Agency Information Collection Activities: Proposed Request and Comment Request, 10623-10627 [2017-02941]
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Federal Register / Vol. 82, No. 29 / Tuesday, February 14, 2017 / Notices
For the Commission, by the Division of
Trading and Markets, pursuant to delegated
authority.27
Eduardo A. Aleman,
Assistant Secretary.
[FR Doc. 2017–02910 Filed 2–13–17; 8:45 am]
Percent
Non-Profit Organizations Without Credit Available Elsewhere .....................................
2.500
The number assigned to this disaster
for physical damage is 15041C and for
economic injury is 15042C.
BILLING CODE 8011–01–P
SMALL BUSINESS ADMINISTRATION
[Disaster Declaration #15041 and #15042]
(Catalog of Federal Domestic Assistance
Number 59008)
James E. Rivera,
Associate Administrator for Disaster
Assistance.
Mississippi Disaster #MS–00098
U.S. Small Business
Administration.
ACTION: Notice.
[FR Doc. 2017–02908 Filed 2–13–17; 8:45 am]
This is a Notice of the
Presidential declaration of a major
disaster for Public Assistance Only for
the State of Mississippi (FEMA–4295–
DR), dated 02/06/2017.
Incident: Severe Storms, Tornadoes,
Straight-line Winds, and Flooding.
Incident Period: 01/20/2017 through
01/21/2017.
Effective Date: 02/06/2017.
Physical Loan Application Deadline
Date: 04/07/2017.
Economic Injury (EIDL) Loan
Application Deadline Date: 11/06/2017.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT: A.
Escobar, Office of Disaster Assistance,
U.S. Small Business Administration,
409 3rd Street SW., Suite 6050,
Washington, DC 20416.
SUPPLEMENTARY INFORMATION: Notice is
hereby given that as a result of the
President’s major disaster declaration on
02/06/2017, Private Non-Profit
organizations that provide essential
services of governmental nature may file
disaster loan applications at the address
listed above or other locally announced
locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties: Forrest, Lamar, Perry.
The Interest Rates are:
SMALL BUSINESS ADMINISTRATION
AGENCY:
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Percent
For Physical Damage:
Non-Profit Organizations With
Credit Available Elsewhere ...
Non-Profit Organizations Without Credit Available Elsewhere .....................................
For Economic Injury:
27 17
2.500
2.500
CFR 200.30–3(a)(12).
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Percent
For Physical Damage:
Non-Profit Organizations with
Credit Available Elsewhere ...
Non-Profit Organizations without Credit Available Elsewhere .....................................
For Economic Injury:
Non-Profit Organizations without Credit Available Elsewhere .....................................
2.500
2.500
2.500
The number assigned to this disaster
for physical damage is 15043C and for
economic injury is 15044C.
(Catalog of Federal Domestic Assistance
Number 59008)
BILLING CODE 8025–01–P
SUMMARY:
10623
[Disaster Declaration #15043 and #15044]
James E. Rivera,
Associate Administrator for Disaster
Assistance.
[FR Doc. 2017–02907 Filed 2–13–17; 8:45 am]
Georgia Disaster #GA–00092
BILLING CODE 8025–01–P
U.S. Small Business
Administration.
ACTION: Notice.
AGENCY:
SOCIAL SECURITY ADMINISTRATION
This is a Notice of the
Presidential declaration of a major
disaster for Public Assistance Only for
the State of Georgia (FEMA–4297–DR),
dated 02/07/2017.
Incident: Severe Storms, Tornadoes,
Straight-line Winds, and Flooding.
Incident Period: 01/21/2017 through
01/22/2017.
Effective Date: 02/07/2017.
Physical Loan Application Deadline
Date: 04/10/2017.
Economic Injury (EIDL) Loan
Application Deadline Date: 11/07/2017.
ADDRESSES: Submit completed loan
applications to: U.S. Small Business
Administration, Processing and
Disbursement Center, 14925 Kingsport
Road, Fort Worth, TX 76155.
FOR FURTHER INFORMATION CONTACT:
A. Escobar, Office of Disaster
Assistance, U.S. Small Business
Administration, 409 3rd Street SW.,
Suite 6050, Washington, DC 20416.
SUPPLEMENTARY INFORMATION: Notice is
hereby given that as a result of the
President’s major disaster declaration on
02/07/2017, Private Non-Profit
organizations that provide essential
services of governmental nature may file
disaster loan applications at the address
listed above or other locally announced
locations.
The following areas have been
determined to be adversely affected by
the disaster:
Primary Counties: Baker, Brooks,
Calhoun, Clay, Cook, Crisp,
Dougherty, Thomas, Turner,
Wilcox, Worth.
The Interest Rates are:
SUMMARY:
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[Docket No: SSA–2017–0003]
Agency Information Collection
Activities: Proposed Request and
Comment Request
The Social Security Administration
(SSA) publishes a list of information
collection packages requiring clearance
by the Office of Management and
Budget (OMB) in compliance with
Public Law 104–13, the Paperwork
Reduction Act of 1995, effective October
1, 1995. This notice includes a new
information collection and revisions of
OMB-approved information collections.
SSA is soliciting comments on the
accuracy of the agency’s burden
estimate; the need for the information;
its practical utility; ways to enhance its
quality, utility, and clarity; and ways to
minimize burden on respondents,
including the use of automated
collection techniques or other forms of
information technology. Mail, email, or
fax your comments and
recommendations on the information
collection(s) to the OMB Desk Officer
and SSA Reports Clearance Officer at
the following addresses or fax numbers.
(OMB) Office of Management and
Budget, Attn: Desk Officer for SSA,
Fax: 202–395–6974, Email address:
OIRA_Submission@omb.eop.gov
(SSA) Social Security Administration,
OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401
Security Blvd., Baltimore, MD 21235,
Fax: 410–966–2830, Email address:
OR.Reports.Clearance@ssa.gov
Or you may submit your comments
online through www.regulations.gov,
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Federal Register / Vol. 82, No. 29 / Tuesday, February 14, 2017 / Notices
referencing Docket ID Number [SSA–
2017–0003].
I. The information collections below
are pending at SSA. SSA will submit
them to OMB within 60 days from the
date of this notice. To be sure we
consider your comments, we must
receive them no later than April 17,
2017. Individuals can obtain copies of
the collection instruments by writing to
the above email address.
1. Supported Employment
Demonstration (SED) Project—0960–
NEW. Sponsored by SSA, the SED
project builds on the success of the
intervention designed for the Mental
Health Treatment Study (MHTS)
previously funded by SSA. The MHTS
provides integrated mental health and
vocational services to disability
beneficiaries with mental illness. The
SED will offer these same services to
individuals with mental illness for
whom SSA denied Social Security
disability benefits. SSA seeks to
determine whether offering this
evidence-based package of integrated
vocational and mental health services to
denied disability applicants fosters
employment that leads to selfsufficiency; improved mental health and
quality of life; and reduced demand for
disability benefits. The SED will use a
randomized controlled trial to compare
the outcomes of two treatment groups
and a control group. Study participation
spans 36 months beginning on the day
following the date of randomization to
one of the three study groups. The SED
study population consists of individuals
aged 18 to 50 who apply for disability
benefits alleging a mental illness, and
the initial decision is a denial of
benefits in the past 60 days. The SED
will enroll up to 1,000 participants in
each of the three study arms for a total
of 3,000 participants: 40 participants in
each of three study arms for the 20
urban sites equaling an n of 2,400 urban
site participants, and 20 participants in
each of three arms for the 10 rural sites
equaling an n of 600 rural site
participants.
We randomly select and assign each
enrolled participant to one of three
study arms:
• Full-Service Treatment (n = 1,000).
The multi-component service model
from the MHTS comprises the FullService Treatment. At its core, it
includes an Individual Placement and
Support (IPS) supported employment
specialist and behavioral health
specialist providing IPS supported
employment services integrated with
behavioral health care. Participants in
the full-service treatment group will
also receive the services of a Nurse Care
Coordinator who coordinates Systematic
Medication Management services, as
well assistance with: Out-of-pocket
expenses associated with prescription
behavioral health medications; workrelated expenses; and services and
treatment not covered by the
participant’s health insurance.
• Basic-Service Treatment (n =
1,000). The Basic-Service Treatment
model leaves intact IPS supported
employment integrated with behavioral
health services as the centerpiece of the
intervention arm. The Basic-Service
Treatment is essentially the Full-Service
model without the services of the Nurse
Care Coordinator; Systematic
Medication Management; and the funds
associated with out-of-pocket expenses
for prescription behavioral health
medications.
• Usual Services (n = 1,000). This
study arm represents a control group
against which we can compare the two
treatment groups. Participants assigned
to this group seek services as they
normally would (or would not) in their
community. However, at the time of
randomization, each Usual Service
participant will receive a
comprehensive manual describing
Number of
respondents
sradovich on DSK3GMQ082PROD with NOTICES
Modality of completion
mental health and vocational services in
their locale, along with state and
national resources.
This study will test the two treatment
conditions against each other and
against the control group on multiple
outcomes of policy interest to SSA. The
key outcomes of interest include: (1)
Employment; (2) earnings; (3) income;
(4) mental status; (5) quality of life; (6)
health services utilization; and (7) SSA
disability benefit receipt and amount.
SSA is also interested in the study take
up rate (participation); knowing who
enrolls (and who does not); and fidelity
to evidence-based treatments; among
other aspects of implementation. Data
collection for the evaluation of the SED
will consist of the following activities:
Baseline in-person participant
interviews; quarterly participant
telephone interviews; receipt of SSA
administrative record data; and
collection of site-level program data.
Evaluation team members will also
conduct site visits involving: (1) Previsit environmental scans to understand
the local context in which we embed
SED services; (2) independent fidelity
assessments in conjunction with those
carried out by state Mental Health or
Vocational Rehabilitation staff; (3) key
informant interviews with the IPS
specialist, the nurse care coordinator,
the case manager, and facility director;
(4) focus groups with participants in the
Full-Service and Basic-Service
Treatment groups; and (5) ethnographic
data collection consisting of
observations in the natural
environment, and person-centered
interviews with participants and nonparticipants. The respondents are study
participants and non-participants;
family members; IPS specialists; nurse
care coordinators; case managers; and
facility directors.
Type of Request: Request for a new
information collection.
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
Competency and CIDI Screener ......................................................................
Baseline Interview ............................................................................................
Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 9, 10, and 11) .........................
Annual Interview (Quarters 4, 8, and 11) ........................................................
Fidelity Assessment Participant Interview .......................................................
Fidelity Assessment Family Member Interview ...............................................
Key Informant Interview ...................................................................................
Participant Focus Groups ................................................................................
Person-Centered Interview ..............................................................................
3,000
3,000
3,000
3,000
180
90
120
600
180
1
1
9
3
4
4
4
2
4
40
45
20
30
60
60
60
60
60
2,000
2,250
9,000
4,500
720
360
480
1,200
720
Totals ........................................................................................................
13,170
........................
........................
21,230
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Federal Register / Vol. 82, No. 29 / Tuesday, February 14, 2017 / Notices
2. Student Reporting Form—20 CFR
404.352(b)(2); 404.367; 404.368;
404.415; 404.434; 422.135—0960–0088.
To qualify for Social Security Title II
student benefits, student beneficiaries
must be in full-time attendance status at
an educational institution. In addition,
SSA requires these beneficiaries to
report events that may cause a
reduction, termination, or suspension of
their benefits. SSA collects this
information on Forms SSA–1383 and
SSA–1383–FC to determine if the
changes or events the student
beneficiaries report will affect their
continuing entitlement to SSA benefits.
SSA also uses the SSA–1383 and SSA–
1383–FC to calculate the correct benefit
amounts for student beneficiaries. The
respondents are Social Security Title II
student beneficiaries.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Modality of completion
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
SSA–1383 ........................................................................................................
SSA–1383–FC .................................................................................................
74,887
1,247
1
1
6
6
7,489
125
Totals ........................................................................................................
76,134
........................
........................
7,614
3. Advanced Notice of Termination of
Child’s Benefits & Student’s Statement
Regarding School Attendance—20 CFR
404.350–404.352, 404.367–404.368—
0960–0105. SSA collects information on
Forms SSA–1372–BK and SSA–1372–
student claimants for Social Security
benefits; their respective schools; and in
some cases; their representative payees.
Type of Request: Revision of an OMBapproved information collection.
BK–FC to determine whether children
of an insured worker meet the eligibility
requirements for student benefits. The
data we collect allows SSA to determine
student entitlement and thether to
terminate benefits. The respondents are
SSA–1372–BK
Number of
respondents
Type of respondent
Average
burden per
response
(minutes)
Frequency
of response
Estimated
total annual
burden
(hours)
Individuals/Households ....................................................................................
State/Local/Tribal Government ........................................................................
99,850
99,850
1
1
8
3
13,313
4,993
Totals ........................................................................................................
199,700
........................
........................
18,306
Frequency
of response
Average
burden per
response
(minutes)
SSA–1372–BK–FC
Number of
respondents
Type of respondent
Estimated
total annual
burden
(hours)
1,198
1,198
1
1
8
3
160
60
Totals ........................................................................................................
2,396
........................
........................
220
Grand Total ...............................................................................................
sradovich on DSK3GMQ082PROD with NOTICES
Individuals/Households ....................................................................................
State/Local/Tribal Government ........................................................................
200,096
........................
........................
18,526
4. Request for Review of Hearing
Decision/Order—20 CFR 404.967–
404.981, 416.1467–416.1481—0960–
0277. Claimants have a statutory right
under the Social Security Act and
current regulations to request review of
an administrative law judge’s (ALJ)
hearing decision or dismissal of a
hearing request on Title II and Title XVI
claims. Claimants may request Appeals
Council review by filing a written
request using Form HA–520. SSA uses
the information to establish the claimant
filed the request for review within the
prescribed time and to ensure the
claimant completed the requisite steps
permitting the Appeals Council review.
The Appeals Council uses the
information to: (1) Document the
claimant’s reason(s) for disagreeing with
the ALJ’s decision or dismissal; (2)
determine whether the claimant has
additional evidence to submit; and (3)
determine whether the claimant has a
representative or wants to appoint one.
The respondents are claimants
requesting review of an ALJ’s decision
or dismissal of hearing.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
HA–520 ............................................................................................................
175,000
1
10
29,167
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Federal Register / Vol. 82, No. 29 / Tuesday, February 14, 2017 / Notices
5. Disability Update Report—20 CFR
404.1589–404.1595 and 416.988–
416.996—0960–0511. As part of our
statutory requirements, SSA
periodically uses Form SSA–455, the
Disability Update Report, to evaluate
current Title II disability beneficiaries’
and Title XVI disability payment
recipients’ continued eligibility for
Social Security disability payments.
Specifically, SSA uses the form to
determine if: (1) There is enough
evidence to warrant referring the
respondent for a full medical
Continuing Disability Review (CDR); (2)
the respondent’s impairments are still
present and indicative of no medical
improvement, precluding the need for a
CDR; or (3) the respondent has
unresolved work-related issues. SSA
mails Form SSA–455 to specific
disability recipients, whom we select as
possibly qualifying for the CDR process.
SSA pre-fills the form with data specific
to the disability recipient, except for the
sections we ask the recipients to
complete. When SSA receives the
completed form, we scan it into SSA’s
system. This allows us to gather the
information electronically, and enables
SSA to process the returned forms
through automated decision logic to
decide the proper course of action to
take. The respondents are recipients of
Title II and Title XVI Social Security
disability payments.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–455 ..........................................................................................................
1,500,000
1
15
375,000
II. SSA submitted the information
collections below to OMB for clearance.
Your comments regarding the
information collections would be most
useful if OMB and SSA receive them 30
days from the date of this publication.
To be sure we consider your comments,
we must receive them no later than
March 16, 2017. Individuals can obtain
copies of the OMB clearance package by
writing to OR.Reports.Clearance@
ssa.gov.
1. Agreement to Sell Property—20
CFR 416.1240–1245—0960–0127.
Individuals or couples who are
otherwise eligible for Supplemental
Security Income (SSI) payments, but
whose resources exceed the allowable
limit may receive conditional payments
if they agree to dispose of the excess
non-liquid resources and make
repayments. SSA uses Form SSA–8060–
U3 to document this agreement, and to
ensure the individuals understand their
obligations. Respondents are applicants
for and recipients of SSI payments who
will be disposing of excess non-liquid
resources.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–8060–U3 .................................................................................................
20,000
1
10
3,333
2. Development of Participation in a
Vocational Rehabilitation or Similar
Program—20 CFR 404.316(c),
404.337(c), 404.352(d), 404.1586(g),
404.1596, 404.1597(a), 404.327, 404.328,
416.1321(d), 416.1331(a)–(b), and
416.1338, 416.1402—0960–0282. State
Disability Determination Services (DDS)
must determine if Social Security
disability payment recipients whose
disability ceased and who participate in
vocational rehabilitation programs may
continue to receive disability payments.
To do this, DDSs need information
about the recipients; the types of
program participation; and the services
they receive under the rehabilitation
program. SSA uses Form SSA–4290 to
collect this information. The
respondents are State employment
networks; vocational rehabilitation
agencies; or other providers of
educational or job training services.
Type of Request: Revision of an OMBapproved information collection.
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–4290 ........................................................................................................
sradovich on DSK3GMQ082PROD with NOTICES
Modality of completion
3,000
1
15
750
3. Appointment of Representative—20
CFR 404.1707, 404.1720, 408.1101,
416.1507, and 416.1520—0960–0527.
Individuals claiming rights or benefits
under the Social Security Act (Act) must
notify SSA in writing when they
appoint an individual to represent them
in dealing with SSA. SSA collects the
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information on Form SSA–1696–U4 to
verify the appointment of these
representatives. The SSA–1696–U4
allows SSA to inform representatives of
items that affect the recipient’s claim,
and allows claimants to give permission
to their appointed representatives to
designate a person to receive their
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claims files. Respondents are applicants
for, or recipients of, Social Security
disability benefits (SSDI) or SSI
payments who are notifying SSA they
have appointed a person to represent
them in their dealings with SSA.
Type of Request: Revision of an OMBapproved information collection.
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Federal Register / Vol. 82, No. 29 / Tuesday, February 14, 2017 / Notices
10627
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–1696–U4 .................................................................................................
800,000
1
10
133,333
4. Work Activity Report (SelfEmployment)—20 CFR 404.1520(b), 20
CFR 404.1571–404.1576, 20 CFR
404.1584–404.1593, and 20 CFR
416.971–416.976—0960–0598. SSA uses
Form SSA–820–U4 to determine initial
or continuing eligibility for (1) Title II
SSDI, or (2) Title XVI SSI payments.
Under Titles II and XVI of the Act,
recipients receive disability benefits and
SSI payments based on their inability to
engage in substantial gainful activity
(SGA) due to a physical or mental
condition. Therefore, when the
recipients resume work, they must
report their work so SSA can evaluate
and determine by law whether they
continue to meet the disability
requirements. SSA uses Form SSA–820–
U4 to obtain information on selfemployment activities of Social Security
Title II and XVI disability applicants
and recipients. We use the data we
obtain to evaluate disability claims, and
to help us determine if the claimant
meets current disability provisions
under Titles II and XVI. Since
applicants for disability benefits or
payments must prove an inability to
perform any kind of SGA generally
available in the national economy for
which we expect them to qualify based
on age, education, and work experience,
any work an applicant performed until,
or subsequent to, the date the disability
allegedly began, affects our disability
determination. The respondents are
applicants and claimants for SSI
payments or SSDI benefits.
Type of Request: Revision of an OMBapproved information collection.
Modality of completion
Number of
respondents
Frequency
of response
Average
burden per
response
(minutes)
Estimated
total annual
burden
(hours)
SSA–820–BK ...................................................................................................
100,000
1
30
50,000
Dated: February 9, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security
Administration.
[FR Doc. 2017–02941 Filed 2–13–17; 8:45 am]
BILLING CODE 4191–02–P
DEPARTMENT OF TRANSPORTATION
Federal Highway Administration
Notice of Final Federal Agency Actions
on Proposed Highway in California
Federal Highway
Administration (FHWA), DOT.
ACTION: Notice of limitation on claims
for Judicial Review of Actions by the
California Department of Transportation
(Caltrans), pursuant to 23 U.S.C. 327,
and other federal agencies.
AGENCY:
The FHWA, on behalf of
Caltrans, is issuing this notice to
announce actions taken by Caltrans, that
are final within the meaning of 23
U.S.C. 139(l)(1). The actions relate to a
proposed highway project, on State
Route 29, in the County of Lake, State
of California. Those actions grant
licenses, permits, and approvals for the
project.
DATES: By this notice, the FHWA, on
behalf of Caltrans, is advising the public
of final agency actions subject to 23
U.S.C. 139(l)(1). A claim seeking
judicial review of the Federal agency
actions on the highway project will be
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SUMMARY:
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barred unless the claim is filed on or
before July 14, 2017. If the Federal law
that authorizes judicial review of a
claim provides a time period of less
than 150 days for filing such claim, then
that shorter time period still applies.
FOR FURTHER INFORMATION CONTACT: For
Caltrans: Chris Quiney, Branch Chief R–
1, Caltrans Environmental Planning
Office—District 2, 1657 Riverside Drive,
Redding, CA 96001, regular office hours
7:30 a.m.–4:15 p.m. Monday–Friday,
telephone: (530) 225–3174, email:
chris.quiney@dot.ca.gov.
SUPPLEMENTARY INFORMATION: Effective
July 1, 2007, the Federal Highway
Administration (FHWA) assigned, and
the California Department of
Transportation (Caltrans) assumed,
environmental responsibilities for this
project pursuant to 23 U.S.C. 327.
Notice is hereby given that the Caltrans
has taken final agency actions subject to
23 U.S.C. 139(l)(1) by issuing licenses,
permits, and approvals for the following
highway project in the State of
California: Widening and improvement
of an eight-mile segment of State Route
(SR) 29, beginning 0.2 miles east of
Diener Drive and ending 0.6 miles west
of the SR 175 intersection, in Lake
County. The project will widen and
improve the existing two-lane highway
to a four-lane divided expressway with
access control to provide a modern
transportation facility that will provide
adequate capacity to accommodate
anticipated traffic growth and improve
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safety and operation of SR 29. The
actions by the Federal agencies, and the
laws under which such actions were
taken, are described in the
Environmental Assessment (EA) for the
project, approved on November 23,
2016, in the FHWA Finding of No
Significant Impact (FONSI) issued on
November 23, 2016, and in other
documents in the FHWA project
records. The EA, FONSI, and other
project records are available by
contacting Caltrans at the addresses
provided above. The Caltrans EA and
FONSI can be viewed and downloaded
from the project Web site at https://
www.dot.ca.gov/dist1/d1projects/
lake29/.
This notice applies to all Federal
agency decisions as of the issuance date
of this notice and all laws under which
such actions were taken, including but
not limited to:
1. General: National Environmental
Policy Act (NEPA) [42 U.S.C. 4321–
4351]; Federal Aid Highway Act [23
U.S.C. 109 and 23 U.S.C. 128]
2. Air: Clean Air Act [42 U.S.C. 7401–
7671(q)]
3. Land: Section 4(f) of the Department
of Transportation Act of 1966 [49
U.S.C. 303]
4. Wildlife: Endangered Species Act [16
U.S.C. 1531–1544 and Section
1536]; Migratory Bird Treaty Act
[16 U.S.C. 703–712]
5. Historic and Cultural Resources:
Section 106 of the National Historic
E:\FR\FM\14FEN1.SGM
14FEN1
]]>Agencies
[Federal Register Volume 82, Number 29 (Tuesday, February 14, 2017)]
[Notices]
[Pages 10623-10627]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2017-02941]
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SOCIAL SECURITY ADMINISTRATION
[Docket No: SSA-2017-0003]
Agency Information Collection Activities: Proposed Request and
Comment Request
The Social Security Administration (SSA) publishes a list of
information collection packages requiring clearance by the Office of
Management and Budget (OMB) in compliance with Public Law 104-13, the
Paperwork Reduction Act of 1995, effective October 1, 1995. This notice
includes a new information collection and revisions of OMB-approved
information collections.
SSA is soliciting comments on the accuracy of the agency's burden
estimate; the need for the information; its practical utility; ways to
enhance its quality, utility, and clarity; and ways to minimize burden
on respondents, including the use of automated collection techniques or
other forms of information technology. Mail, email, or fax your
comments and recommendations on the information collection(s) to the
OMB Desk Officer and SSA Reports Clearance Officer at the following
addresses or fax numbers.
(OMB) Office of Management and Budget, Attn: Desk Officer for SSA, Fax:
202-395-6974, Email address: OIRA_Submission@omb.eop.gov
(SSA) Social Security Administration, OLCA, Attn: Reports Clearance
Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD
21235, Fax: 410-966-2830, Email address: OR.Reports.Clearance@ssa.gov
Or you may submit your comments online through www.regulations.gov,
[[Page 10624]]
referencing Docket ID Number [SSA-2017-0003].
I. The information collections below are pending at SSA. SSA will
submit them to OMB within 60 days from the date of this notice. To be
sure we consider your comments, we must receive them no later than
April 17, 2017. Individuals can obtain copies of the collection
instruments by writing to the above email address.
1. Supported Employment Demonstration (SED) Project--0960-NEW.
Sponsored by SSA, the SED project builds on the success of the
intervention designed for the Mental Health Treatment Study (MHTS)
previously funded by SSA. The MHTS provides integrated mental health
and vocational services to disability beneficiaries with mental
illness. The SED will offer these same services to individuals with
mental illness for whom SSA denied Social Security disability benefits.
SSA seeks to determine whether offering this evidence-based package of
integrated vocational and mental health services to denied disability
applicants fosters employment that leads to self-sufficiency; improved
mental health and quality of life; and reduced demand for disability
benefits. The SED will use a randomized controlled trial to compare the
outcomes of two treatment groups and a control group. Study
participation spans 36 months beginning on the day following the date
of randomization to one of the three study groups. The SED study
population consists of individuals aged 18 to 50 who apply for
disability benefits alleging a mental illness, and the initial decision
is a denial of benefits in the past 60 days. The SED will enroll up to
1,000 participants in each of the three study arms for a total of 3,000
participants: 40 participants in each of three study arms for the 20
urban sites equaling an n of 2,400 urban site participants, and 20
participants in each of three arms for the 10 rural sites equaling an n
of 600 rural site participants.
We randomly select and assign each enrolled participant to one of
three study arms:
Full-Service Treatment (n = 1,000). The multi-component
service model from the MHTS comprises the Full-Service Treatment. At
its core, it includes an Individual Placement and Support (IPS)
supported employment specialist and behavioral health specialist
providing IPS supported employment services integrated with behavioral
health care. Participants in the full-service treatment group will also
receive the services of a Nurse Care Coordinator who coordinates
Systematic Medication Management services, as well assistance with:
Out-of-pocket expenses associated with prescription behavioral health
medications; work-related expenses; and services and treatment not
covered by the participant's health insurance.
Basic-Service Treatment (n = 1,000). The Basic-Service
Treatment model leaves intact IPS supported employment integrated with
behavioral health services as the centerpiece of the intervention arm.
The Basic-Service Treatment is essentially the Full-Service model
without the services of the Nurse Care Coordinator; Systematic
Medication Management; and the funds associated with out-of-pocket
expenses for prescription behavioral health medications.
Usual Services (n = 1,000). This study arm represents a
control group against which we can compare the two treatment groups.
Participants assigned to this group seek services as they normally
would (or would not) in their community. However, at the time of
randomization, each Usual Service participant will receive a
comprehensive manual describing mental health and vocational services
in their locale, along with state and national resources.
This study will test the two treatment conditions against each
other and against the control group on multiple outcomes of policy
interest to SSA. The key outcomes of interest include: (1) Employment;
(2) earnings; (3) income; (4) mental status; (5) quality of life; (6)
health services utilization; and (7) SSA disability benefit receipt and
amount. SSA is also interested in the study take up rate
(participation); knowing who enrolls (and who does not); and fidelity
to evidence-based treatments; among other aspects of implementation.
Data collection for the evaluation of the SED will consist of the
following activities: Baseline in-person participant interviews;
quarterly participant telephone interviews; receipt of SSA
administrative record data; and collection of site-level program data.
Evaluation team members will also conduct site visits involving: (1)
Pre-visit environmental scans to understand the local context in which
we embed SED services; (2) independent fidelity assessments in
conjunction with those carried out by state Mental Health or Vocational
Rehabilitation staff; (3) key informant interviews with the IPS
specialist, the nurse care coordinator, the case manager, and facility
director; (4) focus groups with participants in the Full-Service and
Basic-Service Treatment groups; and (5) ethnographic data collection
consisting of observations in the natural environment, and person-
centered interviews with participants and non-participants. The
respondents are study participants and non-participants; family
members; IPS specialists; nurse care coordinators; case managers; and
facility directors.
Type of Request: Request for a new information collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Competency and CIDI Screener.................... 3,000 1 40 2,000
Baseline Interview.............................. 3,000 1 45 2,250
Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 3,000 9 20 9,000
9, 10, and 11).................................
Annual Interview (Quarters 4, 8, and 11)........ 3,000 3 30 4,500
Fidelity Assessment Participant Interview....... 180 4 60 720
Fidelity Assessment Family Member Interview..... 90 4 60 360
Key Informant Interview......................... 120 4 60 480
Participant Focus Groups........................ 600 2 60 1,200
Person-Centered Interview....................... 180 4 60 720
---------------------------------------------------------------
Totals...................................... 13,170 .............. .............. 21,230
----------------------------------------------------------------------------------------------------------------
[[Page 10625]]
2. Student Reporting Form--20 CFR 404.352(b)(2); 404.367; 404.368;
404.415; 404.434; 422.135--0960-0088. To qualify for Social Security
Title II student benefits, student beneficiaries must be in full-time
attendance status at an educational institution. In addition, SSA
requires these beneficiaries to report events that may cause a
reduction, termination, or suspension of their benefits. SSA collects
this information on Forms SSA-1383 and SSA-1383-FC to determine if the
changes or events the student beneficiaries report will affect their
continuing entitlement to SSA benefits. SSA also uses the SSA-1383 and
SSA-1383-FC to calculate the correct benefit amounts for student
beneficiaries. The respondents are Social Security Title II student
beneficiaries.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Modality of completion respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1383........................................ 74,887 1 6 7,489
SSA-1383-FC..................................... 1,247 1 6 125
---------------------------------------------------------------
Totals...................................... 76,134 .............. .............. 7,614
----------------------------------------------------------------------------------------------------------------
3. Advanced Notice of Termination of Child's Benefits & Student's
Statement Regarding School Attendance--20 CFR 404.350-404.352, 404.367-
404.368--0960-0105. SSA collects information on Forms SSA-1372-BK and
SSA-1372-BK-FC to determine whether children of an insured worker meet
the eligibility requirements for student benefits. The data we collect
allows SSA to determine student entitlement and thether to terminate
benefits. The respondents are student claimants for Social Security
benefits; their respective schools; and in some cases; their
representative payees.
Type of Request: Revision of an OMB-approved information
collection.
SSA-1372-BK
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Type of respondent respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Individuals/Households.......................... 99,850 1 8 13,313
State/Local/Tribal Government................... 99,850 1 3 4,993
---------------------------------------------------------------
Totals...................................... 199,700 .............. .............. 18,306
----------------------------------------------------------------------------------------------------------------
SSA-1372-BK-FC
----------------------------------------------------------------------------------------------------------------
Average Estimated
Number of Frequency of burden per total annual
Type of respondent respondents response response burden
(minutes) (hours)
----------------------------------------------------------------------------------------------------------------
Individuals/Households.......................... 1,198 1 8 160
State/Local/Tribal Government................... 1,198 1 3 60
---------------------------------------------------------------
Totals...................................... 2,396 .............. .............. 220
---------------------------------------------------------------
Grand Total................................. 200,096 .............. .............. 18,526
----------------------------------------------------------------------------------------------------------------
4. Request for Review of Hearing Decision/Order--20 CFR 404.967-
404.981, 416.1467-416.1481--0960-0277. Claimants have a statutory right
under the Social Security Act and current regulations to request review
of an administrative law judge's (ALJ) hearing decision or dismissal of
a hearing request on Title II and Title XVI claims. Claimants may
request Appeals Council review by filing a written request using Form
HA-520. SSA uses the information to establish the claimant filed the
request for review within the prescribed time and to ensure the
claimant completed the requisite steps permitting the Appeals Council
review. The Appeals Council uses the information to: (1) Document the
claimant's reason(s) for disagreeing with the ALJ's decision or
dismissal; (2) determine whether the claimant has additional evidence
to submit; and (3) determine whether the claimant has a representative
or wants to appoint one. The respondents are claimants requesting
review of an ALJ's decision or dismissal of hearing.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated
Modality of completion Number of Frequency of per response total annual
respondents response (minutes) burden (hours)
----------------------------------------------------------------------------------------------------------------
HA-520...................................... 175,000 1 10 29,167
----------------------------------------------------------------------------------------------------------------
[[Page 10626]]
5. Disability Update Report--20 CFR 404.1589-404.1595 and 416.988-
416.996--0960-0511. As part of our statutory requirements, SSA
periodically uses Form SSA-455, the Disability Update Report, to
evaluate current Title II disability beneficiaries' and Title XVI
disability payment recipients' continued eligibility for Social
Security disability payments. Specifically, SSA uses the form to
determine if: (1) There is enough evidence to warrant referring the
respondent for a full medical Continuing Disability Review (CDR); (2)
the respondent's impairments are still present and indicative of no
medical improvement, precluding the need for a CDR; or (3) the
respondent has unresolved work-related issues. SSA mails Form SSA-455
to specific disability recipients, whom we select as possibly
qualifying for the CDR process. SSA pre-fills the form with data
specific to the disability recipient, except for the sections we ask
the recipients to complete. When SSA receives the completed form, we
scan it into SSA's system. This allows us to gather the information
electronically, and enables SSA to process the returned forms through
automated decision logic to decide the proper course of action to take.
The respondents are recipients of Title II and Title XVI Social
Security disability payments.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-455..................................... 1,500,000 1 15 375,000
----------------------------------------------------------------------------------------------------------------
II. SSA submitted the information collections below to OMB for
clearance. Your comments regarding the information collections would be
most useful if OMB and SSA receive them 30 days from the date of this
publication. To be sure we consider your comments, we must receive them
no later than March 16, 2017. Individuals can obtain copies of the OMB
clearance package by writing to OR.Reports.Clearance@ssa.gov.
1. Agreement to Sell Property--20 CFR 416.1240-1245--0960-0127.
Individuals or couples who are otherwise eligible for Supplemental
Security Income (SSI) payments, but whose resources exceed the
allowable limit may receive conditional payments if they agree to
dispose of the excess non-liquid resources and make repayments. SSA
uses Form SSA-8060-U3 to document this agreement, and to ensure the
individuals understand their obligations. Respondents are applicants
for and recipients of SSI payments who will be disposing of excess non-
liquid resources.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-8060-U3................................. 20,000 1 10 3,333
----------------------------------------------------------------------------------------------------------------
2. Development of Participation in a Vocational Rehabilitation or
Similar Program--20 CFR 404.316(c), 404.337(c), 404.352(d),
404.1586(g), 404.1596, 404.1597(a), 404.327, 404.328, 416.1321(d),
416.1331(a)-(b), and 416.1338, 416.1402--0960-0282. State Disability
Determination Services (DDS) must determine if Social Security
disability payment recipients whose disability ceased and who
participate in vocational rehabilitation programs may continue to
receive disability payments. To do this, DDSs need information about
the recipients; the types of program participation; and the services
they receive under the rehabilitation program. SSA uses Form SSA-4290
to collect this information. The respondents are State employment
networks; vocational rehabilitation agencies; or other providers of
educational or job training services.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-4290.................................... 3,000 1 15 750
----------------------------------------------------------------------------------------------------------------
3. Appointment of Representative--20 CFR 404.1707, 404.1720,
408.1101, 416.1507, and 416.1520--0960-0527. Individuals claiming
rights or benefits under the Social Security Act (Act) must notify SSA
in writing when they appoint an individual to represent them in dealing
with SSA. SSA collects the information on Form SSA-1696-U4 to verify
the appointment of these representatives. The SSA-1696-U4 allows SSA to
inform representatives of items that affect the recipient's claim, and
allows claimants to give permission to their appointed representatives
to designate a person to receive their claims files. Respondents are
applicants for, or recipients of, Social Security disability benefits
(SSDI) or SSI payments who are notifying SSA they have appointed a
person to represent them in their dealings with SSA.
Type of Request: Revision of an OMB-approved information
collection.
[[Page 10627]]
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-1696-U4................................. 800,000 1 10 133,333
----------------------------------------------------------------------------------------------------------------
4. Work Activity Report (Self-Employment)--20 CFR 404.1520(b), 20
CFR 404.1571-404.1576, 20 CFR 404.1584-404.1593, and 20 CFR 416.971-
416.976--0960-0598. SSA uses Form SSA-820-U4 to determine initial or
continuing eligibility for (1) Title II SSDI, or (2) Title XVI SSI
payments. Under Titles II and XVI of the Act, recipients receive
disability benefits and SSI payments based on their inability to engage
in substantial gainful activity (SGA) due to a physical or mental
condition. Therefore, when the recipients resume work, they must report
their work so SSA can evaluate and determine by law whether they
continue to meet the disability requirements. SSA uses Form SSA-820-U4
to obtain information on self-employment activities of Social Security
Title II and XVI disability applicants and recipients. We use the data
we obtain to evaluate disability claims, and to help us determine if
the claimant meets current disability provisions under Titles II and
XVI. Since applicants for disability benefits or payments must prove an
inability to perform any kind of SGA generally available in the
national economy for which we expect them to qualify based on age,
education, and work experience, any work an applicant performed until,
or subsequent to, the date the disability allegedly began, affects our
disability determination. The respondents are applicants and claimants
for SSI payments or SSDI benefits.
Type of Request: Revision of an OMB-approved information
collection.
----------------------------------------------------------------------------------------------------------------
Average burden Estimated total
Modality of completion Number of Frequency of per response annual burden
respondents response (minutes) (hours)
----------------------------------------------------------------------------------------------------------------
SSA-820-BK.................................. 100,000 1 30 50,000
----------------------------------------------------------------------------------------------------------------
Dated: February 9, 2017.
Naomi R. Sipple,
Reports Clearance Officer, Social Security Administration.
[FR Doc. 2017-02941 Filed 2-13-17; 8:45 am]
BILLING CODE 4191-02-P
