Att D_PIA

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Privacy Impact Assessment Form
v 1.21
Status

Form Number

Form Date

Question

Answer

1

OPDIV:

CDC

2

PIA Unique Identifier:

TBD

2a Name:

09/06/18

Women's Health Needs Study
General Support System (GSS)
Major Application

3

Minor Application (stand-alone)

The subject of this PIA is which of the following?

Minor Application (child)
Electronic Information Collection
Unknown

3a

Identify the Enterprise Performance Lifecycle Phase
of the system.

Initiation
Yes

3b Is this a FISMA-Reportable system?

4

Does the system include a Website or online
application available to and for the use of the general
public?

5

Identify the operator.

6

Point of Contact (POC):

7

Is this a new or existing system?

8

Does the system have Security Authorization (SA)?

No
Yes
No
Agency
Contractor
POC Title

Health Scientist

POC Name

Margaret Snead

POC Organization National Center for Chronic Disea
POC Email

[email protected]

POC Phone

770-488-6303
New
Existing
Yes
No

8b Planned Date of Security Authorization
Not Applicable

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8c

Briefly explain why security authorization is not
required

10

Describe in further detail any changes to the system
that have occurred since the last PIA.

N/A, no prior PIA.
This survey-based information collection assesses the health
characteristics, experiences, and needs of women living in the
United States who were born in countries, or whose mothers
were born in countries, where female genital mutilation/
cutting (FGM/C) is prevalent.

11 Describe the purpose of the system.

The questionnaire will collect general demographic
information (e.g., age, education, country of birth, time in the
United States, employment history, marital status and family
Describe the type of information the system will
structure), migration, social support, health (overall health,
collect, maintain (store), or share. (Subsequent
health care utilization, health insurance, barriers to accessing
12
questions will identify if this information is PII and ask health care, sexual history and contraceptive use, access to
about the specific data elements.)
obstetric and gynecologic care, cervical cancer screening,
influences on medical decision-making, pregnancy outcomes
and prenatal care), and FGM/C (personal FGM/C history, related
health problems, and beliefs).

Provide an overview of the system and describe the
13 information it will collect, maintain (store), or share,
either permanently or temporarily.

The demographics, migration, social support, health, and
FGM/C information collected for this study will be used to
identify public health needs of women and communities in the
United States that are affected by FGM/C, to formulate public
health strategies to meet identified needs, and to inform
prevention efforts so as to prevent continuation of the practice
of FGM/C on women who may be at risk. information collected
will provide some of the first systematic information on the
reproductive health experiences and needs related to FGM/C
among women who live in selected communities in the United
States with high concentrations of residents from countries
where FGM/C is prevalent.
Interviewers will administer a paper or electronic version of the
questionnaire in face-to-face interviews. Data will be collected
and maintained by a contractor, and data sets will not be
shared with other entities.
Contractors will maintain any collected data temporarily;
keeping it only until data are entered, quality reviewed for
consistency and accuracy, and delivered to the Centers for
Disease Control and Prevention.

14 Does the system collect, maintain, use or share PII?

Yes
No

REVIEWER QUESTIONS: The following section contains Reviewer Questions which are not to be filled out unless the user is an OPDIV
Senior Officer for Privacy.

Reviewer Questions
1

Are the questions on the PIA answered correctly, accurately, and completely?

Answer
Yes
No

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Reviewer Questions

Answer

Reviewer
Notes
2

Does the PIA appropriately communicate the purpose of PII in the system and is the purpose
justified by appropriate legal authorities?

Yes

Do system owners demonstrate appropriate understanding of the impact of the PII in the
system and provide sufficient oversight to employees and contractors?

Yes

No

Reviewer
Notes
3

No

Reviewer
Notes
4

Does the PIA appropriately describe the PII quality and integrity of the data?

Yes
No

Reviewer
Notes
5

Is this a candidate for PII minimization?

Yes
No

Reviewer
Notes
6

Does the PIA accurately identify data retention procedures and records retention schedules?

Yes
No

Reviewer
Notes
7

Are the individuals whose PII is in the system provided appropriate participation?

Yes
No

Reviewer
Notes
8

Does the PIA raise any concerns about the security of the PII?

Yes
No

Reviewer
Notes
9

Is applicability of the Privacy Act captured correctly and is a SORN published or does it need
to be?

Yes
No

Reviewer
Notes
10

Is the PII appropriately limited for use internally and with third parties?

Yes
No

Reviewer
Notes
11

Does the PIA demonstrate compliance with all Web privacy requirements?

Yes
No

Reviewer
Notes

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Reviewer Questions
12

Answer

Were any changes made to the system because of the completion of this PIA?

Yes
No

Reviewer
Notes

General Comments

OPDIV Senior Official
for Privacy Signature

Beverly E.
Walker -S

Digitally signed by
Beverly E. Walker -S
Date: 2018.09.28
12:51:20 -04'00'

HHS Senior
Agency Official
for Privacy

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