Information Collection Request

Emerging Infections Program

ICR 202007-0920-014 · OMB 0920-0978 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0978 COVID-19 - CDI Case Report and Treatment Form Form and Instruction Removed Repair queued
Form 0920-0978 COVID-19 - Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form Form and Instruction Removed Repair queued
Form 0920-0978 COVID-19 - Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Infection Case Report Form Form and Instruction Removed Available
Form 0920-0978 COVID-19 - MuGSI Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) Form and Instruction Removed Repair queued
Form 0920-0978 COVID-19 - MuGSI Case Report Form for Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB) Form and Instruction Removed Repair queued
Form 0920-0978 HAIC Candidemia Periodic Laboratory Survey Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Laboratory Survey Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC CDI LTCF Survey Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC CDI Annual Surveillance Officers Survey Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC CDI Annual Laboratory Survey Form and Instruction Unchanged Repair queued
Form 0920-0978 Flu Surv NET Laboratory Survey Form and Instruction Unchanged Available
Form 0920-0978 Foodnet Clinical Laboratory Practices and Testing Volume Form and Instruction Unchanged Available
Form 0920-0978 HAIC Candidemia Case Report Form Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Form and Instruction Modified Repair queued
Form 0920-0978 HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) Form and Instruction Modified Available
Form 0920-0978 Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) Form and Instruction Unchanged Available
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) Form and Instruction Unchanged Repair queued
Form 0920-0978 ABCs Severe GAS Infection Supplemental Form Form and Instruction Unchanged Repair queued
Form 0920-0978 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction Unchanged Repair queued
Form 0920-0978 HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) Form and Instruction Modified Available
Form 0920-0978 HAIC CDI Case Report Form Form and Instruction Modified Repair queued
Form 0920-0978 FoodNet Yersinia Form and Instruction Unchanged Repair queued
Form 0920-0978 FoodNet Vibrio Form and Instruction Unchanged Available
Form 0920-0978 FoodNet Shigella Form and Instruction Unchanged Available
Form 0920-0978 FoodNet Shiga toxin producing E. coli Form and Instruction Unchanged Repair queued
Form 0920-0978 FoodNet Salmonella Form and Instruction Unchanged Repair queued
Form 0920-0978 FoodNet Listeria monocytogenes Form and Instruction Unchanged Repair queued
Form 0920-0978 FoodNet Cyclospora Form and Instruction Unchanged Repair queued
Form 0920-0978 FoodNet Campylobacter Form and Instruction Unchanged Available
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) Form and Instruction Unchanged Repair queued
Form 0920-0978 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Unchanged Repair queued
Form 0920-0978 Influenza Hospitalization Surveilance Network Case Report Form Form and Instruction Unchanged Repair queued
Form 0920-0978 ABCs Neonatal Infection Expanded Tracking Form Form and Instruction Unchanged Repair queued
Form 0920-0978 ABCs Invasive Pneumococcal Disease in Children Form and Instruction Unchanged Available
Form 0920-0978 HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Form and Instruction Modified Repair queued
Form 0920-0978 ABCs Case Report Form Form and Instruction Unchanged Repair queued
0920-0978 Change Memo - EIP HAIC COVID-19 CRF additions_updated07242020_CLEAN.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-07-29 Repair queued
0920-0978 Change Memo - EIP HAIC COVID-19 CRF additions.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-06-24 Available
Att24_Cross walk.pdf Supplementary Document Uploaded 2019-12-10 Repair queued
Att23_Description of Changes.pdf Supplementary Document Uploaded 2019-12-10 Available
FoodNetSupplemental1_FN Highlights_FDD MMG cross walk_ALL_20190815.xlsx Supplementary Document Uploaded 2019-10-25 Available
FoodNetSupplemental2_FoodNet Variable List_mapping to MMG DRAFT.XLSX Supplementary Document Uploaded 2019-10-25 Repair queued
Non-Sub ChgReq_0920-0978(121019)_OMBupdates (002).doc Justification for No Material/Nonsubstantive Change Uploaded 2019-12-12 Repair queued
Privacy Act Checklist.docx Supplementary Document Uploaded 2019-02-22 Available
Attachment 33 - Non-research determination.pdf Supplementary Document Uploaded 2019-02-22 Available
Att 32- Flu PIA.pdf Supplementary Document Uploaded 2019-02-22 Available
Att 31- ABCs PIA.pdf Supplementary Document Uploaded 2019-02-22 Available
Att 30 - FoodNet PIA.pdf Supplementary Document Uploaded 2019-02-22 Available
Att 29- HAIC PIA.pdf Supplementary Document Uploaded 2019-02-22 Repair queued
60 Day FRN.pdf Supplementary Document Uploaded 2019-02-22 Repair queued
Att 1- Authorizing_Regulations_T42_section_241.pdf Supplementary Document Uploaded 2019-02-22 Available
Non-sub change request_2018.doc Justification for No Material/Nonsubstantive Change Uploaded 2018-09-13 Repair queued
CDI_Non-sub change request_FINAL_20180524.doc Justification for No Material/Nonsubstantive Change Uploaded 2018-05-31 Repair queued
Part B_EIP OMB 2018 Revision_20180926.docx Supporting Statement B Uploaded 2019-02-22 Repair queued
Part A_EIP OMB 2018 Revision_20180926 ICRO revised.docx Supporting Statement A Uploaded 2019-02-22 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
242442 COVID-19 - CDI Case Report and Treatment Form Form and Instruction Removed
242439 COVID-19 - Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form Form and Instruction Removed
242425 COVID-19 - Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Infection Case Report Form Form and Instruction Removed
242423 COVID-19 - MuGSI Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) Form and Instruction Removed
242413 COVID-19 - MuGSI Case Report Form for Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB) Form and Instruction Removed
235058 HAIC Candidemia Periodic Laboratory Survey Form and Instruction Unchanged
235057 HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey Form and Instruction Unchanged
235056 HAIC Invasive Staphylococcus aureus Annual Laboratory Survey Form and Instruction Unchanged
235055 HAIC CDI LTCF Survey Form and Instruction Unchanged
235054 HAIC CDI Annual Surveillance Officers Survey Form and Instruction Unchanged
235053 HAIC CDI Annual Laboratory Survey Form and Instruction Unchanged
235052 Flu Surv NET Laboratory Survey Form and Instruction Unchanged
235051 Foodnet Clinical Laboratory Practices and Testing Volume Form and Instruction Unchanged
231114 HAIC Candidemia Case Report Form Form and Instruction Unchanged
231113 HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Form and Instruction Modified
231112 HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) Form and Instruction Modified
231111 Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) Form and Instruction Unchanged
231110 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) Form and Instruction Unchanged
230869 ABCs Severe GAS Infection Supplemental Form Form and Instruction Unchanged
220380 ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form Form and Instruction Unchanged
217336 HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) Form and Instruction Modified
217334 HAIC CDI Case Report Form Form and Instruction Modified
207663 FoodNet Yersinia Form and Instruction Unchanged
207662 FoodNet Vibrio Form and Instruction Unchanged
207661 FoodNet Shigella Form and Instruction Unchanged
207660 FoodNet Shiga toxin producing E. coli Form and Instruction Unchanged
207659 FoodNet Salmonella Form and Instruction Unchanged
207658 FoodNet Listeria monocytogenes Form and Instruction Unchanged
207657 FoodNet Cyclospora Form and Instruction Unchanged
207655 FoodNet Campylobacter Form and Instruction Unchanged
207653 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) Form and Instruction Unchanged
207652 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Unchanged
207651 Influenza Hospitalization Surveilance Network Case Report Form Form and Instruction Unchanged
207649 ABCs Neonatal Infection Expanded Tracking Form Form and Instruction Unchanged
207648 ABCs Invasive Pneumococcal Disease in Children Form and Instruction Unchanged
207647 HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Form and Instruction Modified
207646 ABCs Case Report Form Form and Instruction Unchanged
ICR Details
0920-0978 202007-0920-014
Historical Active 202006-0920-015
HHS/CDC 0920-0978-20QT
Emerging Infections Program
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 07/31/2020
Retrieve Notice of Action (NOA) 07/29/2020
Previous terms continue: OMB is approving this information collection request for a period of three years during which time CDC will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action. Similarly, any changes to EIP as a result of ETEC pilot will be submitted for review and approval prior to fielding the data collection. Finally, approval is consistent with the understanding that CDC will continue to add language to its website and reports that clearly caveats the interpretation of longitudinal trends due to changes in the number and characteristics of participating hospitals
  Inventory as of this Action Requested Previously Approved
04/30/2022 04/30/2022 04/30/2022
99,955 0 138,735
39,673 0 40,816
0 0 0

The Emerging Infections Programs (EIP) is to 1) detect and monitor emerging pathogens, the diseases they cause, and the factors influencing their emergence, and respond to problems as they are identified, 2) integrate laboratory science and epidemiology to optimize public health practice, 3) strengthen infrastructure to support surveillance and research and to implement prevention and control programs, and to 4) ensure implementation of prevention strategies and communication of public health information about emerging diseases. Surveillance efforts of the core EIP activities generate reliable estimates of the incidence of certain infections and provide the foundation for a variety of epidemiologic studies. This is a request for a non-substantive change. Requested changes represent minor modifications to already-approved instruments to include a limited number of data elements pertaining to COVID-19.

US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  83 FR 57488 11/15/2018
84 FR 5685 02/22/2019
No

32
IC Title Form No. Form Name
COVID-19 - MuGSI Case Report Form for Carbapenem-resistant Enterobacteriaceae (CRE) and Acinetobacter baumannii (CRAB) 0920-0978 COVID-19 - Carbapenem Resistant Enterobacteriaceae (CRE)/ Carbapenem Resistant A. baumannii (CRAB) MUGSI-HAIC
COVID-19 - MuGSI Extended-Spectrum Beta-Lactamase-Producing Enterobacteriaceae (ESBL) 0920-0978 COVID-19 42020 Extended-Spectrum Beta-Lactamase (ESBL)-Producing Enterobacteriaceae MuGSI-HAIC
COVID-19 - Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Infection Case Report Form 0920-0978 COVID-19 Invasive Methicillin-Resistant Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2020
COVID-19 - Invasive Methicillin-sensitive Staphylococcus aureus (MSSA) Infection Case Report Form 0920-0978 COVID -19 Invasive Methicillin-Sensitive Staphylococcus aureus Healthcare-Associated Infections Community Interface (HAIC) Case Report – 2020
COVID-19 - CDI Case Report and Treatment Form 0920-0978 COVID-19 CLOSTRIDIOIDES DIFFICILE INFECTION (CDI) SURVEILLANCE
Flu Surv NET Laboratory Survey 0920-0978 FluSurv-NET Laboratory Survey 2019-2020 Season
HAIC CDI LTCF Survey 0920-0978 Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) 0920-0978, 0920-0978 FluSurv NET Vaccination Phone Script ,   FluSurv NET Consent From English
HAIC Invasive Staphylococcus aureus Annual Laboratory Survey 0920-0978 HAIC Staphylococcus aureus Laboratory Survey: Use of Nucleic Acid Amplificaiton Testing (NAAT)
HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey 0920-0978 2019 HAIC Invasive Staphylococcus aureus Supplemental Surveiallance Officer Survey
ABCs Neonatal Infection Expanded Tracking Form 0920-0978 ABC Neonatal Infection Expanded Tracking Form
Influenza Hospitalization Surveilance Network Case Report Form 0920-0978 2019-2020 FluSurv-NET Influenza Hospitalization Surveillance Project Case Report Form
FoodNet Hemolytic Uremic Syndrome (HUS) 0920-0978 FoodNet HUS CRF
FoodNet Campylobacter 0920-0978 FoodNet Active Surveillance Variable List
FoodNet Cyclospora 0920-0978 FoodNet Active Surveillance Variable List
FoodNet Listeria monocytogenes 0920-0978 FoodNet Active Surveillance Variable List
FoodNet Salmonella 0920-0978 FoodNet Active Surveillance Variable List
FoodNet Shigella 0920-0978 FoodNet Active Surveillance Variable List
FoodNet Vibrio 0920-0978 FoodNet Active Surveillance Variable List
FoodNet Yersinia 0920-0978 Foodborne and DIarrheal Diseases Message Mapping Guide (FDD MMG - FoodNet only portion)
HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) 0920-0978 2020 Carbapenem Resistant Enterobacteriaceae (CRE) Carbapenem Resistant A. baumannii (CRAB) Multi-site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB)
ABCs Severe GAS Infection Supplemental Form 0920-0978 ABC Severe GAS Infection Supplemental Form
HAIC Multi-Site Gram-Negative Surveillance Initiative - Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae (MuGSI-ESBL) 0920-0978 2020 Extended-Spectrum Beta-Lactamase (ESBL)- Producting Enterobacteriaceae MuGSI (HAIC)
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) 0920-0978 Invasive Methicillin-Sensitive Staphylococcus aureau (HAIC) Case Report 2020
HAIC Candidemia Case Report Form 0920-0978 Candidemia 2020 Case Report Form
HAIC Candidemia Periodic Laboratory Survey 0920-0978 2020 Laboratory Testing Practices for Candidemia Questionnaire
Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) 0920-0978 FluSurv Net Provider Vaccination History Fax Form
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) 0920-0978, 0920-0978 FluSurv NET Vaccination Phone Script ,   FluSurv NET Consent Form Spanish
FoodNet Shiga toxin producing E. coli 0920-0978 FoodNet Active Surveillance Variable List 2019-2020
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form 0920-0978 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
HAIC CDI Case Report Form 0920-0978 Clostridioides Difficile Infection (CDI Surveillance Emerging Infections Program Case Report
ABCs Case Report Form 0920-0978 2020 ABC Surveillance Case Report
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) 0920-0978 Invasive Methicillin-Resistant Staphylococcus aureus (MRSA) HAIC Case Report
ABCs Invasive Pneumococcal Disease in Children 0920-0978 ABC Invasive Pneumococcal Disease in Children (age>2 months to <5 years
HAIC CDI Annual Laboratory Survey 0920-0978 Annual Survey of Laboratory Testing Practices for C. difficile Infection
HAIC CDI Annual Surveillance Officers Survey 0920-0978 Surveillance Officer's Survey
Foodnet Clinical Laboratory Practices and Testing Volume 0920-0978 Foodnet Lab Practices Volume

  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 99,955 138,735 0 0 -38,780 0
Annual Time Burden (Hours) 39,673 40,816 0 2,089 -3,232 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
Addition of COVID-19 related questions to 0920-0978 EIP Forms results in increased burden hours for some instruments but an overall decrease due to entry error on last submission.

$31,091,990
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
Yes
Kevin Joyce 404 639-1944 [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.
07/29/2020