Medical Monitoring Project Facility Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
MMP Short Facility Survey (Word version)	Form and Instruction	New	Available
Medical Monitoring Project Short Facility Survey (screenshots)	Form and Instruction	New	Available
MMP Short Facility Survey	Form and Instruction	New	Repair queued
Medical Monitoring Project Facility Survey (paper)	Form and Instruction	New	Available
Medical Monitoring Project Facility Survey (screenshots)	Form and Instruction	New	Available
Medical Monitoring Project (MMP) Facility Survey	Form and Instruction	New	Repair queued
Att 10 MMP facility survey references.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 9 MMP Facility Survey Minimal Dataset.docx	Supplementary Document	Uploaded 2021-02-01	Available
Att 8 NCHHSTP Project Determination Form.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 5e MMP facilty survey thank you_final.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
SS B 2021 02 01.docx	Supporting Statement B	Uploaded 2021-02-01	Repair queued
SS A 2021 02 01.docx	Supporting Statement A	Uploaded 2021-02-01	Available
Att 5d MMP facilty survey reminder cover letter_final edited.docx	Supplementary Document	Uploaded 2021-02-01	Available
Att 5c MMP facilty survey postcard_final.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 5b MMP facilty survey outgoing envelope_final.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 5a MMP facilty survey initial cover letter_final edited.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 2b CDC Response to Public Comments.docx	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 2a CDC-2020-0059-0002_attachment_1 comments on 60 day notice.pdf	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 2 MMP Facility Survey 60-day Federal Register Notice.pdf	Supplementary Document	Uploaded 2021-02-01	Repair queued
Att 1_Sect 301 PHSA.PDF	Supplementary Document	Uploaded 2021-02-01	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
245511	MMP Short Facility Survey	Form and Instruction	New	MMP Short Facility Survey (Word version)
245511	MMP Short Facility Survey	Form and Instruction	New	Medical Monitoring Project Short Facility Survey (screenshots)
245511	MMP Short Facility Survey	Form and Instruction	New
245510	Medical Monitoring Project (MMP) Facility Survey	Form and Instruction	New	Medical Monitoring Project Facility Survey (paper)
245510	Medical Monitoring Project (MMP) Facility Survey	Form and Instruction	New	Medical Monitoring Project Facility Survey (screenshots)
245510	Medical Monitoring Project (MMP) Facility Survey	Form and Instruction	New

ICR Details

OMB Control No: 0920-1340	ICR Reference No: 202012-0920-020
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-20OM
Title: Medical Monitoring Project Facility Survey
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: 07/01/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 02/08/2021
Terms of Clearance: CDC will work with HRSA to consider ways to streamline and better integrate data collections in the future.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2024	36 Months From Approved
Responses	1,425	0	0
Time Burden (Hours)	619	0	0
Cost Burden (Dollars)	21,779	0	0

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Abstract: The Medical Monitoring Project (MMP) Facility Survey will survey approximately 1,500 HIV medical care facilities where participants of the Medical Monitoring Project (MMP; OMB # 0920-0740) received health care. The objectives of the project are to describe the characteristics of HIV care facilities, scope of clinical services provided, and alignment of those services with the goals, objectives, and strategies of Ending the HIV Epidemic federal initiative.

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Authorizing Statute(s): US Code: 42 USC 241 Name of Law: Public Health Service Act: Research and investigations
  

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:
	85 FR 33681	06/02/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 8648	02/08/2021
Did the Agency receive public comments on this ICR? Yes

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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
MMP Short Facility Survey	n/a, n/a	Medical Monitoring Project Short Facility Survey (screenshots) ,   MMP Short Facility Survey (Word version)
Medical Monitoring Project (MMP) Facility Survey	n/a, n/a	Medical Monitoring Project Facility Survey (screenshots) ,   Medical Monitoring Project Facility Survey (paper)

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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	1,425	0	0	1,425	0	0
Annual Time Burden (Hours)	619	0	0	619	0	0
Annual Cost Burden (Dollars)	21,779	0	0	21,779	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, one-time information collection request.

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Annual Cost to Federal Government: $565,000

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? No

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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: 02/08/2021

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