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Federal forms, ICRs, and supporting documents

Information Collection Request

Information Collection for Tuberculosis Data from Referring Entities to CureTB

ICR 202004-0920-019 · OMB 0920-1186 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Individual Followup with Tuberculosis (TB) Patients Referred by ICE Form and Instruction New Repair queued
Coordination with TB Treating Physician/Foreign Health Authority in New Country Form and Instruction Modified Repair queued
Cure TB Contact Source Investigation (CI/SI) Notification - LHD Form and Instruction Modified Missing upstream
Individual Followup with Tuberculosis (TB) Patients Referred by LHD Form and Instruction Modified Repair queued
Cure TB Transnational Notification - Referral from Local Health Departments Form and Instruction Modified Repair queued
Att. G 20200520 CureTB PIA Signed.pdf Supplementary Document Uploaded 2020-06-15 Repair queued
SSA-CureTB06.15.2020-Final.docx Supporting Statement A Uploaded 2020-06-15 Missing upstream
Att. F - IRB Determination.pdf Supplementary Document Uploaded 2020-06-08 Repair queued
Att. B - Published 60-day FRN-12.23.2019.pdf Supplementary Document Uploaded 2020-06-08 Repair queued
Att. A5 - Section 311.pdf Supplementary Document Uploaded 2020-06-08 Repair queued
Att. A4 - Section 301.pdf Supplementary Document Uploaded 2020-06-08 Repair queued
Att. A3 - 42 CFR Part 71.pdf Supplementary Document Uploaded 2020-06-08 Repair queued
Att. A2 - 42 CFR Part 70.pdf Supplementary Document Uploaded 2020-06-08 Repair queued
Att. A1 - Section 361 of the Public Health Service Act (42 USC 264).pdf Supplementary Document Uploaded 2020-06-08 Repair queued
SSB-CureTB5.29.2020-Final.docx Supporting Statement B Uploaded 2020-06-08 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
242057 Individual Followup with Tuberculosis (TB) Patients Referred by ICE Form and Instruction New
226739 Coordination with TB Treating Physician/Foreign Health Authority in New Country Form and Instruction Modified
226738 Cure TB Contact Source Investigation (CI/SI) Notification - LHD Form and Instruction Modified
226737 Individual Followup with Tuberculosis (TB) Patients Referred by LHD Form and Instruction Modified
226736 Cure TB Transnational Notification - Referral from Local Health Departments Form and Instruction Modified
ICR Details
0920-1186 202004-0920-019
Received in OIRA 201705-0920-004
HHS/CDC 16AWE
Information Collection for Tuberculosis Data from Referring Entities to CureTB
Revision of a currently approved collection   No
Regular 06/15/2020
  Requested Previously Approved
36 Months From Approved 01/31/2021
3,764 2,200
1,081 558
30,139 0
The objective of this information collection is to facilitate CDC coordinating of the continuity of care for individuals affected by TB who enter US jurisdictions from foreign nations who or who leave US jurisdictions bound for foreign nations.
US Code: 42 USC Code of Federal Regulations Name of Law: Public Health Service Act
   US Code: 42 USC Code of Federal Regulations Name of Law: Part 70 Interstate Quarantine
   US Code: 42 USC Code of Federal Regulations Name of Law: Part 71 Foreign Quarantine
  
None
Not associated with rulemaking
  84 FR 70555 12/23/2019
85 FR 36211 06/15/2020
No
  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 3,764 2,200 0 1,564 0 0
Annual Time Burden (Hours) 1,081 558 0 523 0 0
Annual Cost Burden (Dollars) 30,139 0 0 30,139 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
CDC is changing the forms slightly to allow for more space, and more complete information sharing. The burden has increased because there were more referrals made by Immigration and Customs Enforcement (ICE) instead of health departments, and more time had to be spent to fill in gaps of information from ICE.
$234,343
No
    Yes
    No
No
No
No
No
Renita Macaluso 770 488-6458 [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.
06/15/2020