference No: 202310-0920-005
Status: Received in OIRA	Previous ICR Reference No: 202205-0920-008
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1238-24AE
Title: [NCEZID] US Tuberculosis Follow-up Worksheet for Newly Admitted Persons with Overseas Tuberculosis Classifications
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/12/2023

table that charts list comparision

	Requested	Previously Approved
Expiration Date	03/31/2026	03/31/2026
Responses	9,048	9,048
Time Burden (Hours)	4,524	4,524
Cost Burden (Dollars)	169,107	169,107

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Abstract: The purpose of this data collection is to follow-up with and assess newly-arrived persons in the United States who received overseas tuberculosis classifications in order to assist in the national effort to prevent new transmission of TB. The information collected by The EDN Tuberculosis Follow-Up Worksheet for Newly-Arrived Persons with Overseas Tuberculosis Classifications, also commonly known as the TB Follow-Up Worksheet, will provide outcomes for improving national TB prevention programs. The Division of Global Migration and Quarantine (DGMQ) staff, along with other federal partners will use this information to assess overseas panel physician performance, overseas prevention activities, and TB control program performance in the United States. Specifically, to improve overseas panel physician performance and TB prevention activities, CDC needs information on the U.S. domestic chest x-rays, chest x-ray comparison sputum smear and culture, and diagnosis results along with U.S. domestic reviews of overseas treatment. To monitor and assess U.S. domestic TB program performance, CDC needs to collect data on all elements of TB U.S. domestic follow-up evaluations, including chest x-rays, diagnosis, and U.S. treatment outcomes. This Non-Substantive Change Request is submitted to make minor modifications that do not alter the overall scope of the currently approved collection. Additionally, there is no change in burden associated to respondents.

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Authorizing Statute(s): US Code: 42 USC 252 Name of Law: PHSA
   US Code: 8 USC 1182 Name of Law: Immigration and Nationality Act
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 14921	03/19/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 40052	06/26/2021
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
EDN TB Follow-up Worksheet	0920-1238, 0920-1238	The EDN Tuberculosis Follow-Up Worksheet for Newly-Arrived Persons with Overseas Tuberculosis Classifications ,   EDN Tuberculosis Follow-Up Worksheet for Newly-Arrived Persons with Overseas Tuberculosis Classifications - 12 OCT2023

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	9,048	9,048	0	0	0	0
Annual Time Burden (Hours)	4,524	4,524	0	0	0	0
Annual Cost Burden (Dollars)	169,107	169,107	0	0	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: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $137,417

Does this IC contain surveys, censuses, or employ statistical methods? No

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.     Yes

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.     Yes

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? No

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Common Form ICR:  No

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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: 10/12/2023

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