Medical Monitoring Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Patient Short interview	Form	Removed	Available
Patients Standard Interview	Form	Removed	Available
Att 18_Sample sizes.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 17_Model Consent Form.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 16_AgreementToAbide by Restrictions.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 15_Project Determination.pdf	Supplementary Document	Uploaded 2015-03-31	Available
Att 14_Consultants.doc	Supplementary Document	Uploaded 2015-03-31	Available
Att 13_Assurance of Confidentiality.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 12_DCC ATO.pdf	Supplementary Document	Uploaded 2015-03-31	Available
Att 11_MMP Bibliography.pdf	Supplementary Document	Uploaded 2015-03-31	Available
Att 10_Minimum Dataset Elements.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 9_MMP MRA Data Structure 2015.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 7_Contact Tracking Data Elements.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 6_Agreement for Cross-Jurisdictional Data Collection.pdf	Supplementary Document	Uploaded 2015-03-31	Available
Att 5_References.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 3b_Proposed Changes Data Collection Elements Clean.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 3a_Overall Summary of Changes.docx	Supplementary Document	Uploaded 2015-03-31	Available
Att 2 60 day FRN.pdf	Supplementary Document	Uploaded 2015-03-31	Available
Att 1_Sect 301 PHSA.pdf	Supplementary Document	Uploaded 2015-03-31	Available
Supporting Statement B_Clean 5_27_15.doc	Supporting Statement B	Uploaded 2015-05-28	Available
Supporting Statement A_Clean 5_27_15.doc	Supporting Statement A	Uploaded 2015-05-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
180569	Att 4b_Approaching Sampled Patients for Enrollment	Instruction	Modified
180568	Att 4c_Patient Recruitment Script Looking up Contact Info	Instruction	Modified
180566	Att 4a_Model Patient Recruitment Letter	Instruction	Modified
180565	8a_MMP 2015 Interview Questionnaire (English)	Other-WORD	Modified
178498	Patient Short interview	Form	Removed
178497	Patients Standard Interview	Form	Removed

ICR Details

OMB Control No: 0920-0740	ICR Reference No: 201503-0920-017
Status: Historical Active	Previous ICR Reference No: 201311-0920-014
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0740
Title: Medical Monitoring Project
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/01/2015
	Date Received in OIRA: 04/10/2015
Terms of Clearance: We strongly encourage CDC to streamline surveillance activities across the Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2018	36 Months From Approved	06/30/2015
Responses	20,710	0	20,126
Time Burden (Hours)	7,140	0	8,537
Cost Burden (Dollars)	157,341	0	0

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Abstract: The Medical Monitoring Project (MMP) was designed to address the need for a national behavioral and clinical surveillance system for HIV-infected persons, as articulated in CDC's HIV Prevention Strategic Plan. The primary objective of MMP is to conduct behavioral and clinical surveillance among a probability sample of persons with HIV infection in the United States in order to assess prevalence of and trends in: 1) risk behaviors for HIV transmission, 2) HIV care and treatment, and 3) exposure to, use of, and impact of HIV prevention services. Through MMP, CDC works with state and local health departments to obtain HIV-related behavioral and clinical data through confidential interviews and medical record abstractions.

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Authorizing Statute(s): PL: Pub.L. 111 - 241 301 Name of Law: Title III - General Powers and Duties of Public Health Service
  

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:
	79 FR 55497	09/16/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 18625	04/07/2015
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Att 4b_Approaching Sampled Patients for Enrollment
Att 4c_Patient Recruitment Script Looking up Contact Info
Patients Standard Interview	None	2014 Standard Questionnaire for Medical Monitoring Project (MMP)
Patient Short interview	none	Standard Interview
Att 4a_Model Patient Recruitment Letter
8a_MMP 2015 Interview Questionnaire (English)

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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	20,710	20,126	0	584	0	0
Annual Time Burden (Hours)	7,140	8,537	0	-1,397	0	0
Annual Cost Burden (Dollars)	157,341	0	0	157,341	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: Changing Forms

Short Statement: Due to proposed changes in sampling methods, the burden has decreased by 1,397 hours (see Exhibit 12.A). Specifically, because MMP will sample directly from HIV/AIDS surveillance program records instead of from facility sampling frames, facility staff will no longer be asked to provide estimated HIV patient loads and patient lists. Changes to the proposed project are fully described in section A.1 "Circumstances Making the Collection of Information Necessary."

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Annual Cost to Federal Government: $16,258,810

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? Yes

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: 04/10/2015

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