SCTF AM-DAM EmergReq SS_B 20150330clean

SCTF AM-DAM EmergReq SS_B 20150330clean.docx

Emergency Submission for Active Monitoring of Travelers Coming from Ebola-affected Countries and Their Contacts Currently Residing in State, Territorial, and Local Jurisdictions

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Emergency Submission for


Active Monitoring of Travelers Coming from Ebola-affected Countries and

Their Contacts Currently Residing in

State, Territorial, and Local Jurisdictions




Supporting Statement B


Collection of Information Employing Statistical Methods





Existing Collection in Use without OMB Control Number








Program Contact


Sara Vagi

Ebola State Coordination Task Force – Evaluation and Monitoring Unit

Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention

1600 Clifton Road, N.E., MS D18

Atlanta, Georgia 30333

Phone: (404) 639-0879

Email: hgq2@cdc.gov


Submission Date: March 23, 2015

Table of Contents



  1. Collection of Information Employing Statistical Methods

1. Respondent Universe and Sampling Methods

2. Procedures for the Collection of Information

3. Methods to Maximize Response Rates and Deal with No response

4. Tests of Procedures or Methods to be Undertaken

5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data



List of Attachments

Attachment A: Authorizing Legislation

Attachment B: CDC Interim Guidance for Monitoring and Movement of Persons with Potential Ebola Virus Exposure

Attachment C: Daily Direct Active Monitoring (DAM) Recording and CDC Reporting Form (Excel)

Attachment D: Daily Direct Active Monitoring (DAM) Recording and CDC Reporting Form (Web)

Attachment E: Weekly Active Monitoring (AM) CDC Reporting Form (Word)

Attachment F: Weekly Active Monitoring (AM) CDC Reporting Form (Web)

Attachment G- Weekly Notification Email

Attachment H: CDC Assistance Memo for State Ebola Preparedness and Response

Attachment I: Association of State and Territorial Health Officers Comments

Attachment J: National Association of County and City Health Officers Comments




Emergency Submission for

Active Monitoring of Travelers Coming from Ebola-affected Countries and Their Contacts Currently Residing in State, Territorial, and Local Jurisdictions



B. Collections of Information Employing Statistical Methods


  1. Respondent Universe and Sampling Methods


The potential respondent universe for these data collections consists of the 62 state, territorial and local health departments (50 states, 8 territories, and 4 cities)1 that receive funds through the CDC Public Health Preparedness (PHEP) Cooperative Agreement (CDC-RFA-TP12-1201). Only states, territories, and cities that have persons assigned to active or direct active monitoring will be required to report; jurisdictions that do not have persons at risk of Ebola virus disease (EVD) will not be required to report.


2. Procedures for the Collection of Information


Daily direct active monitoring will be collected via one of two methods. Each jurisdiction will receive a daily Excel spreadsheet [Attachment C & D: Daily Direct Active Monitoring (DAM) Recording and CDC Reporting Form (Excel & Web)] containing information for the persons in the jurisdiction who are under direct active monitoring. Respondents will be asked to either 1) complete between 1 and 5 fields (as appropriate) in the spreadsheet and to return the spreadsheet by email; or 2) to respond directly via email with the pertinent information.


Data for the weekly active monitoring reporting will be collected by two optional modes: either by a Word reporting form or by a web-based tool [Attachments E & F: Weekly Active Monitoring (AM) CDC Reporting Form (Word & Web)]. Respondents will receive a weekly email on Tuesdays (Attachment H- Weekly Notification Email) containing a link to the active monitoring tool. Respondents will have 24 hours to provide information for the preceding week (Monday- Sunday).




3. Methods to Maximize Response Rates and Deal with Nonresponse


The State Epidemiologist, representing any jurisdiction that does not respond within the prescribed time period for reporting, will receive a phone from the CDC State Coordination Task Force. State Epidemiologists will be reminded of the reasons that reporting is required, the uses of the requested information and the proper procedures for reporting.

In addition, the weekly notification email (Attachment G) will serve as a reminder that CDC is expecting timely reports.

4. Tests of Procedures or Methods to be Undertaken


The web-based assessment was pilot tested by 7 public health professionals within the jurisdictions receiving the greatest numbers of travelers from Ebola- affected countries. In the pilot test, the average time to complete the daily direct active monitoring form was 5 minutes. The average time to complete the weekly active monitoring report instrument including time for gathering needed information and completing the instrument, was approximately 8 minutes. Based on these results, the estimated time range for actual respondents to complete the instrument is 5-15 minutes. For the purposes of estimating burden hours, the upper limit of this range (i.e. 15 minutes) is used.


5. Individuals Consulted on Statistical Aspects and Individuals Collecting and/or Analyzing Data


Two CDC staff members will be responsible for majority of the data collection and analysis activities.


Name: Sara Vagi

Title: Senior Epidemiologist

Phone: 404-639-0879

Email: SVagi@cdc.gov


Name: Michael Fanning

Title: Behavioral Scientist

Email: eocstate@cdc.gov


1 There are the 62 PHEP cooperative agreement awardees who are the respondents. For more information on the cooperative agreement program, see: http://www.cdc.gov/phpr/coopagreement.htm.

  • All 50 states

  • Four major metropolitan areas (Chicago, Los Angeles County, New York City, and Washington, D.C.)

  • Eight U.S. territories and freely associated states (American Samoa, Guam, U.S. Virgin Islands, Northern Mariana Islands, Puerto Rico, Federated States of Micronesia, Republic of the Marshall Islands, and Republic of Palau).

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