60 Day FRN

Att2 60D FRN ATSDR-2024-0002.pdf

[ATSDR] Assessment of Chemical Exposures (ACE) Investigations

60 Day FRN

OMB: 0923-0051

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Federal Register / Vol. 89, No. 122 / Tuesday, June 25, 2024 / Notices
bank holding company and all of the
banks and nonbanking companies
owned by the bank holding company,
including the companies listed below.
The public portions of the
applications listed below, as well as
other related filings required by the
Board, if any, are available for
immediate inspection at the Federal
Reserve Bank(s) indicated below and at
the offices of the Board of Governors.
This information may also be obtained
on an expedited basis, upon request, by
contacting the appropriate Federal
Reserve Bank and from the Board’s
Freedom of Information Office at
https://www.federalreserve.gov/foia/
request.htm. Interested persons may
express their views in writing on the
standards enumerated in the BHC Act
(12 U.S.C. 1842(c)).
Comments received are subject to
public disclosure. In general, comments
received will be made available without
change and will not be modified to
remove personal or business
information including confidential,
contact, or other identifying
information. Comments should not
include any information such as
confidential information that would not
be appropriate for public disclosure.
Comments regarding each of these
applications must be received at the
Reserve Bank indicated or the offices of
the Board of Governors, Ann E.
Misback, Secretary of the Board, 20th
Street and Constitution Avenue NW,
Washington, DC 20551–0001, not later
than July 25, 2024.
A. Federal Reserve Bank of Richmond
(Brent B. Hassell, Assistant Vice
President) P.O. Box 27622, Richmond,
Virginia 23261. Comments can also be
sent electronically to
[email protected]:
1. United Bankshares, Inc.,
Charleston, West Virginia; to acquire
Piedmont Bancorp, Inc., and thereby
indirectly acquire The Piedmont Bank,
both of Peachtree Corners, Georgia.

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Board of Governors of the Federal Reserve
System.
Erin Cayce,
Assistant Secretary of the Board.
[FR Doc. 2024–13913 Filed 6–24–24; 8:45 am]

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Toxic Substances and
Disease Registry
[60Day–24–0051; Docket No. ATSDR–2024–
0002]

Proposed Data Collection Submitted
for Public Comment and
Recommendations
Agency for Toxic Substances
and Disease Registry (ATSDR),
Department of Health and Human
Services (HHS).
ACTION: Notice with comment period.
AGENCY:

The Agency for Toxic
Substances and Disease Registry
(ATSDR), as part of its continuing effort
to reduce public burden and maximize
the utility of government information,
invites the general public and other
Federal agencies the opportunity to
comment on a continuing information
collection, as required by the Paperwork
Reduction Act of 1995. This notice
invites comment on a proposed
information collection project titled
Assessment of Chemical Exposures
(ACE) Investigations. The purpose of
ACE Investigations is to focus on
performing rapid epidemiological
assessments to assist State, regional,
local, or Tribal health departments (the
requesting agencies) to respond to or
prepare for acute environmental
incidents].
DATES: ATSDR must receive written
comments on or before August 26, 2024.
ADDRESSES: You may submit comments,
identified by Docket No. ATSDR–2024–
0002 by either of the following methods:
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. ATSDR will post,
without change, all relevant comments
to www.regulations.gov.
SUMMARY:

Please note: Submit all comments through
the Federal eRulemaking portal
(www.regulations.gov) or by U.S. mail to the
address listed above.

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To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and

FOR FURTHER INFORMATION CONTACT:

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Prevention, 1600 Clifton Road, NE, MS
H21–8, Atlanta, Georgia 30329;
Telephone: 404–639–7570; Email: omb@
cdc.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), Federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires Federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.
Proposed Project
Assessment of Chemical Exposures
(ACE) Investigations (OMB Control
Number 0923–0051, Exp. 10/31/2024)—
Revision—Agency for Toxic Substances
and Disease Registry (ATSDR).
Background and Brief Description
The Agency for Toxic Substances and
Disease Registry (ATSDR) is requesting
to revise the Assessment of Chemical
Exposures (ACE) Investigations
information collection project and seeks
a three-year OMB approval to assist
state and local health departments after
toxic substance spills or other acute
environmental incidents. ATSDR has
successfully completed three

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Federal Register / Vol. 89, No. 122 / Tuesday, June 25, 2024 / Notices

investigations to date, and would like to
continue this impactful information
collection. See below for a brief
summary of information collections
approved under this tool:
• During 2015, in U.S. Virgin Islands
there was a methyl bromide exposure at
a condominium resort. Under this ACE
investigation, pest control companies
were made aware that methyl bromide
use is prohibited in homes and other
residential settings. Additionally,
clinicians were made aware of the
toxicologic syndrome caused by
exposure to methyl bromide and the
importance of notifying first responders
immediately when they have
encountered contaminated patients.
• During 2016, the ACE team
conducted a rash investigation in Flint,
Michigan. Persons exposed to Flint
municipal water who had current or
worsening rashes were surveyed and
referred to free dermatologist screening
if desired. Findings revealed that when
the city was using water from the Flint
River, there were large swings in
chorine, pH, and hardness, which could
be one possible explanation for the
eczema-related rashes.
• During 2016, the ACE team also
conducted a follow-up investigation for
people who were exposed to the Flint
municipal water and sought care from
dermatologists. The follow-up
interviews resulted in improvement of
the exam and referral processes that
were still ongoing at the time.
ACE Investigations have focused on
performing rapid epidemiological
assessments to assist state, regional,
local, or tribal health departments
(requesting agencies) to respond to or
prepare for acute environmental
incidents. The main objectives for
performing these rapid assessments are
to:
• Characterize exposure and acute
health effects of the affected community
to inform health officials and the
community;
• Identify needs (i.e., medical, mental
health, and basic) of those exposed
during the incidents to aid in planning
interventions in the community;
• Determine the sequence of events
responsible for the incident so that
actions can be taken to prevent future
incidents;
• Assess the impact of the incidents
on the emergency response and health
services used and share lessons learned
for use in hospital, local, and state
planning for environmental incidents;
and
• Identify cohorts that may be
followed and assessed for persistent
health effects resulting from
environmental releases.

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Because each incident is different, it
is not possible to predict in advance
exactly what type of, and how many
respondents will be consented and
interviewed to effectively evaluate the
incident. Respondents typically include,
but are not limited to, emergency
responders such as police, fire,
hazardous material technicians,
emergency medical services, and
personnel at hospitals where patients
from the incident were treated.
Incidents may occur at businesses or in
the community setting; therefore,
respondents may also include business
owners, managers, workers, customers,
community residents, and those passing
through the affected area.
The multidisciplinary ACE Team
consisting of staff from ATSDR, the
Centers for Disease Control and
Prevention (CDC), and the requesting
agencies will be collecting data. ATSDR
has developed a quickly tailored series
of draft survey forms used in the field
to collect data that will meet the goals
of the investigation. ATSDR collections
will be administered based on time
permitted and urgency. For example, it
is preferable to administer the General
Survey to as many respondents as
possible. However, if there are time
constraints, the shorter Epidemiologic
Contact Assessment Symptom Exposure
(Epi CASE) Survey, may be
administered instead. The individual
surveys collect information about
exposure, acute health effects, health
services use, medical history, needs
resulting from the incident,
communication during the release,
health impact on children, and
demographic data. Hospital personnel
are asked about the surge, response and
communication, decontamination, and
lessons learned. Depending on the
situation, data collected by face-to-face
interviews, telephone interviews,
written surveys, mailed surveys, or online self-administered surveys can be
collected. Medical charts may also be
considered for review. In rare situations,
an investigation might involve
collection of clinical specimens.
ATSDR is proposing to increase the
utility of this Generic ICR in response to
stakeholder requests. We would also
like to broaden who we may assist to
include other federal public health
agencies. ATSDR proposes revisions to
select information collection forms,
which will be deployed online or using
handheld devices whenever possible to
reduce burden, and to adjust the
number of responses and time per
response for several forms. Because of
this addition of online selfadministration we are expecting to be
able to survey more respondents than

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previously done during large disasters.
A brief Eligibility Screener will be
conducted before the General or Epi
CASE survey to make sure they were in
the area at the time of the incident,
before consenting them to be surveyed.
The number of people to be screened
will be increased to 2,500 responses per
year. The shorter Epi CASE survey has
been modified to incorporate the
symptom checker showcard into the
survey so that it can be easily selfadministered online, and questions on
functional disabilities were added as
requested by stakeholders adding two
minutes and 1,000 respondents. The
General survey will also have an online
option. For simplicity, adolescents will
no longer be eligible to take the General
Survey and the Child Survey will
become a module of the General Survey
for adults to answer for their minor
children. At stakeholder direction,
ATSDR has added modules to the
General Survey for responder, pets, and
livestock health, and a community
resilience qualitative question bank. The
General Survey has also added
questions requested by stakeholders on
functional disabilities and maternal and
child health. The two existing long-term
mental health screeners are replaced by
three shorter versions and the race/
ethnicity questions are now consistent
with revised OMB Standards.
Qualitative questions were added to
several sections throughout the survey.
These changes add to the time of the
survey and the online selfadministration option allows for an
increase in respondents (60 minutes,
1000 responses annually). The
Household Survey will be removed
because of little use. The Hospital
Survey for emergency department
nurses and other health professionals on
how they handled the response is
unchanged (40 responses per year; 17
hours). We are modifying the Medical
Chart Abstraction Form with slight
question changes suggested by a
medical toxicologist, and by adding
functional disability questions and
modifying the race/ethnicity questions
to the OMB Standard. This results in no
change to burden (250 responses per
year; 125 hours).
ATSDR anticipates one ACE
investigation per year and is requesting
OMB approval for 4,815 annual
responses and for 1,508 annual burden
hours. Participation in ACE
investigations is voluntary and there are
no anticipated costs to respondents
other than their time.

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Federal Register / Vol. 89, No. 122 / Tuesday, June 25, 2024 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS
Average
Burden
per response
(in hours)

Total burden
(in hours)

Form name

Residents, first responders, business owners,
employees, customers.

Eligibility Screener ........
Epi CASE Survey .........

2,500
1,000

1
1

2/60
17/60

83
283

General survey .............
Hospital Survey ............
Medical Chart Abstraction Form.
.......................................

1,000
40
25

1
1
10

60/60
25/60
30/60

1,000
17
125

4,565

........................

........................

1,508

Hospital staff .........................................................
Staff from state, local, or tribal health agencies ...
Total ...............................................................

Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Public Health Ethics and
Regulations, Office of Science, Centers for
Disease Control and Prevention.
[FR Doc. 2024–13904 Filed 6–24–24; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day-24–24AZ]

Agency Forms Undergoing Paperwork
Reduction Act Review

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Number of
Responses
per
respondent

Number of
respondents

Type of respondents

In accordance with the Paperwork
Reduction Act of 1995, the Centers for
Disease Control and Prevention (CDC)
has submitted the information
collection request titled ‘‘OD2A: LOCAL
Linkage to and Retention in Care
Surveillance’’ to the Office of
Management and Budget (OMB) for
review and approval. CDC previously
published a ‘‘Proposed Data Collection
Submitted for Public Comment and
Recommendations’’ notice on November
14, 2023, to obtain comments from the
public and affected agencies. CDC
received two comments related to the
previous notice. This notice serves to
allow an additional 30 days for public
and affected agency comments.
CDC will accept all comments for this
proposed information collection project.
The Office of Management and Budget
is particularly interested in comments
that:
(a) Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
(b) Evaluate the accuracy of the
agencies estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;

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(c) Enhance the quality, utility, and
clarity of the information to be
collected;
(d) Minimize the burden of the
collection of information on those who
are to respond, including, through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submission of
responses; and
(e) Assess information collection
costs.
To request additional information on
the proposed project or to obtain a copy
of the information collection plan and
instruments, call (404) 639–7570.
Comments and recommendations for the
proposed information collection should
be sent within 30 days of publication of
this notice to www.reginfo.gov/public/
do/PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. Direct written
comments and/or suggestions regarding
the items contained in this notice to the
Attention: CDC Desk Officer, Office of
Management and Budget, 725 17th
Street NW, Washington, DC 20503 or by
fax to (202) 395–5806. Provide written
comments within 30 days of notice
publication.
Proposed Project
OD2A: LOCAL Linkage to and
Retention in Care Surveillance—New—
National Center for Injury Prevention
and Control (NCIPC), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
In the United States, opioid overdose
deaths have increased significantly over
the years, and drug overdose deaths in
the United States increased by 14%
from 2020 to 2021. Of the 106,699 drug
overdose deaths in 2021, over 75%
involved an opioid. Deaths involving
psychostimulants, such as
methamphetamine, also increased from

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2020 to 2021. Scaling up prevention and
surveillance activities to address
substance misuse and nonfatal and fatal
drug overdoses are priorities for the
Centers for Disease Control and
Prevention (CDC). Evidence shows that
reducing drug overdoses requires
increased capacity for linking people to
treatment and harm reduction services
and improving retention across care
settings. Linking individuals with a
substance use disorder to treatment and
harm reduction is a key strategy for
saving lives and it is crucial that
jurisdictions implement surveillance
strategies that can inform and improve
their linkage to and retention in care
activities.
In September 2023, CDC launched a
new surveillance program as part of the
Overdose Data to Action: Limiting
Overdose through Collaborative Actions
in Localities (OD2A: LOCAL) Notice of
Funding Opportunity (NOFO): Linkage
to and Retention in Care Surveillance.
Linkage to Care is a five-year NOFO
which connects individuals at risk of
overdose to evidence-based treatment,
services, and supports, thereby reducing
future overdoses and other harms
associated with substance use.
Implementation of surveillance systems
to collect data on standardized Linkage
to and Retention in Care indicators is
needed so that health departments can
measure the impact of their linkage to
care programs, inform overdose
prevention activities, and appropriately
allocate public health resources where
they are most needed.
Funded local health departments will
be tasked with the collection and
sharing of standardized Linkage to and
Retention in Care indicators with CDC,
as part of this effort. Local health
departments are uniquely suited to
implement surveillance systems for
standardized Linkage to and Retention
in Care (LTC) indicators due to their
proximity to the communities they serve
and access to data from local linkage to
care programs and activities. Following
an extensive environmental scan and

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