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Federal forms, ICRs, and supporting documents

Information Collection Request

Adult and Pediatric HIV/AIDS Confidential Case Reports for National HIV/AIDS Surveillance

ICR 201106-0920-003 · OMB 0920-0573 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Adult HIV/AIDS Confidential Case Report Form Modified Available
Enhanced Perinatal Surveillance (EPS) Form Modified Repair queued
Case Report Updates Form Modified Available
Pediatric HIV/AIDS Confidential Case Report Form Modified Repair queued
PCRF 19May2011.pdf Supplementary Document Uploaded 2011-06-01 Repair queued
ACRF Changes HARS to eHARS_omb_fin26May11.docx Supplementary Document Uploaded 2011-06-01 Available
0920-0573_nonsubchange_26May11.docx Justification for No Material/Nonsubstantive Change Uploaded 2011-06-01 Repair queued
0920-0573_att 4(d) EPS Sum of form changes_draft User Guide .pdf Supplementary Document Uploaded 2009-11-30 Repair queued
0920-0573_att 4(c) VARHS Technical_Guidance.pdf Supplementary Document Uploaded 2009-11-30 Available
0920-0573_att 4(b)Technical_Guidance_HIV Incidence Surveillance.pdf Supplementary Document Uploaded 2009-11-30 Available
0920-0573_att 3(c)_eHARS Variables.doc Supplementary Document Uploaded 2009-11-30 Available
0920-0573_att 4(a) adult and ped instruct_Tech_Guidance_vol2.pdf Supplementary Document Uploaded 2009-11-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
7028 Adult HIV/AIDS Confidential Case Report Form Modified
46035 Enhanced Perinatal Surveillance (EPS) Form Modified
46034 VARHS - Variant, Atypical, and Resistant HIV Surveillance Data Elements Other-Data Elements Modified
46033 HIV Incidence Surveillance Data Elements Other-Incidence Data Elements Modified
46032 Case Report Updates Form Modified
46030 Pediatric HIV/AIDS Confidential Case Report Form Modified
ICR Details
0920-0573 201106-0920-003
Historical Active 200912-0920-003
HHS/CDC
Adult and Pediatric HIV/AIDS Confidential Case Reports for National HIV/AIDS Surveillance
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/03/2011
Retrieve Notice of Action (NOA) 06/02/2011
  Inventory as of this Action Requested Previously Approved
01/31/2013 01/31/2013 01/31/2013
200,335 0 200,335
51,311 0 51,311
0 0 0
This is a request to make minor changes to the adult and pediatric AIDS/HIV surveillance forms. The revised forms reflect the OMB approved eHARS data elements and one additional element.
US Code: 42 USC 242k Name of Law: National Center for Health Statistics
   US Code: 42 USC 242b Name of Law: General Authority Respecting Research...
   US Code: 42 USC 242m Name of Law: General Provisions Respecting Effectiveness, Efficiency, and Quality of Health Services
  
None
Not associated with rulemaking
No
  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 200,335 200,335 0 0 0 0
Annual Time Burden (Hours) 51,311 51,311 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$61,445,689
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Daniel Holcomb 770 488-4472 [email protected]
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/02/2011