[NCEZID] 2024 Marburg Airport Entry Questionnaires

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
POE Public Health Risk Assessment Form - CDC Marburg Response	Form and Instruction	Unchanged	Missing upstream
Form 0920-1443 CDC Initial Screening – Marburg	Form and Instruction	Modified	Repair queued
Att 1_Explanation for Program Changes_0920-1443_non-sub_11.12.2024.docx	Supplementary Document	Uploaded 2024-11-16	Repair queued
0920-1443 Change Request-2024 Marburg Entry Screening_11.12.2024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-11-16	Missing upstream
0920-1443 Change Request-2024 Marburg Entry Screening_10.14.2024.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-10-16	Repair queued
Explanation for Program Changes_0920-1443_non-sub.docx	Supplementary Document	Uploaded 2024-10-16	Missing upstream
Emergency Request Memo_2024 Marburg Entry Risk Assessment dbj_10.9.24.pdf	Supplementary Document	Uploaded 2024-10-09	Repair queued
Attachment F- IRB Non-Research Determination.pdf	Supplementary Document	Uploaded 2024-10-09	Available
Attachment E-Privacy Impact Assessment_QARS_Signed_2022-07-29.pdf	Supplementary Document	Uploaded 2024-10-09	Repair queued
Attachment A2-42 CFR part 71.pdf	Supplementary Document	Uploaded 2024-10-09	Missing upstream
Attachment A1-42 USC 264.pdf	Supplementary Document	Uploaded 2024-10-09	Repair queued
SSB Emergency Clearance - 2024 Marburg Airport Entry Questions.docx	Supporting Statement B	Uploaded 2024-10-09	Repair queued
SSA Emergency Clearance - 2024 Marburg Airport Entry Questions.docx	Supporting Statement A	Uploaded 2024-10-09	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
271517	POE Public Health Risk Assessment Form - CDC Marburg Response	Form and Instruction	Unchanged
271515	CDC Initial Screening – Marburg	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-1443	ICR Reference No: 202411-0920-008
Status: Received in OIRA	Previous ICR Reference No: 202410-0920-017
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-1443-25AM
Title: [NCEZID] 2024 Marburg Airport Entry Questionnaires
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 10/11/2024
Date Submitted to OIRA: 11/19/2024

table that charts list comparision

	Requested	Previously Approved
Expiration Date	03/31/2025	03/31/2025
Responses	48,180	48,180
Time Burden (Hours)	5,110	5,110
Cost Burden (Dollars)	0	0

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Abstract: CDC has been tasked with conducting public health assessments at U.S. airports of travelers coming from areas experiencing an outbreak of Marburg virus disease (MVD) originating in Rwanda. The purpose is to detect ill travelers or travelers at high-risk of becoming ill with MVD from regions affected by the outbreak. As the response evolves, CDC may be tasked with performing this action for additional travelers in the future. This information will help CDC determine if illness investigations and medical care is needed, or if CDC should inform state and local health departments of travelers. This Non-Substantive Change Request is submitted to modify the CDC Initial Screening and POE Public Health Risk Assessment forms. The purpose of this change is to streamline the data collection by providing clarifying language and reordering the questions to streamline the forms for both travelers and CDC staff conducting these screenings. There is no change to the approved burden hours.

Emergency Justfication: To further protect U.S. communities from an imported case of MVD, the United States must be prepared to respond domestically by providing state and local health departments and healthcare facilities with the necessary assessments and questionnaires that can assist in identifying symptoms of or high-risk exposures to MVD in travelers arriving from areas affected by the outbreak. With assistance from the Department of Homeland Security, CDC will conduct these emergency assessments at designated U.S. airports that are receiving travelers from the outbreak areas, with assistance from the Department of Homeland Security. This system of risk assessment and triage will facilitate transmission of information to assist state and local health departments to complete a 21-day follow-up period and prevent introduction and spread of MVD into the United States.

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Authorizing Statute(s): US Code: 42 USC 264 Name of Law: PHSA
  

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
CDC Initial Screening – Marburg	0920-1443, 0920-1443	CDC Initial Screening at POE (CDC Primary) – Marburg Response 16OCT2024 ,   CDC Initial Screening Form_Marburg_
POE Public Health Risk Assessment Form - CDC Marburg Response	0920-1443, n/a	CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Response ,   CDC RISK ASSESSMENT AT POE (CDC Secondary) – Marburg Response

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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	48,180	48,180	0	0	0	0
Annual Time Burden (Hours)	5,110	5,110	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:

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Annual Cost to Federal Government: $8,871,147

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.     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

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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: 11/19/2024

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