Request for one time addition of 16 data elements

National Notifiable Diseases Surveillance System (NNDSS)

OMB Control Number 0920-0728

Expiration Date: 02/28/2021

Program Contact

Umed Ajani

Associate Director for Science

Division of Health Informatics and Surveillance

Center for Surveillance, Epidemiology and Laboratory Services

Centers for Disease Control and Prevention

1600 Clifton Rd, MS-E91

Atlanta, GA 30329

Phone: (404) 498-0258

E-mail: uajani@cdc.gov

Submission Date: March 23, 2018

Circumstances of Change Request for OMB 0920-0728

This is a nonmaterial/non-substantive change request for OMB No. 0920-0728, expiration date 02/28/2021, for the reporting of Nationally Notifiable Diseases. The National Notifiable Diseases Surveillance System (NNDSS) is the nation’s public health surveillance system that enables all levels of public health (local, state, territorial, federal and international) to monitor the occurrence and spread of the diseases and conditions that the Council of State and Territorial Epidemiologists (CSTE) has officially designated as either “nationally notifiable” or as under “standardized surveillance.”

The NNDSS facilitates the submission and aggregation of case notification data voluntarily submitted to CDC from 60 jurisdictions: health departments in every U.S. state, New York City, Washington DC, 5 U.S. territories (American Samoa, the Commonwealth of Northern Mariana Islands, Guam, Puerto Rico, and the U.S. Virgin Islands), and 3 freely associated states (Federated States of Micronesia, the Republic of the Marshall Islands, and the Republic of Palau). NNDSS also facilitates relevant data management, analysis, interpretation and dissemination of the information. The data are used to monitor health occurrence of notifiable conditions and to plan and conduct prevention and control programs at the state, territorial, local and national levels.

This request is for the addition of 16 new disease-specific data elements: 7 new data elements for rubella, 1 new data element for congenital rubella syndrome (CRS) and 8 new data elements for measles.

The first request is for the addition of 7 new data elements for rubella. The data elements included in this change request will contribute to enhanced surveillance efforts on the part of the CDC program and allow the program to perform additional epidemiological analyses for rubella.

The new data elements requiring the change request are in the following table:

New Rubella Data Elements

Data Element Identifier	Data Element Name	Data Element Description
INV963	Part of Outbreak	Is this case part of an outbreak of 3 or more
TRAVEL08	Date of Return from Travel	Date of return from most recent travel
223366009	Case Patient a Healthcare Worker	Was the case patient a healthcare provider (HCP) at illness onset?
85676-5	Previous case diagnosed by	Who diagnosed previous case?
82745-1	Vaccination Doses Prior to Onset	Number of vaccine doses against this disease prior to illness onset
VAC142	Date of Last Dose Prior to Illness Onset	Date of last vaccine dose against this disease prior to illness onset
VAC133	Vaccine History Comments	Comments about the subject's vaccination history

The second request is for the addition of 1 new disease-specific data element for CRS. This requested data element will enhance CDC’s surveillance efforts by allowing identification of clinical specimens collected from the mother or infant.

The new data element requiring the change request is in the following table:

New CRS Data Element

Data Element Identifier	Data Element Name	Data Element Description
85793-8	Specimen from mother or infant	Is the specimen from the mother or infant?

The third request is for the addition of 8 new data elements for measles. The data elements included in this change request will contribute to enhanced surveillance efforts on the part of the CDC program and allow the program to perform additional epidemiological analyses for measles.

The new data elements requiring the change request are in the following table:

New Measles Data Elements

Data Element Identifier	Data Element Name	Data Element Description
85949-6	Age at Rash Onset	Age of patient at rash onset
N/A: OBX-6 for 85949-6	Age Type at rash Onset	Age units of patient at rash onset
INV923	Chest x-ray for pneumonia	Was a chest x-ray for pneumonia done?
223366009	Case Patient a Healthcare Worker	Was the case patient a healthcare provider (HCP) at illness onset?
INV293	Import Status	Was this case imported?
82745-1	Vaccination Doses Prior to Illness Onset	Number of vaccine doses against this disease prior to illness onset
VAC142	Date of Last Dose Prior to Illness Onset	Date of last vaccine dose against this disease prior to illness onset
VAC133	Vaccine History Comments	Comments about the subject's vaccination history

Burden

Reporting jurisdictions will send these additional rubella, CRS and measles data elements to CDC electronically through NNDSS since rubella, CRS, and measles case notifications from these reporting jurisdictions are submitted electronically from existing surveillance databases. This change request does not apply to the territories and freely associated states since they do not yet send their rubella, CRS and measles case notifications electronically to CDC. The addition of rubella, CRS and measles data elements will add a minimal one-time burden for reporting jurisdictions. Many jurisdictions already collect this information through routine case reporting; for jurisdictions not currently collecting these data, future implementation will be prospective, not requiring re-coding or re-ascertainment of any new information for previously reported cases. A one-time average burden of 70 minutes will be incurred for jurisdictions to modify their electronic case notification message to accommodate the additional data elements. For the jurisdictions that do not already collect these data, an additional one-time average burden of 70 minutes will be incurred to add the additional data elements to their jurisdiction’s surveillance system. This one-time burden of up to 140 minutes is noted in the following table:

One Time Burden to Add 4 Data Elements to NNDSS

Type of Respondents	Number of Respondents	Number of Responses per Respondent	Average One-Time Burden (in hours)	Total One-Time Burden (in hours)
States	50	1	140/60	117
Territories	5	N/A	N/A	0
Freely Associated States	3	N/A	N/A	0
Cities	2	1	140/60	5
Total				122

Since this increase in burden is one-time, minimal, and only applicable to those jurisdictions that transmit case notifications electronically, its effect on the annualized burden hours is 41 hours (39 hours for states and 2 hour for cities).

A.12A. Estimates of Annualized Burden Hours

Type of Respondents	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden Per Response (in hours)	Total Burden (in hours)
States	Weekly (Automated)	50	52	20/60	867
States	Weekly (Non- automated)	10	52	2	1,040
States	Weekly (NMI Implementation)	50	52	4	10,400
States	Annual	50	1	75	3,750
States	One-time Addition of Diseases and Data Elements	50	1	8	458*
Territories	Weekly (Automated)	1	52	20/60	17
Territories	Weekly, Quarterly (Non-automated)	5	56	20/60	93
Territories	Weekly (NMI Implementation)	5	52	4	1,040
Territories	Annual	5	1	5	25
Territories	One-time Addition of Diseases and Data Elements	1	1	10/60	0**
Freely Associated States	Weekly, Quarterly (Non-automated)	3	56	20/60	56
Freely Associated States	Annual	3	1	5	15
Cities	Weekly (Automated)	2	52	20/60	35
Cities	Weekly (Non-automated)	2	52	2	208
Cities	Weekly (NMI Implementation)	2	52	4	416
Cities	Annual	2	1	75	150
Cities	One-time Addition of Diseases and Data Elements	2	1	8	19*
Total					18,589

*An incremental amount of time was added to the average burden per response to equal the one-time addition of burden hours.

**Table A12A in Supporting Statement A shows 1 burden hour but ROCIS rounded it down to 0.

A.12B. Estimates of Annualized Cost Burden

Type of Respondents	Form Name	Number of Respondents	Number of Responses per Respondent	Average Burden Per Response (in hours)	Total Burden Hours	Hourly Wage Rate	Respondent Cost
States	Weekly (Automated)	50	52	20/60	867	$44.05	$38,191
States	Weekly (Non-automated)	10	52	2	1,040	$37.37	$38,865
States	Weekly (NMI Implementation)	50	52	4	10,400	$44.05	$458,120
States	Annual	50	1	75	3,750	$37.37	$140,138
States	One-time Addition of Diseases and Data Elements	50	1	8	458	$44.05	$20,175
Territories	Weekly (Automated)	1	52	20/60	17	$44.05	$749
Territories	Weekly, Quarterly (Non-automated)	5	56	20/60	93	$37.37	$3,475
Territories	Weekly (NMI Implementation)	5	52	4	1,040	$44.05	$45,812
Territories	Annual	5	1	5	25	$37.37	$934
Territories	One-time Addition of Diseases and Data Elements	1	1	10/60	1	$44.05	$44
Freely Associated States	Weekly, Quarterly (Non-automated)	3	56	20/60	56	$37.37	$2,093
Freely Associated States	Annual	3	1	5	15	$37.37	$561
Cities	Weekly (Automated)	2	52	20/60	35	$44.05	$1,542
Cities	Weekly (Non-automated)	2	52	2	208	$37.37	$7,773
Cities	Weekly (NMI Implementation)	2	52	4	416	$44.05	$18,325
Cities	Annual	2	1	75	150	$37.37	$5,606
Cities	One-time Addition of Diseases and Data Elements	2	1	8	19	$44.05	$837
Total							$783,240

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