Information Collection Request

Emerging Infections Program

ICR 202009-0920-004 · OMB 0920-0978 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
HAIC Candidemia Periodic Laboratory Survey Form and Instruction Modified Repair queued
Form 0920-0978 HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey Form and Instruction Unchanged Available
HAIC Invasive Staphylococcus aureus Annual Laboratory Survey Form and Instruction Modified 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
HAIC CDI Annual Laboratory Survey Form and Instruction Modified Available
Flu Surv NET Laboratory Survey Form Modified Available
Foodnet Clinical Laboratory Practices and Testing Volume Form and Instruction Modified Available
HAIC Candidemia Case Report Form Form and Instruction Modified Available
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) Form and Instruction Modified Repair queued
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 Repair queued
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) Form and Instruction Unchanged Available
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
HAIC Multi-Site Gram-Negative Bacilli Case Report Form (MuGSI-CRE/CRAB) Form and Instruction Modified Available
HAIC CDI Case Report Form Form and Instruction Modified Repair queued
Form 0920-0978 Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) Form and Instruction Unchanged Available
Form 0920-0978 FoodNet Hemolytic Uremic Syndrome (HUS) Form and Instruction Unchanged Repair queued
Influenza Hospitalization Surveilance Network Case Report Form Form and Instruction Modified Available
ABCs Neonatal Infection Expanded Tracking Form Form and Instruction Modified Repair queued
Form 0920-0978 ABCs Invasive Pneumococcal Disease in Children Form and Instruction Unchanged Repair queued
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) Form and Instruction Modified Repair queued
Form 0920-0978 ABCs Case Report Form Form and Instruction Unchanged Available
Att2_EIP2021_NonSub_Crosswalk_Sept2020.docx Supplementary Document Uploaded 2020-09-08 Repair queued
EIP 0920-0978_Non-sub change request_Sept2020.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-09-08 Available
Att1_EIP2021_NonSub_DescriptionChanges_Sept2020.docx Supplementary Document Uploaded 2020-09-08 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 Available
0920-0978 Change Memo - EIP HAIC COVID-19 CRF additions.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-06-24 Repair queued
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 Repair queued
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 Repair queued
Attachment 33 - Non-research determination.pdf Supplementary Document Uploaded 2019-02-22 Repair queued
Att 32- Flu PIA.pdf Supplementary Document Uploaded 2019-02-22 Repair queued
Att 31- ABCs PIA.pdf Supplementary Document Uploaded 2019-02-22 Repair queued
Att 30 - FoodNet PIA.pdf Supplementary Document Uploaded 2019-02-22 Repair queued
Att 29- HAIC PIA.pdf Supplementary Document Uploaded 2019-02-22 Available
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 Repair queued
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 Available
IC Document Collections
IC IDCollectionTypeStatusForm
235058 HAIC Candidemia Periodic Laboratory Survey Form and Instruction Modified
235057 HAIC Invasive Staphylococcus aureus Annual Surveillance Officers Survey Form and Instruction Unchanged
235056 HAIC Invasive Staphylococcus aureus Annual Laboratory Survey Form and Instruction Modified
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 Modified
235052 Flu Surv NET Laboratory Survey Form Modified
235051 Foodnet Clinical Laboratory Practices and Testing Volume Form and Instruction Modified
231114 HAIC Candidemia Case Report Form Form and Instruction Modified
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 Other-Variable list Modified
207662 FoodNet Vibrio Other-Variable list Modified
207661 FoodNet Shigella Other-Variable list Modified
207660 FoodNet Shiga toxin producing E. coli Other-Variable list Modified
207659 FoodNet Salmonella Other-Variable list Modified
207658 FoodNet Listeria monocytogenes Other-Variable list Modified
207657 FoodNet Cyclospora Other-Variable list Modified
207655 FoodNet Campylobacter Other-Variable list Modified
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 Modified
207649 ABCs Neonatal Infection Expanded Tracking Form Form and Instruction Modified
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 202009-0920-004
Historical Active 202007-0920-014
HHS/CDC 0920-0978-20RV
Emerging Infections Program
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 09/22/2020
Retrieve Notice of Action (NOA) 09/09/2020
Previous terms continue: CDC will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved. 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
100,480 0 99,955
38,876 0 39,673
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
FoodNet Listeria monocytogenes
FoodNet Cyclospora
FoodNet Salmonella
FoodNet Shigella
FoodNet Vibrio
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) none Multi-site GSI CRE CRAB Report
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) none Multi-site GSI ESBL Report
HAIC Invasive Methicillin-Sensitive Staphylococcus aureus (MSSA) none MSSA Report 2021
HAIC Candidemia Case Report Form none Candidemia Case Report
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (Spanish) 0920-0978, 0920-0978 FluSurv NET Vaccination Phone Script ,   FluSurv NET Consent Form Spanish
HAIC Candidemia Periodic Laboratory Survey none Candidemia Lab Survey
Influenza Hospitalization Surveillance Project Provider Vaccination History Fax Form (Children/Adults) 0920-0978 FluSurv Net Provider Vaccination History Fax Form
Flu Surv NET Laboratory Survey none FluSurv Lab Survey
HAIC CDI LTCF Survey 0920-0978 Emerging Infections Progrom C. difficile Surveillance Nuring Home Telephone Call Survey
HAIC Invasive Staphylococcus aureus Annual Laboratory Survey none Invasive Staph aureus Lab Survey
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 none Neonatal Infection Expanded Tracking Form
Influenza Hospitalization Surveilance Network Case Report Form none Influenza Hospitalization Surveillance Network Case Report
FoodNet Hemolytic Uremic Syndrome (HUS) 0920-0978 FoodNet HUS CRF
Influenza Hospitalization Surveillance Project Vaccination Telephone Script / Consent Form (English) 0920-0978, 0920-0978 FluSurv NET Vaccination Phone Script ,   FluSurv NET Consent From English
FoodNet Campylobacter
HAIC CDI Annual Laboratory Survey none CDI Lab Survey
HAIC CDI Annual Surveillance Officers Survey 0920-0978 Surveillance Officer's Survey
Foodnet Clinical Laboratory Practices and Testing Volume none FoodNET Lab Practices Volume
FoodNet Shiga toxin producing E. coli
ABCs H. Influenzae Neonatal Sepsis Expanded Surveillance Form 0920-0978 ABC H. Influenzae Neonatal Sepsis Expanded Surveillance Form
HAIC CDI Case Report Form none CDI Case Report
ABCs Case Report Form 0920-0978 2020 ABC Surveillance Case Report
HAIC Invasive Methicillin-resistant Staphylococcus aureus (MRSA) none Invasive MRSA Case Report
ABCs Invasive Pneumococcal Disease in Children 0920-0978 ABC Invasive Pneumococcal Disease in Children (age>2 months to <5 years

  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 100,480 99,955 0 525 0 0
Annual Time Burden (Hours) 38,876 39,673 0 -797 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
The changes made to the forms under this request will aid in improving surveillance efficiency and data quality to clarify the burden of disease and possible risk factors for disease. This information can be used to inform strategies for preventing disease and negative outcomes. Specifically, changes were made for clarification purposes, to assist data collectors in capturing data in a standardized fashion to improve accuracy. Burden numbers are subject to rounding.

$31,091,990
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
Yes
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.
09/09/2020