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Federal forms, ICRs, and supporting documents

Information Collection Request

Information Collection for Tuberculosis Data from Panel Physicians

ICR 201804-0920-009 · OMB 0920-1102 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
TB Indicator Spreadsheet Form and Instruction Modified Available
0920-1102 Non Sub Change 04112018.docx Justification for No Material/Nonsubstantive Change Uploaded 2018-04-12 Available
Attachment D TB Indicators IRB Form.pdf Supplementary Document Uploaded 2015-09-17 Available
Attachment 2A - 8 USC 1182.pdf Supplementary Document Uploaded 2015-09-17 Available
Attachment 1A 42 CFR Part 34 Medical Examination of Aliens.pdf Supplementary Document Uploaded 2015-09-17 Available
60 day published.pdf Supplementary Document Uploaded 2015-09-17 Available
SupSta B TB Indicators 22FEB2016_OMB_DGMQ.docx Supporting Statement B Uploaded 2016-02-22 Repair queued
SupSta A TB Indicators 22FEB2016_OMB_DGMQ.docx Supporting Statement A Uploaded 2016-02-22 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
218237 TB Indicator Spreadsheet Form and Instruction Modified
ICR Details
0920-1102 201804-0920-009
Historical Active 201509-0920-006
HHS/CDC 0920-1102-18AAW
Information Collection for Tuberculosis Data from Panel Physicians
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 04/19/2018
Retrieve Notice of Action (NOA) 04/12/2018
Previous terms continue: Because TB Indicator data is not obtained from a national surveillance system, the database is representative only of TB incidence rates among U.S. migrant populations and not intended to develop country-wide prevalence estimates. This collection is approved with the understanding that when disseminating any data gathered from this collection, CDC will compare the characteristics of the population covered in the database to that of the population to whom they intend to generalize, and clearly caveat the likelihood of over or under-estimates of TB burden.
  Inventory as of this Action Requested Previously Approved
02/28/2019 02/28/2019 02/28/2019
353 0 353
2,648 0 2,648
0 0 0
More than 760 panel physicians perform overseas pre-departure medical examinations at 353 panel sites. Screening for tuberculosis is an important part of the medical exam in order to diagnose active TB disease prior to arrival in the U.S. CDC needs to collect TB indicator data to have a more accurate system to collect information on immigrants. CDC requests minor changes to some data fields related to moving the collection time frame from January to March.
US Code: 42 USC 241 Name of Law: Public Health Service Act
   US Code: 8 USC 1182 Name of Law: Immigration and Nationality Act
  
None
Not associated with rulemaking
  80 FR 44355 07/27/2015
80 FR 59154 10/01/2015
No
1
IC Title Form No. Form Name
TB Indicator Spreadsheet none TB Indicator Data Reporting Form
  Total Approved 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 353 353 0 0 0 0
Annual Time Burden (Hours) 2,648 2,648 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$25,050
Yes Part B of Supporting Statement
    No
    No
No
No
No
Uncollected
Shari Steinberg 404 639-4942 [email protected]
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
04/12/2018