View Information Collection Request (ICR) Package
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Brief and OIRA conclusion
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FR Notices/Comments
IC List
Burden
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Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0696
ICR Reference No:
201108-0920-006
Status:
Historical Active
Previous ICR Reference No:
201103-0920-001
Agency/Subagency:
HHS/CDC
Agency Tracking No:
Title:
National HIV Prevention Program Monitoring and Evaluation (NHM&E) Data.
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
10/12/2011
Retrieve Notice of Action (NOA)
Date Received in OIRA:
08/18/2011
Terms of Clearance:
Previous terms of clearance continue: Approved with the understanding that additional modifications to the collection may be made in light of the National HIV/AIDS Strategy released in 2010.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2013
08/31/2013
08/31/2013
Responses
3,580
0
3,580
Time Burden (Hours)
301,208
0
298,660
Cost Burden (Dollars)
0
0
0
Abstract:
The HIV Prevention Program Evaluation and Monitoring System (PEMS) collects standardized HIV prevention program data from health departments and community-based organizations. The data are used to monitor the delivery of prevention services data to clients and report on required program performance indicators. CDC requests minor changes to the variable collected.
Authorizing Statute(s):
US Code:
42 USC 306
Name of Law: Public Health Service Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
7
IC Title
Form No.
Form Name
Counseling, Testing and Referral for Community-Based Organizations
none, none, none, none
HIV test form - page 1
,
HIV test form - page 2
,
HIV test form - page 3
,
HIV test form - Pacific Islands
Counseling, Testing and Referral for Health Jurisdictions (CTR scan)
none, none, none, none
HIV test scan form - page 3
,
HIV test scan form - page 1
,
HIV test scan form - page 2
,
HIV test scan form - Pacific Islands
PEMS Data Collection for Community-Based Organizations
none
NHM&E variables
PEMS Data Collection for Community-Based Organizations (Training)
none
NHM&E variables
PEMS Data Collection for Health Jurisdictions
none
NHM&E Variables
PEMS Data Collection for Health Jurisdictions (HIV testing non-scan)
none
NHM&E variables
PEMS Data Collection for Health Jurisdictions (Training)
none
NHM&E variables
ICR Summary of Burden
Total Approved
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
3,580
3,580
0
0
0
0
Annual Time Burden (Hours)
301,208
298,660
0
2,548
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$439,666
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Daniel Holcomb 770 488-4472 dwh6@cdc.gov
Common Form ICR:
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
08/18/2011
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