80 FR 9725 - Agency Forms Undergoing Paperwork Reduction Act Review

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention

Federal Register Volume 80, Issue 36 (February 24, 2015)

Page Range		9725-9727
FR Document		2015-03616

Federal Register, Volume 80 Issue 36 (Tuesday, February 24, 2015)

[Federal Register Volume 80, Number 36 (Tuesday, February 24, 2015)]
[Notices]
[Pages 9725-9727]
From the Federal Register Online [www.thefederalregister.org]
[FR Doc No: 2015-03616]

-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-15-0900]

Agency Forms Undergoing Paperwork Reduction Act Review

The Centers for Disease Control and Prevention (CDC) has submitted
the following information collection request to the Office of
Management and Budget (OMB) for review and approval in accordance with
the Paperwork Reduction Act of 1995. The notice for the proposed
information collection is published to obtain comments from the public
and affected agencies.
Written comments and suggestions from the public and affected
agencies concerning the proposed collection of information are
encouraged. Your comments should address any of the following: (a)
Evaluate whether the proposed collection of information is necessary
for the proper performance of

[[Page 9726]]

the functions of the agency, including whether the information will
have practical utility; (b) Evaluate the accuracy of the agencies
estimate of the burden of the proposed collection of information,
including the validity of the methodology and assumptions used; (c)
Enhance the quality, utility, and clarity of the information to be
collected; (d) Minimize the burden of the collection of information on
those who are to respond, including through the use of appropriate
automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology, e.g., permitting
electronic submission of responses; and (e) Assess information
collection costs.
To request additional information on the proposed project or to
obtain a copy of the information collection plan and instruments, call
(404) 639-7570 or send an email to omb@cdc.gov. Written comments and/or
suggestions regarding the items contained in this notice should be
directed to the Attention: CDC Desk Officer, Office of Management and
Budget, Washington, DC 20503 or by fax to (202) 395-5806. Written
comments should be received within 30 days of this notice.

Proposed Project

Contact Investigation Outcome Reporting Forms (0920-0900)--
Revision--(expiration date: October 31, 2017)--National Center for
Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Global
Migration and Quarantine (DGMQ), Centers for Disease Control and
Prevention (CDC).

Background and Brief Description

The Centers for Disease Control and Prevention (CDC), Division of
Global Migration and Quarantine (DGMQ) requests revision to a currently
approved information collection, OMB Control No 0920-0900, Contact
Investigation Outcome Reporting Forms. CDC is requesting the addition
of Ebola-specific information collection tools to supplement the
Centers for Disease Control and Prevention's (CDC) routine contact
investigation activities so that CDC can better assess the risk to
individuals who may have been exposed to a confirmed case of Ebola
while traveling to or within the United States. These forms were
approved by OMB under an emergency clearance, OMB Control No 0920-1032.
The additional forms to be added are as follows:
Ebola Airline passenger exposure questionnaire--This
contact investigation form gathers information from airline passengers
who traveled on plane(s) and sat within a 3 foot area around the
suspected case and travel companions of the suspected case to determine
the level of exposure and risk, as well as other passengers who may
have had contact with the case's bodily fluids. Information gathered in
this form is shared with the CDC to determine risk level. Risk levels
are outlined in CDC's Movement and Monitoring Guidance.
Ebola exposure Assessment Flight Crew--The flight exposure
questionnaire is used to ascertain the same relevant information
included in the passenger questionnaire for all crew who worked on
flight(s) and came into contact with Ebola patient(s).
Ebola exposure Assessment Cleaning Crew--This form
collects the same information as the flight crew exposure
questionnaire, used to determine the level of exposure a member of the
cleaning crew who serviced a flight with an ill patient(s).
Ebola exposure Assessment Airport or other port of entry
staff--This questionnaire is utilized for airport staff who may have
come into contact with a person ill with Ebola. Airport staff is
identified through conversations with airport authority to determine
which employees carried out tasks that would have put them in contact
with the ill person or their body fluids.
Passengers of other commercial conveyance Ebola exposure
questionnaire--This questionnaire collects the same information as the
airline passenger questionnaire but will be utilized for passengers of
commercial conveyance that is land- or waterborne.
Finally, the introduction and confirmation script is to be
used by CDC staff manning open call lines available for persons who
traveled on planes that carried suspected or confirmed patients with
Ebola. As with the other questionnaires, this script assesses the risk
of a plan passenger who was not in the immediate vicinity of the Ebola
patient but still has concerns about the level of exposure and risk of
contracting the virus.
CDC is not proposing any changes to the routine contact
investigation forms already approved under this information collection
request.
The total burden associated with this revision is 10,949 hours,
including both standard contact investigation forms and updated forms
to account for Ebola transmission. There are no costs to respondents
other than their time.

Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of Number of Average burden
Type of respondent Form name respondents responses per per response
----------------------------------------------------------------------------------------------------------------
State/local health department staff... General Contact 12 1 5/60
Investigation Outcome
Reporting Form (Air).
Cruise Ship Physicians/Cargo Ship General Contact 100 1 5/60
Managers. Investigation Outcome
Reporting Form
(Maritime--word
version).
Cruise Ship Physicians/Cargo Ship General Contact 100 1 5/60
Managers. Investigation Outcome
Reporting Form
(Maritime--Excel
version).
State/local health department staff... General Contact 12 1 5/60
Investigation Outcome
Reporting Form (Land).
State/local health department staff... TB Contact Investigation 1,244 1 5/60
Outcome Reporting Form
(Air).
Cruise Ship Physicians/Cargo Ship TB Contact Investigation 150 1 5/60
Managers. Outcome Reporting Form
(Maritime--word
version).
Cruise Ship Physicians/Cargo Ship TB Contact Investigation 150 1 5/60
Managers. Outcome Reporting Form
(Maritime--Excel
version).
State/local health department staff... Measles Contact 964 1 5/60
Investigation Outcome
Reporting Form (Air).
Cruise Ship Physicians/Cargo Ship Measles Contact 63 1 5/60
Managers. Investigation Outcome
Reporting Form
(Maritime--word
version).

[[Page 9727]]

Cruise Ship Physicians/Cargo Ship Measles Contact 63 1 5/60
Managers. Investigation Outcome
Reporting Form
(Maritime--excel
version).
State/local health department staff... Rubella Contact 95 1 5/60
Investigation Outcome
Reporting Form (Air).
Cruise Ship Physicians/Cargo Ship Rubella Contact 12 1 5/60
Managers. Investigation Outcome
Reporting Form
(Maritime -word
version).
Cruise Ship Physicians/Cargo Ship Rubella Contact 12 1 5/60
Managers. Investigation Outcome
Reporting Form
(Maritime--excel
version).
Passenger............................. Ebola Airline Exposure 3,400 2 20/60
Assessment Passenger.
Flight Crew........................... Ebola Airline Exposure 2,400 2 20/60
Assessment Flight Crew.
Cleaning Crew......................... Ebola Airline Exposure 1,200 2 20/60
Assessment Cleaning
Crew.
Airport or Other Port of Entry Staff.. Ebola Airline Exposure 1,000 2 20/60
Assessment Airport or
Other Port of Entry
Staff.
Passengers on other commercial Ebola Exposure 1,800 2 20/60
conveyances. Questionnaire for
Passengers on other
commercial conveyances.
Traveler.............................. Script--Introduction and 50,000 1 5/60
Confirmation.
----------------------------------------------------------------------------------------------------------------

Leroy A. Richardson,
Chief, Information Collection Review Office, Office of Scientific
Integrity, Office of the Associate Director for Science, Office of the
Director, Centers for Disease Control and Prevention.
[FR Doc. 2015-03616 Filed 2-23-15; 8:45 am]
BILLING CODE 4163-18-P

Federal Register / Vol. 80, No. 36 / Tuesday, February 24, 2015 / Notices 9725

interventions and core public health disease intervention specialist, partner of knowledge and skills, potential
strategies for HIV prevention. CBA is services provider, physicians, nurses, organization changes as a result of CBA
provided to support health departments, and health educators, etc. services) and to solicit information
community-based organizations, and CDC is requesting to use two web- about how the CBA program can be
healthcare organizations in the based assessments that will be improved. Administered by the project
implementation, monitoring and administered to recipients of CBA contractor, the CBA key informant
evaluation of evidence-based HIV services: (1) Training Follow-Up interviews will be conducted via
prevention interventions and programs; Instrument and (2) Technical Assistance telephone with a subset of up to 40
building organizational infrastructure; Satisfaction Instrument. The first recipients of CBA services. The
and community mobilization to quantitative assessment will be interview takes approximately 15
decrease stigma and increase HIV disseminated 90 days after a training
minutes to complete.
testing in high risk communities. CBA event to agency staff who participated in
services are requested by health a training activity. It takes The 7,400 respondents represent an
departments, community-based approximately 12 minutes to complete. average of the number of health
organizations, and healthcare The purpose of this web-based professionals who receive training and
organizations and also offered assessment is to determine the training technical assistance from the CBA and
proactively. Under this project, there participants’ satisfaction with the PTC grantees during the years 2010 and
will be no duplication of information trainers, training materials, and the 2011. The data collection is necessary
collection, because it builds on existing, course pace, benefits from the training, (a) to assess CBA consumers’
OMB approved data collection and CBA needs, how relevant the (community-based organizations, health
activities. training was to their work, and whether departments, and healthcare
The PTCs and CBA providers offer they were able to utilize the information organizations) satisfaction with and
classroom and experiential training, gained from the training. The second short-term outcomes from the overall
web-based training, clinical quantitative assessment will be CBA program as well as specific
consultation, and capacity building disseminated 45 days after a technical elements of the CBA program; (b) to
assistance to maintain and enhance the assistance event to agency staff who improve CBA services and enhance the
capacity of healthcare professionals to participated in a technical assistance. Capacity Building Branch’s national
control and prevent STDs and HIV. The This instrument takes approximately 12 capacity building strategy over time; (c)
CBA service recipients are healthcare minutes to complete. The purpose of the to assess the performance of the grantees
professionals who work at community- second assessment is to assess in delivering training and technical
based organizations (CBOs), health participants’ satisfaction with the
assistance and to standardize the
departments, and healthcare technical assistance they received,
registration processes across the two
organizations, most of whom are funded intended or actual use of enhanced
CBA programs (i.e., the PTC program
directly or indirectly by the CDC, capacity, barriers and facilitators to use,
involved in HIV prevention service and the CBA program) and multiple
and benefits of the technical assistance.
delivery. Their positions include HIV The purpose of the CBA Key grantees funded by each program.
educator, clinical supervisor, HIV Informant Interview is to collect There are no costs to respondents
prevention specialist, clinician, qualitative information to assess the other than their time. The estimated
outreach worker, case manager director, impact of CBA services on annualized burden hours for this data
program coordinator, program manager, organizational capacity (e.g., application collection activity are 3,710 hours.

ESTIMATED ANNUALIZED BURDEN HOURS
Average
Number of Total
Number of burden per
Type of respondent Form name responses per burden
respondents response
respondent hours
(in hours)

Healthcare professionals .................. Training Follow-up Instrument ......... 3,700 2 15/60 1,850
Technical Assistance Satisfaction 3,700 2 15/60 1,850
Instrument.
CBA Key Informant Interview ........... 40 1 15/60 10

Total ........................................... ........................................................... ........................ ........................ ........................ 3,710

Leroy A. Richardson, DEPARTMENT OF HEALTH AND (OMB) for review and approval in
Chief, Information Collection Review Office, HUMAN SERVICES accordance with the Paperwork
Office of Scientific Integrity, Office of the Reduction Act of 1995. The notice for
Associate Director for Science, Office of the Centers for Disease Control and the proposed information collection is
Director, Centers for Disease Control and Prevention published to obtain comments from the
Prevention. public and affected agencies.
[FR Doc. 2015–03618 Filed 2–23–15; 8:45 am] [30Day–15–0900] Written comments and suggestions
tkelley on DSK3SPTVN1PROD with NOTICES

BILLING CODE 4163–18–P
Agency Forms Undergoing Paperwork from the public and affected agencies
Reduction Act Review concerning the proposed collection of
information are encouraged. Your
The Centers for Disease Control and comments should address any of the
Prevention (CDC) has submitted the following: (a) Evaluate whether the
following information collection request proposed collection of information is
to the Office of Management and Budget necessary for the proper performance of

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9726 Federal Register / Vol. 80, No. 36 / Tuesday, February 24, 2015 / Notices

the functions of the agency, including Migration and Quarantine (DGMQ) determine the level of exposure a
whether the information will have requests revision to a currently member of the cleaning crew who
practical utility; (b) Evaluate the approved information collection, OMB serviced a flight with an ill patient(s).
accuracy of the agencies estimate of the Control No 0920–0900, Contact • Ebola exposure Assessment Airport
burden of the proposed collection of Investigation Outcome Reporting Forms. or other port of entry staff—This
information, including the validity of CDC is requesting the addition of Ebola-
questionnaire is utilized for airport staff
the methodology and assumptions used; specific information collection tools to
(c) Enhance the quality, utility, and who may have come into contact with
supplement the Centers for Disease
clarity of the information to be Control and Prevention’s (CDC) routine a person ill with Ebola. Airport staff is
collected; (d) Minimize the burden of contact investigation activities so that identified through conversations with
the collection of information on those CDC can better assess the risk to airport authority to determine which
who are to respond, including through individuals who may have been employees carried out tasks that would
the use of appropriate automated, exposed to a confirmed case of Ebola have put them in contact with the ill
electronic, mechanical, or other while traveling to or within the United person or their body fluids.
technological collection techniques or States. These forms were approved by • Passengers of other commercial
other forms of information technology, OMB under an emergency clearance, conveyance Ebola exposure
e.g., permitting electronic submission of OMB Control No 0920–1032. The questionnaire—This questionnaire
responses; and (e) Assess information additional forms to be added are as collects the same information as the
collection costs. follows: airline passenger questionnaire but will
To request additional information on • Ebola Airline passenger exposure
the proposed project or to obtain a copy be utilized for passengers of commercial
questionnaire—This contact conveyance that is land- or waterborne.
of the information collection plan and investigation form gathers information
instruments, call (404) 639–7570 or from airline passengers who traveled on • Finally, the introduction and
send an email to omb@cdc.gov. Written plane(s) and sat within a 3 foot area confirmation script is to be used by CDC
comments and/or suggestions regarding around the suspected case and travel staff manning open call lines available
the items contained in this notice companions of the suspected case to for persons who traveled on planes that
should be directed to the Attention: determine the level of exposure and carried suspected or confirmed patients
CDC Desk Officer, Office of Management risk, as well as other passengers who with Ebola. As with the other
and Budget, Washington, DC 20503 or may have had contact with the case’s questionnaires, this script assesses the
by fax to (202) 395–5806. Written bodily fluids. Information gathered in risk of a plan passenger who was not in
comments should be received within 30 this form is shared with the CDC to the immediate vicinity of the Ebola
days of this notice. determine risk level. Risk levels are patient but still has concerns about the
Proposed Project outlined in CDC’s Movement and level of exposure and risk of contracting
Contact Investigation Outcome Monitoring Guidance. the virus.
Reporting Forms (0920–0900)— • Ebola exposure Assessment Flight CDC is not proposing any changes to
Revision—(expiration date: October 31, Crew—The flight exposure the routine contact investigation forms
2017)—National Center for Emerging questionnaire is used to ascertain the already approved under this
and Zoonotic Infectious Diseases same relevant information included in information collection request.
(NCEZID), Division of Global Migration the passenger questionnaire for all crew
who worked on flight(s) and came into The total burden associated with this
and Quarantine (DGMQ), Centers for
contact with Ebola patient(s). revision is 10,949 hours, including both
Disease Control and Prevention (CDC).
• Ebola exposure Assessment standard contact investigation forms
Background and Brief Description Cleaning Crew—This form collects the and updated forms to account for Ebola
The Centers for Disease Control and same information as the flight crew transmission. There are no costs to
Prevention (CDC), Division of Global exposure questionnaire, used to respondents other than their time.

ESTIMATED ANNUALIZED BURDEN HOURS
Average
Number of Number of
Type of respondent Form name burden per
respondents responses per response

State/local health department staff ................. General Contact Investigation Outcome Re- 12 1 5/60
porting Form (Air).
Cruise Ship Physicians/Cargo Ship Managers General Contact Investigation Outcome Re- 100 1 5/60
porting Form (Maritime—word version).
Cruise Ship Physicians/Cargo Ship Managers General Contact Investigation Outcome Re- 100 1 5/60
porting Form (Maritime—Excel version).
State/local health department staff ................. General Contact Investigation Outcome Re- 12 1 5/60
porting Form (Land).
State/local health department staff ................. TB Contact Investigation Outcome Reporting 1,244 1 5/60
Form (Air).
Cruise Ship Physicians/Cargo Ship Managers TB Contact Investigation Outcome Reporting 150 1 5/60
tkelley on DSK3SPTVN1PROD with NOTICES

Form (Maritime—word version).
Cruise Ship Physicians/Cargo Ship Managers TB Contact Investigation Outcome Reporting 150 1 5/60
Form (Maritime—Excel version).
State/local health department staff ................. Measles Contact Investigation Outcome Re- 964 1 5/60
porting Form (Air).
Cruise Ship Physicians/Cargo Ship Managers Measles Contact Investigation Outcome Re- 63 1 5/60
porting Form (Maritime—word version).

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Document Created: 2015-12-18 13:23:20
Document Modified: 2015-12-18 13:23:20

Category		Regulatory Information
Collection		Federal Register
sudoc Class		AE 2.7: GS 4.107: AE 2.106:
Publisher		Office of the Federal Register, National Archives and Records Administration
Section		Notices
Dates		October 31, 2017)--National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Global Migration and Quarantine (DGMQ), Centers for Disease Control and Prevention (CDC).
FR Citation		80 FR 9725

80 FR 9725 - Agency Forms Undergoing Paperwork Reduction Act Review

DEPARTMENT OF HEALTH AND HUMAN SERVICESCenters for Disease Control and Prevention

Federal Register Volume 80, Issue 36 (February 24, 2015)

DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention