Medical Monitoring Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
MMP Attach 5 B3.doc	Supplementary Document	Uploaded 2007-06-07	Available
MMP Attach 5A4.doc	Supplementary Document	Uploaded 2007-06-07	Available
MMP Attach 5A3.doc	Supplementary Document	Uploaded 2007-06-07	Available
MMP Attach 4.doc	Supplementary Document	Uploaded 2007-06-07	Available
MMP Attach 3 Medical Record Abst instr[1]..doc	Supplementary Document	Uploaded 2007-06-07	Available
Attachment 10 MMP Sample Size by Project Area.doc	Supplementary Document	Uploaded 2007-06-07	Available
Attachment 9 Model Patient Recruitment Scripts.doc	Supplementary Document	Uploaded 2007-06-07	Available
Attachment 8 Assurance confid.doc	Supplementary Document	Uploaded 2007-06-07	Available
Attachment 7 MMP Model consent form.doc	Supplementary Document	Uploaded 2007-06-07	Available
Supporting Statement Section B only.doc	Supporting Statement B	Uploaded 2007-01-03	Available
Supporting Statement revised for OMB 5-15-2007.doc	Supporting Statement A	Uploaded 2007-06-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
180569	Patients approached by facility staff for enrollment	Instruction	New
180568	Facility staff providing patient lists	Instruction	New
180566	Facility staff providing EPLs	Instruction	New
180565	Facility Staff pulling medical records	Instruction	New
178498	Persons interviewed with short and Proxy interview	Instruction	New
178497	Persons Interviewed with standard interview	Instruction	New

ICR Details

OMB Control No: 0920-0740	ICR Reference No: 200701-0920-006
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Medical Monitoring Project
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/11/2007
	Date Received in OIRA: 01/26/2007
Terms of Clearance: Approved consistent with CDC revisions to the ICR justification and associated forms.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2010	36 Months From Approved
Responses	20,894	0	0
Time Burden (Hours)	9,123	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Institute of Medicine recommended that HRSA and CDC evaluate the cost and utility of redesigning studies to assess the specific needs and circumstances of people living with HIV and the benefits of obtaining locally and nationally representative data on behaviors and clinical outcomes. CDC, in partnership with other federal agencies and state and local health departments, is working to obtain a national probability sample of patients in care for HIV infection through the Medical Monitoring Project (MMP). The MMP will provide population-based estimates of clinical outcomes of interest, including quality of care, access to and use of HIV care, treatment and prevention services, and levels of ongoing risk behaviors among person living with HIV infection.

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Authorizing Statute(s): US Code: 42 USC 301 (241.)a. Name of Law: Research and investigations generally
  

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:
	71 FR 63016	10/27/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 567	01/05/2007
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Persons Interviewed with standard interview
Persons interviewed with short and Proxy interview
Facility Staff pulling medical records
Facility staff providing EPLs
Patients approached by facility staff for enrollment
Facility staff providing patient lists

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ICR Summary of Burden

table that charts list 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	20,894	0	0	20,894	0	0
Annual Time Burden (Hours)	9,123	0	0	9,123	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: No

Burden Reduction Due to:

Short Statement: This is a new collection request.

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Annual Cost to Federal Government: $12

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

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: 01/12/2007

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