OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NCEZID] Enhanced surveillance of respiratory illness among people experiencing homelessness in Anchorage, Alaska

ICR 202310-0920-012 · OMB 0920-1399 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
CRF Symptom Screener Form and Instruction Modified Repair queued
Non-substantive change_Respiratory Surveillance Alaska_Revised.10.18.23.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-10-27 Missing upstream
Project Protocol Respiratory surveillance Alaska. 5.25.23.Amended10.10.2023 - Clean.docx Supplementary Document Uploaded 2023-10-27 Repair queued
Attachment 7_20220721_REDCap_PIA_Signed.pdf Supplementary Document Uploaded 2022-11-21 Repair queued
Attachment 6_Consent Respiratory surveillance Alaska 25July2022.docx Supplementary Document Uploaded 2022-11-21 Available
Attachment 5_Protocol Respiratory surveillance Alaska 25July2022_edited_final.docx Supplementary Document Uploaded 2023-05-01 Missing upstream
Attachment 4 080322SS-NR-signed.pdf Supplementary Document Uploaded 2022-11-21 Missing upstream
Attachment 2_60dayPublished FRN 2022-11771.pdf Supplementary Document Uploaded 2022-11-21 Repair queued
Attachment 1_Section 301 of the Public Health Service Act (42 USC 241).pdf Supplementary Document Uploaded 2022-11-21 Repair queued
Supporting Statement B_edited_final.docx Supporting Statement B Uploaded 2023-05-01 Repair queued
SSA_OIRA 4.28.23 - edited_final.docx Supporting Statement A Uploaded 2023-05-01 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
257029 CRF Symptom Screener Form and Instruction Modified
ICR Details
0920-1399 202310-0920-012
Received in OIRA 202211-0920-009
HHS/CDC 0920-1399-24AM
[NCEZID] Enhanced surveillance of respiratory illness among people experiencing homelessness in Anchorage, Alaska
No material or nonsubstantive change to a currently approved collection   No
Regular 11/01/2023
  Requested Previously Approved
05/31/2024 05/31/2024
1,000 1,000
500 500
0 0
People experiencing homelessness are at risk for respiratory infectious diseases. This project involves enhanced surveillance for respiratory pathogens in congregate and non-congregate homeless shelters to provide evidence to improve public health for people who are experiencing homelessness in Anchorage, Alaska. The project team will collect a nasopharyngeal swab (NP) from people experiencing respiratory symptoms who are accessing shelters. The project team will complete demographic information, a short symptom questionnaire with the participant, and test the NP for respiratory pathogens among people experiencing homelessness. This Non-Substantive Change Request is submitted to include sequencing of the collected positive respiratory specimens (which will be performed by CDC), and to modify currently approved versions of several questions. There is no change to the burden.
US Code: 42 USC 241 Name of Law: PHSA
  
None
Not associated with rulemaking
  87 FR 33490 06/02/2022
87 FR 70831 11/21/2022
No
1
IC Title Form No. Form Name
CRF Symptom Screener 0920-1399, n/a CRF Symptom Screener ,   CRF Symptom Screener - Enrollment form, symptom screening, and vaccination status 27OCT2023
  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 1,000 1,000 0 0 0 0
Annual Time Burden (Hours) 500 500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$128,768
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [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.
11/01/2023