N.J. Admin. Code § 8:65-1.4

Current through Register Vol. 56, No. 11, June 3, 2024

Section 8:65-1.4 - Forms and instructions

(a) The Department incorporates herein by reference the following forms and instructions for information collection, as amended and supplemented, promulgated by the National HIV Surveillance System of the CDC in accordance with procedures of the OIRA:

1. The information collection bearing OMB Control No. 0920-0573, particularly the following forms, and the instructions for completion thereof, which are available from the Department's forms page at http://www.nj.gov/health/forms or upon request to the Division:

i. Adult HIV Confidential Case Report Form (ACRF), CDC Form 50.42A (Revised November 2019);

ii. The instructions for completion of the ACRF, entitled the Technical Guidance for HIV Surveillance Programs: Adult HIV Confidential Case Report Form (revised November 2019) (ACRF Technical Guidance);

iii. Pediatric HIV Confidential Case Report Form (PCRF), CDC Form 50.42B (revised November 2019);

iv. Perinatal HIV Exposure Reporting Form (PHER), CDC Form 50.42D (revised November 2019); and

v. The instructions for completion of the PCRF and the PHER, entitled the Technical Guidance for HIV Surveillance Programs: Pediatric HIV Confidential Case Report Form and Perinatal HIV Exposure Reporting Form (PCRF and PHER Technical Guidance) (revised November 2019); and

2. The information collection bearing OMB Control No. 0920-0696, which is accessible by users of the website, http://www.evaluationweb.com, and available for review at http://help.lutherconsulting.com/index.html, particularly:

i. The 2019 EvaluationWeb(R) HIV Test Template and EvaluationWeb(R) HIV Test Template Guidance (revised January 18, 2019); and

ii. CDC, National HIV Prevention Program Monitoring and Evaluation: NHM&E Data Variables and Values (February 21, 2019).

N.J. Admin. Code § 8:65-1.4

Adopted by 54 N.J.R. 1408(a), effective 7/18/2022