[NCEZID] Enhanced surveillance of respiratory illness among people experiencing homelessness in Anchorage, Alaska

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
CRF Symptom Screener	Form and Instruction	Modified	Repair queued
Non-substantive change_Respiratory Surveillance Alaska_Revised.10.18.23.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2023-10-27	Repair queued
Project Protocol Respiratory surveillance Alaska. 5.25.23.Amended10.10.2023 - Clean.docx	Supplementary Document	Uploaded 2023-10-27	Repair queued
Attachment 7_20220721_REDCap_PIA_Signed.pdf	Supplementary Document	Uploaded 2022-11-21	Repair queued
Attachment 6_Consent Respiratory surveillance Alaska 25July2022.docx	Supplementary Document	Uploaded 2022-11-21	Available
Attachment 5_Protocol Respiratory surveillance Alaska 25July2022_edited_final.docx	Supplementary Document	Uploaded 2023-05-01	Repair queued
Attachment 4 080322SS-NR-signed.pdf	Supplementary Document	Uploaded 2022-11-21	Repair queued
Attachment 2_60dayPublished FRN 2022-11771.pdf	Supplementary Document	Uploaded 2022-11-21	Repair queued
Attachment 1_Section 301 of the Public Health Service Act (42 USC 241).pdf	Supplementary Document	Uploaded 2022-11-21	Repair queued
Supporting Statement B_edited_final.docx	Supporting Statement B	Uploaded 2023-05-01	Repair queued
SSA_OIRA 4.28.23 - edited_final.docx	Supporting Statement A	Uploaded 2023-05-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
257029	CRF Symptom Screener	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1399	ICR Reference No: 202310-0920-012
Status: Received in OIRA	Previous ICR Reference No: 202211-0920-009
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1399-24AM
Title: [NCEZID] Enhanced surveillance of respiratory illness among people experiencing homelessness in Anchorage, Alaska
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: 11/01/2023

table that charts list comparision

	Requested	Previously Approved
Expiration Date	05/31/2024	05/31/2024
Responses	1,000	1,000
Time Burden (Hours)	500	500
Cost Burden (Dollars)	0	0

---

Abstract: People experiencing homelessness are at risk for respiratory infectious diseases. This project involves enhanced surveillance for respiratory pathogens in congregate and non-congregate homeless shelters to provide evidence to improve public health for people who are experiencing homelessness in Anchorage, Alaska. The project team will collect a nasopharyngeal swab (NP) from people experiencing respiratory symptoms who are accessing shelters. The project team will complete demographic information, a short symptom questionnaire with the participant, and test the NP for respiratory pathogens among people experiencing homelessness. This Non-Substantive Change Request is submitted to include sequencing of the collected positive respiratory specimens (which will be performed by CDC), and to modify currently approved versions of several questions. There is no change to the burden.

---

Authorizing Statute(s): US Code: 42 USC 241 Name of Law: PHSA
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 33490	06/02/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 70831	11/21/2022
Did the Agency receive public comments on this ICR? No

---

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

table that charts list of burden

IC Title	Form No.	Form Name
CRF Symptom Screener	0920-1399, n/a	CRF Symptom Screener ,   CRF Symptom Screener - Enrollment form, symptom screening, and vaccination status 27OCT2023

---

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	1,000	1,000	0	0	0	0
Annual Time Burden (Hours)	500	500	0	0	0	0
Annual Cost Burden (Dollars)	0	0	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:

---

Annual Cost to Federal Government: $128,768

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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.     No

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

---

Common Form ICR:  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:

(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: 11/01/2023

---