Emergency Approval Letter

July 22, 2022

Sharon Block, Acting Administrator

Office of Information and Regulatory Affairs

Office of Management and Budget

Dear Acting Administrator Block,

The Department of State requests Office of Management and Budget (OMB) emergency processing of the proposed expansion of the respondent pool for DS-7794, Electronic Medical Examination for Visa Applicant, also known as “eMedical”(OMB Control Number 1405-0230) to include parolees, pursuant to the process established in 5 C.F.R. 1320.13.

In August 2021, the Department issued a series of Security Alerts for Afghanistan due to increased Taliban activity throughout the country, including in the capital of Kabul. In response to these developments, the U.S. government implemented measures to expedite the evacuation of U.S. citizens, lawful permanent residents, immigrant visa applicants, or others affiliated with the U.S. government. Due to the emergency circumstances, many of the Afghan evacuees were unable to apply for an immigrant visa prior to the evacuation and therefore must apply for humanitarian parole with the U.S. Citizenship and Immigration Services (USCIS) to be granted parolee status upon arrival to the United States. Many of the people seeking parolee status are coming from areas with limited healthcare access and were in congregate settings during the evacuation process, raising the risk of disease spread such as COVID-19 and measles. It has been determined by USCIS and by HHS/CDC as a condition of being granted humanitarian parole, these individuals must undergo a physical exam, which includes a tuberculosis exam and the administration of certain specified vaccinations. This is necessary to prevent introduction and spread of communicable diseases in U.S. communities receiving parolees.

The Secretary of HHS also has statutory authority to prevent the introduction, transmission, and spread of communicable diseases into the United States (42 U.S.C. § 264). These functions are also carried out by the Director of the CDC. In furtherance of carrying out this authority, CDC has promulgated regulations at 42 C.F.R. Parts 70 and 71. Under 42 C.F.R. 71.20, CDC may conduct public health prevention measures, at U.S. ports of entry or other locations, through non-invasive procedures as defined in section 42 C.F.R. 71.1 to detect the potential presence of communicable diseases. Consistent with these authorities, CDC and USCIS are coordinating to ensure that the medical examination data is transferred to state health departments. Under CDC’s System of Records Notice 09-90-2001, Records Used for Surveillance and Study of Epidemics, Preventable Diseases and Problems, CDC will share this information with state health departments to facilitate medical care to these populations as needed to protect the public health of U.S. communities.

 

USCIS and CDC believe using DS-7794, Electronic Medical Examination for Visa Applicant, is the most efficient and rapid way to record the information and share it with the necessary federal, state, and local authorities and requested from the Department of State permission to use eMedical for the purposes described above. Pursuant to 5 CFR 1320.13, the Department of State has determined that expanding the DS-7794 to include this medical information for parolee applicants is needed prior to the expiration of periods normally associated with a routine submission for review under the provisions of the Paperwork Reduction Act, that this information collection is essential to the mission of processing Afghan parolees, and that public harm is reasonably likely to result if normal clearance procedures are followed.

The medical examination data collected using the DS-7794 will be entered into the eMedical system to securely transfer health information to CDC’s Electronic Disease Notification (EDN) system, a system that already actively notifies U.S. public health departments and/or other authorized healthcare providers when a visa holder or refugee arrives in their jurisdiction to reduce the risk of transmission and spread of communicable diseases in U.S. communities. The parolee information that will be collected and submitted to eMedical includes name and contact information, alien registration number, tuberculosis testing, vaccination records, and if available, any significant medical history and or conditions that may require medical follow-up. This information will be shared with relevant state health departments so they can share with local health departments to facilitate any needed medical care to reduce risk of communicable disease spread. It also helps reduce duplication in vaccination of these populations and costs if state health departments know which vaccines have already been provided. The information collected will not be shared with or housed in any Department of State system.

Were eMedical not used to collect this information, it could result in an increased risk of transmission and spread of communicable diseases in U.S. communities and has the potential to overwhelm the state health departments and the healthcare industry, which has already been struggling to respond to the COVID-19 pandemic. By allowing this information to be collected on the DS-7794, (OMB Control No. 1405-0230) the government will be able to mitigate the risk of communicable disease transmission and minimize harm.

Therefore, the Department requests emergency OMB processing and approval for this revised information collection by January 5, 2022 to allow for immediate use.

Sincerely,

Julie M. Stufft

Deputy Assistant Secretary,

Bureau of Consular Affairs,

Department of State.