U.S. DIRECT HIRE REQUEST FOR A MEDICAL EXCEPTION TO THE COVID-19 VACCINATION REQUIREMENT

ICR 202110-0412-003

OMB: 0412-0612

Federal Form Document

IC Document Collections
ICR Details
202110-0412-003
Received in OIRA
AID
U.S. DIRECT HIRE REQUEST FOR A MEDICAL EXCEPTION TO THE COVID-19 VACCINATION REQUIREMENT
New collection (Request for a new OMB Control Number)   No
Emergency 11/01/2021
10/28/2021
  Requested Previously Approved
6 Months From Approved
40 0
30 0
0 0

As required by Executive Order 14043, USAID is implementing the federal COVID-19 vaccination mandate and is considering employees’ requests for legally-required exceptions or delays to the mandate. In order to process and determine appropriate accommodations for requests for medical exceptions or delays, USAID must collect the medical information necessary for case evaluation. Respondents will be USAID direct-hire employees requesting a medical exceptions to the COVID-19 vaccination mandate.
Our request meets the standard for emergency processing as the Agency needs adequate medical information and time to process legally-required medical exceptions to the federal vaccine requirement, and Federal employees must receive their last dose of their vaccine no later than November 8, 2021, to meet the November 22, 2021 deadline to be fully vaccinated. Additionally, the COVID-19 pandemic is an unanticipated event with immediate risks to workforce lives, warranting emergency processing. These forms are critical to USAID's compliance with the federal vaccination mandate and COVID-19 response efforts as we need employees requesting medical exceptions to obtain verified medical information from their health care provider(s) in order to adequately evaluate employees for an exception or delay.

EO: EO 13991 Name/Subject of EO: Executive Order on Protecting the Federal Workforce and Requiring Mask-Wearing
   EO: EO 14043 Name/Subject of EO: Executive Order on Requiring Coronavirus Disease 2019 Vaccination for Federal Employees
   US Code: 5 USC 2105 Name of Law: Government Organization and Employees
  
None

Not associated with rulemaking

No

  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 40 0 0 40 0 0
Annual Time Burden (Hours) 30 0 0 30 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new collection.

$0
No
    Yes
    Yes
No
No
No
Yes
Taniesha Tolbert 202 712-1217 ttolbert@usaid.gov

  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.
10/28/2021


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