Submission for OMB Review; Comment Request, 29314-29315 [05-10121]
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29314
Federal Register / Vol. 70, No. 97 / Friday, May 20, 2005 / Notices
providers. The use of this standard
improves the Medicare and Medicaid
programs, other Federal health programs
and private health programs, by
simplifying the administration of the
system and enabling the efficient
electronic transmission of certain health
information; Frequency: Other—onetime; Affected Public: Business or other
for-profit, Not-for-profit institutions,
Federal Government, and State, Local or
Tribal Government; Number of
Respondents: 2,550,000; Total Annual
Responses: 2,550,000; Total Annual
Hours: 1.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’ Web site
address at https://www.cms.hhs.gov/
regulations/pra/, or E-mail your request,
including your address, phone number,
OMB number, and CMS document
identifier, to Paperwork@cms.hhs.gov,
or call the Reports Clearance Office on
(410) 786–1326.
Written comments and
recommendations for the proposed
information collections must be mailed
within 60 days of this notice to the
address below: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: William N. Parham, III, PRA
Analyst, Room C5–13–27, 7500 Security
Boulevard, Baltimore, Maryland 21244–
1850.
Dated: May 2, 2005.
Michelle Shortt,
Acting Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 05–9642 Filed 5–19–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–37]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services.
AGENCY:
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS) is publishing the
following summary of proposed
collections for public comment.
Interested persons are invited to send
comments regarding this burden
estimate or any other aspect of this
collection of information, including any
of the following subjects: (1) The
necessity and utility of the proposed
information collection for the proper
performance of the agency’s functions;
(2) the accuracy of the estimated
burden; (3) ways to enhance the quality,
utility, and clarity of the information to
be collected; and (4) the use of
automated collection techniques or
other forms of information technology to
minimize the information collection
burden.
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicaid
Program Budget Report; Form Nos.:
CMS–37 (OMB # 0938–0101); Use: The
Medicaid Program Budget Report is
prepared by the State Medicaid
Agencies and is used by the Centers for
Medicare & Medicaid Services (CMS) for
(1) developing National Medicaid
Budget estimates, (2) qualification of
Budget Estimate Changes, and (3) the
issuance of quarterly Medicaid Grant
Awards. The structure of the currently
approved CMS–37 was revised based on
CMS experience with budget
information provided by the States.
(Note: Details are outlined in the
Addendum which can be found on the
CMS Web site address below.)
Frequency: Quarterly; Affected Public:
State, Local or Tribal Government;
Number of Respondents: 56; Total
Annual Responses: 224; Total Annual
Hours: 7,616.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’ Web site
address at https://www.cms.hhs.gov/
regulations/pra/, or e-mail your request,
including your address, phone number,
OMB number, and CMS document
identifier, to Paperwork@cms.hhs.gov,
or call the Reports Clearance Office on
(410) 786–1326.
Written comments and
recommendations for the proposed
information collections must be mailed
within 60 days of this notice to the
address below: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Melissa Musotto, PRA
Analyst, Room C4–26–05, 7500 Security
Boulevard, Baltimore, Maryland 21244–
1850.
Dated: May 12, 2005.
Michelle Shortt,
Acting Director, Regulations Development
Group, Office of Strategic Operations and
Regulatory Affairs.
[FR Doc. 05–10054 Filed 5–19–05; 8:45 am]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: LIHEAP Quarterly Allocation
Estimates Form ACF–535.
OMB No.: 0970–0037
Description: The Low Income Home
Energy Assistance Program (LIHEAP)
Quarterly Allocation Estimates Form–
535 is a one-page form that is sent to 50
State grantees and to the District of
Columbia. It is also sent to Tribal
Government grantees that receive over
$1 million annually for LIHEAP.
Grantees are asked to complete and
submit the form in the 4th quarter of
each fiscal year. The data collected on
the form are grantees’ estimates of
obligations they expect to make each
quarter of the upcoming fiscal year for
the LIHEAP program. This is the only
method used to request anticipated
distributions of the grantee’s LIHEAP
funds. The information is used to
develop apportionment requests to OMB
and to make grant awards based on
grantee anticipated needs. Information
collected on this form is not available
through any other Federal source.
Submission of the form is voluntary.
Respondents: 50 States, the District of
Columbia and those Tribal governments
that receive over $1 million annually.
ANNUAL BURDEN ESTIMATES
Instrument
Number of
respondents
Number of
responses per
respondent
Average burden hours per
response
Total burden
hours
ACF–535 ..........................................................................................................
55
1
.25
13.75
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Federal Register / Vol. 70, No. 97 / Friday, May 20, 2005 / Notices
Estimated Total Annual Burden
Hours: 13.75.
Additional Information: Copies of the
proposed collection may be obtained by
writing to The Administration for
Children and Families, Office of
Administration, Office of Information
Services, 370 L’Enfant Promenade, SW.,
Washington, DC 20447. Attn: ACF
Reports Clearance Officer. E-mail:
grjohnson@acf.hhs.gov.
OMB Comment: OMB is required to
make a decision concerning the
collection of information between 30
and 60 days after publication of this
document in the Federal Register.
Therefore, a comment is best assured of
having its full effect if OMB receives it
within 30 days of publication. Written
comments and recommendations for the
proposed information collection should
be sent directly to the following: Office
of Management and Budget, Paperwork
Reduction Project, Attn: Desk Officer for
ACF. E-mail address:
Katherine_T._Astrich@omb.eop.gov.
Dated: May 16, 2005.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 05–10121 Filed 5–19–05; 8:45 am]
BILLING CODE 4184–01–M
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: Employment Retention and
Advancement (ERA) Evaluation 42Month Survey.
OMB No.: New Collection.
Description: The proposed
information collection is for follow-up
information within the Employment
Retention and Advancement (ERA)
Evaluation that is sponsored by the
Administration for Children and
Families (ACF) of the U.S. Department
of Health and Human Services.1 The
ERA project is a multi-year evaluation
that is designed to study the net impact
and cost-benefits of programs designed
to help Temporary Assistance for Needy
Families (TANF) recipients, former
recipients, or families at-risk of needing
TANF retain and advance in
employment.2 The ERA Evaluation
involves 15 random assigment
experiments in eight states, testing a
diverse set of strategies. The ERA
project will generate rigorous data on
the implementation, effects, and costs of
these alternative approaches. The data
collected as part of the 42-month survey
will be used for the purposes described
below.
• The survey data will allow for the
analysis of ERA programs’ impacts on a
wider range of outcome measures than
is available through welfare or
29315
Unemployment Insurance
administrative records in order to more
fully understand how individuals were
affected by such programs. This will
include outcomes such as length of job
retention; job quality; educational
attainment; household composition;
employment barriers (such as child care,
health status, and transportation); health
insurance coverage; income; wealth,
debt, and consumption; hardship (such
as food insecurity); and children wellbeing.
• The data will allow for the conduct
of non-experimental analyses to explain
participation decisions and provide a
descriptive picture of the circumstances
of low-wage workers.
• The survey will address
participation information important to
the evaluation’s cost-benefit component.
Respondents: The respondents of the
42-month survey are TANF applicants,
current and former TANF recipients, or
individuals in families at-risk of
needing TANF benefits (working poor
and hard-to-employ) who are in the
research sample in a subset of the 15
programs participating in the ERA
Evaluation. Survey participants will be
administered a telephone survey
approximately 42 months after the date
they were enrolled in the research
sample and randomly assigned to the
treatment or control group. For those
individuals who cannot be reached by
phone, survey firm staff will attempt to
contact them in person. A total of
approximately 3,500 participants will
complete the survey over a 2-year
period (1,750 respondents annually).
ANNUAL BURDEN ESTIMATES
Instrument
Number of
respondents
Number of
responses per
respondent
Average burden hours per response
Total burden
hours
42-Month Survey .............................................
1,750
1
30 minutes (or .50 hrs) ..................................
875.0.
Estimated Total Annual Burden
Hours: 875.0.
Additional Information: Copies of the
proposed collection may be obtained by
writing to the Administration for
Children and Families, Office of
Administration, Office of Information
Services, 370 L’Enfant Promenade, SW.,
Washington, DC 20447, Attn: ACF
Reports Clearance Officer. All requests
should be identified by the title of the
information collection. E-mail address:
grjohnson@acf.hhs.gov.
OMB Comment: OMB is required to
make a decision concerning the
1 The U.S. Department of Labor has also provided
funding to support the ERA project.
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collection of information between 30
and 60 days after publication of this
document in the Federal Register.
Therefore, a comment is best assured of
having its full effect if OMB receives it
within 30 days of publication. Written
comments and recommendations for the
proposed information collection should
be sent directly to the following: Office
of Management and Budget, Paperwork
Reduction Project, Attn: Desk Officer for
ACF. E-mail address:
Katherine_T._Astrich@omb.eop.gov.
Dated: May 16, 2005.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 05–10122 Filed 5–19–05; 8:45 am]
BILLING CODE 4184–01–M
2 From the Department of Health and Human
Services RFP No.: 105–99–8100.
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]]>Agencies
[Federal Register Volume 70, Number 97 (Friday, May 20, 2005)]
[Notices]
[Pages 29314-29315]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-10121]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Submission for OMB Review; Comment Request
Title: LIHEAP Quarterly Allocation Estimates Form ACF-535.
OMB No.: 0970-0037
Description: The Low Income Home Energy Assistance Program (LIHEAP)
Quarterly Allocation Estimates Form-535 is a one-page form that is sent
to 50 State grantees and to the District of Columbia. It is also sent
to Tribal Government grantees that receive over $1 million annually for
LIHEAP. Grantees are asked to complete and submit the form in the 4th
quarter of each fiscal year. The data collected on the form are
grantees' estimates of obligations they expect to make each quarter of
the upcoming fiscal year for the LIHEAP program. This is the only
method used to request anticipated distributions of the grantee's
LIHEAP funds. The information is used to develop apportionment requests
to OMB and to make grant awards based on grantee anticipated needs.
Information collected on this form is not available through any other
Federal source. Submission of the form is voluntary.
Respondents: 50 States, the District of Columbia and those Tribal
governments that receive over $1 million annually.
Annual Burden Estimates
----------------------------------------------------------------------------------------------------------------
Number of Average burden
Instrument Number of responses per hours per Total burden
respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
ACF-535..................................... 55 1 .25 13.75
----------------------------------------------------------------------------------------------------------------
[[Page 29315]]
Estimated Total Annual Burden Hours: 13.75.
Additional Information: Copies of the proposed collection may be
obtained by writing to The Administration for Children and Families,
Office of Administration, Office of Information Services, 370 L'Enfant
Promenade, SW., Washington, DC 20447. Attn: ACF Reports Clearance
Officer. E-mail: grjohnson@acf.hhs.gov.
OMB Comment: OMB is required to make a decision concerning the
collection of information between 30 and 60 days after publication of
this document in the Federal Register. Therefore, a comment is best
assured of having its full effect if OMB receives it within 30 days of
publication. Written comments and recommendations for the proposed
information collection should be sent directly to the following: Office
of Management and Budget, Paperwork Reduction Project, Attn: Desk
Officer for ACF. E-mail address: Katherine--T.--Astrich@omb.eop.gov.
Dated: May 16, 2005.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 05-10121 Filed 5-19-05; 8:45 am]
BILLING CODE 4184-01-M
