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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-0696 Community-Based Organization Report - NHME	Form and Instruction	Modified	Available
Form 0920-0696 Health Department Report - NHME	Form and Instruction	Modified	Available
Justification for the modification of 0920-0696 NHME April 11 2018.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2018-05-16	Available
Attachment C. NHME DVS Variables No Longer Required April 11 2018.docx	Supplementary Document	Uploaded 2018-05-11	Available
Attachment B. NHME DVS Variables Added April 11 2018.docx	Supplementary Document	Uploaded 2018-05-11	Available
Att 10 SummaryOfChanges.docx	Supplementary Document	Uploaded 2016-02-09	Available
Supporting Statement B DD 080515.docx	Supporting Statement B	Uploaded 2015-09-02	Available
Supporting Statement A 05FEB2016.docx	Supporting Statement A	Uploaded 2016-02-09	Available
Project Determination.pdf	Supplementary Document	Uploaded 2015-08-26	Available
Att 9 Assurance of Confidentiality.pdf	Supplementary Document	Uploaded 2015-08-26	Available
Att 8 Burden Calculations.docx	Supplementary Document	Uploaded 2015-08-26	Available
Att 7 EvalWeb Authority to Operate.pdf	Supplementary Document	Uploaded 2015-08-26	Available
Att 6 Data Security Guidelines.pdf	Supplementary Document	Uploaded 2015-08-26	Available
Att 4 Agencies and Persons Consulted.doc	Supplementary Document	Uploaded 2015-08-26	Available
Att 3 EvalWeb home page login screen.docx	Supplementary Document	Uploaded 2015-08-26	Available
Att 2 60 Day FRN.pdf	Supplementary Document	Uploaded 2015-08-26	Available
Att 1 Legislative Authority.pdf	Supplementary Document	Uploaded 2015-08-26	Available
IRB Determination.pdf	Supplementary Document	Uploaded 2013-01-03	Available
Final Renewal AoC NHM&E Document (3).pdf	Supplementary Document	Uploaded 2013-01-03	Available
Attach7 CDC HIV Data Collections.docx	Supplementary Document	Uploaded 2013-01-03	Available
Attach8 Eval-Web_ATO.pdf	Supplementary Document	Uploaded 2013-01-03	Available
Attach4 Agencies and Persons Consulted.doc	Supplementary Document	Uploaded 2013-01-03	Available
Attach2 60 Day FRN Published.pdf	Supplementary Document	Uploaded 2013-01-03	Available
Attach1 Legislative Authority.pdf	Supplementary Document	Uploaded 2013-01-03	Available
Attachment 6 B CDC Data Systems ROB Systems Administrators.pdf	Supplementary Document	Uploaded 2013-01-28	Available
Attach6 A CDC Data Systems ROB System Users.pdf	Supplementary Document	Uploaded 2013-01-28	Available
Attach5 PEB NHME Comprehensive DVS v11-02-2012.pdf	Supplementary Document	Uploaded 2013-01-03	Available
Attachment 3 A PEMS Home Page.docx	Supplementary Document	Uploaded 2010-06-21	Available
Attach5 PEB NHME Comprehensive DVS v11-02-2012.pdf	Supplementary Document	Uploaded 2013-01-03	Available
Attach5 PEB NHME Comprehensive DVS v11-02-2012.pdf	Supplementary Document	Uploaded 2013-01-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
217851	Community-Based Organization Report - NHME	Form and Instruction	Modified
217850	Health Department Report - NHME	Form and Instruction	Modified

ICR Details

OMB Control No: 0920-0696	ICR Reference No: 201805-0920-002
Status: Historical Active	Previous ICR Reference No: 201508-0920-003
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0696-18AFH
Title: National HIV Prevention Program Monitoring and Evaluation (NHM&E)
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 without change	Conclusion Date: 05/25/2018
	Date Received in OIRA: 05/22/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2019	02/28/2019	02/28/2019
Responses	538	0	538
Time Burden (Hours)	206,226	0	206,226
Cost Burden (Dollars)	0	0	0

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Abstract: NHM&E data are a set of standardized variables that CDC uses to monitor and evaluate HIV prevention programs funded by the Division of HIV/AIDS Prevention (DHAP) at CDC. These data are used to report key program performance indicators to CDC to show whether the programs implemented or supported are efficient and effective in achieving their stated goals. NHM&E data also assist Health Departments and Community-Based Organizations (CBOs) in monitoring and evaluating their activities to help them develop, deliver, and refine successful HIV prevention interventions. Grantees may differ in how quickly they are able to implement new NHM&E requirements associated with a funding announcement. Challenges may include updating existing systems, developing and printing new data forms, and training of staff and contractors on the new requirements. This Non-Substantive Change Request is to modify the currently approved NHM&E variables by having two options to monitor and evaluate strategies and interventions that are critical to national HIV prevention goals. Option 1 will retain a subset of the currently approved NHM&E variables for a limited period of time for health departments and CBOs. Following approval of this change request, this option will be available to health departments funded under PS18-1802 until December 31, 2018 to facilitate the transition to the new requirements (Option 2). For CBOs, this option will be available through the last year of current funding. Option 2 will retain a smaller subset of the currently approved NHM&E variables (than Option 1) and introduce a number of new variables to inform progress toward meeting national HIV prevention goals and objectives that align with the Division’s current strategic plan. Option 2 will be available to health departments for transitioning to this option beginning July 1, 2018 and required for all health departments on January 1, 2019. Option 2 will be required for any new CBO NOFO. All other project activities and methods remain the same as in the previously approved information collect request. The proposed revisions do not change the burden shown in the current inventory.

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Authorizing Statute(s): US Code: 42 USC 241 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:
	80 FR 22197	04/21/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 50291	08/19/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Health Department Report - NHME	0920-0696	NHME Data Variables and Values
Community-Based Organization Report - NHME	0920-0696	NHME Data Variables and Values

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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	538	538	0	0	0	0
Annual Time Burden (Hours)	206,226	206,226	0	0	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:

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Annual Cost to Federal Government: $804,211

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 05/22/2018

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