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Privacy Impact Assessment Form
v 1.47.4
Status Draft

Form Number

F-90047

Form Date

Question

Answer

1

OPDIV:

CDC

2

PIA Unique Identifier:

P-8497377-841085

2a Name:

6/3/2016 7:38:20 AM

EvaluationWeb
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.

Operations and Maintenance
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)?

8a Date of Security Authorization

No
Yes
No
Agency
Contractor
POC Title

IT Specialist

POC Name

Wiliam Dolan

POC Organization NCHHSTP/OD
POC Email

ixi4@cdc.gov

POC Phone

404.639.6233
New
Existing
Yes
No

7/15/2013 12:00:00 AM

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9

PIA Validation (PIA
Refresh/Annual Review)
Anonymous to NonAnonymous
New Public Access
Internal Flow or Collection

Indicate the following reason(s) for updating this PIA.
Choose from the following options.

Significant System
Management Change
Alteration in Character of
Data
New Interagency Uses
Conversion

Commercial Sources

10

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

11 Describe the purpose of the system.

N/A
EvaluationWeb is an existing web-based data collection and
management system that will be used to provide CDC and
DHAP grantees with real-time access to HIV prevention
program data. CDC-funded community-based organizations
(CBOs) and local and state health departments will use
EvaluationWeb to report their HIV prevention activities.

EvaluationWeb will be used by the Division of HIV/AIDS
Prevention's (DHAP) Expanded Testing Program (ETP)
Describe the type of information the system will
grantees, comprised of state and local health departments, to
collect, maintain (store), or share. (Subsequent
12
questions will identify if this information is PII and ask submit all of their HIV testing data: client demographics (e.g.,
race, ethnicity, and year of birth), relationship status, HIV risk
about the specific data elements.)
profile, HIV testing information, HIV referrals, and High-Impact
Prevention (HIP) behavioral interventions.
EvaluationWeb is web-based system that provides CDC-funded
HIV prevention program and Division of HIV/AIDS Prevention's
(DHAP) Expanded Testing Program (ETP) grantees, a
standardized platform for data entry, reporting, and
submission. EvaluationWeb does not collect social security
numbers or any personally identifiable information (PII).

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

CDC-funded community-based organizations (CBOs) and local
and state health departments will use EvaluationWeb to report
their HIV prevention activities: client demographics (e.g., race,
ethnicity, and year of birth), relationship status, HIV risk profile,
HIV testing information, HIV referrals, and High-Impact
Prevention (HIP) behavioral interventions. These data allow
CDC to describe, at the local and national levels, all of the HIV
prevention activities that are funded by CDC.
CDC will use these data to assess and improve performance of
agencies delivering HIV prevention services with CDC funds,
assess and improve performance of CDC in terms of priorities,
focus, guidance, and funding, respond to the needs of national
partners, and report to Congress, the White House, and other
stakeholders.

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

Yes
No

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General Comments

OPDIV Senior Official
for Privacy Signature

Beverly E.
Walker -S

Digitally signed by Beverly E. Walker -S
DN: c=US, o=U.S. Government,
ou=HHS, ou=CDC, ou=People,
0.9.2342.19200300.100.1.1=10014403
43, cn=Beverly E. Walker -S
Date: 2016.06.09 21:10:47 -04'00'

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