[Federal Register Volume 86, Number 164 (Friday, August 27, 2021)]
[Notices]
[Pages 48144-48145]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-18539]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-21-1102]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled Tuberculosis Data from Panel Physicians to 
the Office of Management and Budget (OMB) for review and approval. CDC 
previously published a ``Proposed Data Collection Submitted for Public 
Comment and Recommendations'' notice on May 26, 2021 to obtain comments 
from the public and affected agencies. CDC received one non-substantive 
comment related to the previous notice. This notice serves to allow an 
additional 30 days for public and affected agency comments.
    CDC will accept all comments for this proposed information 
collection project. The Office of Management and Budget is particularly 
interested in comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of 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. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. Direct 
written comments and/or suggestions regarding the items contained in 
this notice to the Attention: CDC Desk Officer, Office of Management 
and Budget, 725 17th Street NW, Washington, DC 20503 or by fax to (202) 
395-5806. Provide written comments within 30 days of notice 
publication.

Proposed Project

    Tuberculosis Data from Panel Physicians (OMB Control No. 0920-1102, 
Exp. 9/30/2021)--Revision--National Center for Emerging and Zoonotic 
Infectious Diseases (NCEZID), Centers for Disease Control and 
Prevention (CDC).

Background and Brief Description

    The Centers for Disease Control and Prevention's (CDC), National 
Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division 
of Global Migration and Quarantine (DGMQ), Immigrant, Refugee, and 
Migrant Health Branch (IRMH), requests approval for a Revision to an 
approved information collection. The respondents are U.S. panel 
physicians. Panel physicians are medically trained, licensed, and 
experienced medical doctors practicing overseas who are appointed by 
the local U.S. Embassy or Consulate General to perform medical 
examinations for prospective immigrants to the United States. More than 
760 panel physicians perform overseas pre-departure medical 
examinations at 336 panel sites, in accordance with requirements, 
referred to as Technical Instructions, provided by the Centers for 
Disease Control and Prevention's Division of Global Migration and 
Quarantine, Quality Assessment Program (QAP). The QAP program is housed 
in the Immigrant, Refugee, and Migrant Health Branch (IRMH). The role 
of QAP is to assist and guide panel physicians in the implementation of 
the Technical Instructions; evaluate the quality of the overseas 
medical examination for U.S.-bound immigrants and refugees; assess 
potential panel physician sites; and provide recommendations to the 
U.S. Department of State in matters of immigrant medical screening.
    To achieve DGMQ's mission, IRMH works with domestic and 
international programs to improve the health of U.S.-bound immigrants 
and refugees to protect the U.S. public by preventing the importation 
of infectious disease. These goals are accomplished through IRMH's 
oversight of medical exams required for all U.S.-bound immigrants and 
refugees who seek permanent residence in the U.S. IRMH is responsible 
for assisting and training the international panel physicians with the 
implementation of medical exam Technical Instructions. CDC's Technical 
Instructions are detailed requirements and national policies regarding 
the medical screening and treatment of all U.S.-bound immigrants and 
refugees.
    Screening for tuberculosis (TB) is a particularly important 
component of the immigration medical exam and allows panel physicians 
to diagnose active TB disease prior to arrival in the United States. As 
part of the Technical Instructions requirements, panel physicians 
perform chest x-rays and laboratory tests that aid in the 
identification of tuberculosis infection (Class B1 applicants) and 
diagnosis of active tuberculosis disease (Class A, inadmissible 
applicants). CDC uses these classifications to report new immigrant and 
refugee arrivals with a higher risk of developing TB disease to U.S. 
state and local health departments for further follow-up. Some 
information that panel physicians collect as part of the medical exam 
is not reported on the standard Department of State forms (DS-forms), 
thereby preventing CDC from evaluating TB trends in globally mobile 
populations and monitoring program effectiveness.
    In 2007, CDC revised the Tuberculosis Technical Instructions to 
include several new requirements for Mycobacteria tuberculosis (MTB) 
testing and treatment. Important changes included the requirements for: 
(1) Sputum cultures in addition to sputum smears; (2) tuberculin skin 
tests or interferon gamma release assays (beginning in 2009) for 
certain children aged 2-14 years examined in countries where the World 
Health Organization estimated TB incidence is >=20 per 100,000 persons; 
(3) drug-susceptibility testing of positive isolates; and (4) treatment 
being delivered as directly observed therapy (DOT) throughout the 
entire course.
    Since implementation of these new Culture and Directly Observed 
Therapy TB Technical Instructions (CDOT TB TI), overseas TB case 
detection has increased by an estimated 60% and allowed U.S. public 
health programs to save millions of dollars annually. Overseas TB 
screening data (referred to by DGMQ as `TB Indicator data') is critical 
to support the continued analysis of these trends and the monitoring of 
TB control efforts in the U.S.
    CDC requests this data collection approval for three years. This 
Revision includes a decrease in respondents from 336 to 333, and a 
decrease in the requested number of burden hours from

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1,008 hours to 999. There is no cost to respondents other than their 
time to participate.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
          Type of respondents                   Form name            Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
International Panel Physicans.........  TB Indicators REDCap web             333               1               3
                                         form.
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-18539 Filed 8-26-21; 8:45 am]
BILLING CODE 4163-18-P