National HIV Prevention Program Monitoring and Evaluation (NHM&E)

Forms and Documents

Document Name	Status
PEMS Data Collection for Community-Based Organizations (Training) Form	Removed
PEMS Data Collection for Health Jurisdictions (Training) Form	Removed
Counseling, Testing and Referral for Community-Based Organizations Form and Instruction	Removed
PEMS Data Collection for Health Jurisdictions (HIV testing non-scan) Form	Removed
Supporting Statement B.docx Supporting Statement B	2013-01-03
IRB Determination.pdf Supplementary Document	2013-01-03
Final Renewal AoC NHM&E Document (3).pdf Supplementary Document	2013-01-03
Attach7 CDC HIV Data Collections.docx Supplementary Document	2013-01-03
Attach8 Eval-Web_ATO.pdf Supplementary Document	2013-01-03
Attach4 Agencies and Persons Consulted.doc Supplementary Document	2013-01-03
Attach2 60 Day FRN Published.pdf Supplementary Document	2013-01-03
Attach1 Legislative Authority.pdf Supplementary Document	2013-01-03
Attachment 6 B CDC Data Systems ROB Systems Administrators.pdf Supplementary Document	2013-01-28
Attach6 A CDC Data Systems ROB System Users.pdf Supplementary Document	2013-01-28
Attach5 PEB NHME Comprehensive DVS v11-02-2012.pdf Supplementary Document	2013-01-03
Attachment 3 A PEMS Home Page.docx Supplementary Document	2010-06-21
Attach5 PEB NHME Comprehensive DVS v11-02-2012.pdf Supplementary Document	2013-01-03
Attach5 PEB NHME Comprehensive DVS v11-02-2012.pdf Supplementary Document	2013-01-03
Sup_Sta_A[012813].docx Supporting Statement A	2013-01-28

IC Document Collections

IC ID	Document Title	Status
7165	Health Department Data Other-Evaluation Web	Modified
205581	Community Based Organizations: NH&E Data Training Other-WORD	New
180698	PEMS Data Collection for Community-Based Organizations (Training) Form	Removed
180697	PEMS Data Collection for Health Jurisdictions (Training) Form	Removed
180696	Counseling, Testing and Referral for Community-Based Organizations Form and Instruction	Removed
180695	PEMS Data Collection for Health Jurisdictions (HIV testing non-scan) Form	Removed
180694	Community Based Organization HE/RR Data Other-EvaluationWeb	Modified
180693	Community-Based Organizations - Agency Data Other-EvaluationWeb	Modified

ICR Details

OMB Control No: 0920-0696	ICR Reference No: 201301-0920-009
Status: Historical Active	Previous ICR Reference No: 201108-0920-006
Agency/Subagency: HHS/CDC	Agency Tracking No: 18378
Title: National HIV Prevention Program Monitoring and Evaluation (NHM&E)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/20/2013
	Date Received in OIRA: 01/30/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2016	36 Months From Approved	08/31/2013
Responses	1,338	0	3,580
Time Burden (Hours)	206,226	0	301,208
Cost Burden (Dollars)	0	0	0

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Abstract: CDC is requesting approval for a 3 year REVISION of a previously approved project. The initial PEMS OMB request was approved in 2005, for one year; reinstated 2007, for three years; and revised 2010 for three years. The purpose of this revision is to continue collecting standardized HIV prevention program evaluation data from health departments and community-based organizations (CBOs) who receive federal funds for HIVE prevention activities. The previous reporting system PEMS has been replaced by a more efficient reporting software National HIV Prevention Program Monitoring and Evaluation (NHM&E).

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Authorizing Statute(s): US Code: 42 USC 306 Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 163	08/22/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 307	01/03/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
PEMS Data Collection for Health Jurisdictions (Training)	none	NHM&E variables
PEMS Data Collection for Community-Based Organizations (Training)	none	NHM&E variables
Health Department Data
Community-Based Organizations - Agency Data
Community Based Organization HE/RR Data
Community Based Organizations: NH&E Data Training
PEMS Data Collection for Health Jurisdictions (HIV testing non-scan)	none	NHM&E variables
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

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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	1,338	3,580	0	-2,242	0	0
Annual Time Burden (Hours)	206,226	301,208	0	-94,982	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is a Revision there has been a significant decrease in burden which is caused by a significant reduction in the number of required and optional reported variables. The change from quarterly to semiannual reporting also reduced the burden. In addition, the switch to more efficient reporting software has provided a reduction in the actual data entry burden.

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Annual Cost to Federal Government: $788,424

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

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Common Form ICR:  No

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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: 01/30/2013

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