Agency Information Collection Activities: Proposed Collection; Comment Request, 32338 [05-10981]
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Federal Register / Vol. 70, No. 105 / Thursday, June 2, 2005 / Notices
This is a new data collection.
SUPPLEMENTARY INFORMATION:
Respondent type
Activity
Number of
respondents
Responses/
respondent
Time (hr)/
response
Total
burden
Program staff ...........
HIV/AIDS Knowledge Form (pre and post) .......
HIV/AIDS Risk Behavior Form ..........................
Encounter Form .................................................
Client Background Form ....................................
Process Evaluation Form-Staff ..........................
............................................................................
Client Utilization Form (RS/INR) ........................
6
6
14
6
18
....................
210
240
240
120
120
2
....................
1
0.25
0.33
0.25
0.17
1.00
....................
0.33
360
475
420
122
36
....................
70
Recruiting Script for Utilization survey ..............
............................................................................
´ ´
Protege Utilization Form ....................................
300
....................
8
1
....................
1
0.17
....................
0.50
51
....................
4
Organizational Assessment Questionnaire (pre
and post).
Process Evaluation Form-Director .....................
Stakeholder Survey ...........................................
12
2
1.50
36
18
24
2
1
1.00
1
36
24
$1,200.00
552
....................
....................
1,635
$1,200.00
Clients of Funded
programs.
Directors, Funded
programs.
Stakeholders ............
Total .................
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access the HHS Web
site address at https://www.hhs.gov/
oirm/infocollect/pending/ or e-mail your
request, including your address, phone
number, OMB number, and OS
document identifier, to
naomi.cook@hhs.gov, or call the Reports
Clearance Office on (202) 690–6162.
Written comments and
recommendations for the proposed
information collections must be mailed
within 30 days of this notice directly to
the Desk Officer at the address below:
OMB Desk Officer: John Kraemer, OMB
Human Resources and Housing Branch,
Attention: (OMB #0990–NEW), New
Executive Office Building, Room 10235,
Washington DC 20503.
Dated: May 20, 2005.
Robert E. Polson,
Office of the Secretary, Paperwork Reduction
Act Reports Clearance Officer.
[FR Doc. 05–10980 Filed 6–1–05; 8:45 am]
BILLING CODE 4168–17–U
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Office of the Secretary
[Document Identifier: OS–0990–0258]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Office of the Secretary.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Office of the Secretary (OS), Department
of Health and Human Services, is
AGENCY:
VerDate jul<14>2003
16:54 Jun 01, 2005
Jkt 205001
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.
Type of Information Collection
Request: Extension of Currently
Approved Collection.
Title of Information Collection:
National Study of Stroke Post Acute
Care: Outcomes and Costs.
Form/OMB No.: OS–0990–0258.
Use: This study will provide
information on Medicare outcomes and
costs of care for Medicare beneficiaries
who suffer a stroke and received
treatment in a post acute care setting
skilled nursing facility, home health, or
rehabilitation hospital.
Frequency: Reporting on occasion.
Affected Public: Business or other forprofit, not-for-profit institutions; and
individuals or households.
Annual Number of Respondents: 350.
Total Annual Responses: 350.
Average Burden Per Response: 1 hour.
Total Annual Hours: 298.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access the HHS Web
site address at https://www.hhs.gov/
oirm/infocollect/pending/ or e-mail your
PO 00000
Frm 00050
Fmt 4703
Sfmt 4703
Total cost to
respondent
$0.00
$0.00
request, including your address, phone
number, OMB number, and OS
document identifier, to
naomi.cook@hhs.gov, or call the Reports
Clearance Office on (202) 690–6162.
Written comments and
recommendations for the proposed
information collections must be mailed
within 60 days of this notice directly to
the OS Paperwork Clearance Officer
designated at the following address:
Department of Health and Human
Services, Office of the Secretary,
Assistant Secretary for Budget,
Technology, and Finance, Office of
Information and Resource Management,
Attention: Naomi Cook (0990–0258),
Room 531–H, 200 Independence
Avenue, SW., Washington, DC 20201.
Dated: May 20, 2005.
Robert E. Polson,
Office of the Secretary, Paperwork Reduction
Act Reports Clearance Officer.
[FR Doc. 05–10981 Filed 6–1–05; 8:45 am]
BILLING CODE 4168–17–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Committee on Vital and Health
Statistics: Meeting
Pursuant to the Federal Advisory
Committee Act, the Department of
Health and Human Services (HHS)
announces the following advisory
committee meeting.
Name: National Committee on Vital and
Health Statistics (NCVHS).
Time and Date: June 29, 2005 9 a.m.–3:30
p.m., June 30, 2005 9 a.m.–3 p.m.
Place: Hubert H. Humphrey Building, 200
Independence Avenue, SW., Room 705A,
Washington, DC 20201.
Status: Open.
E:\FR\FM\02JNN1.SGM
02JNN1
]]>Agencies
[Federal Register Volume 70, Number 105 (Thursday, June 2, 2005)]
[Notices]
[Page 32338]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 05-10981]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
[Document Identifier: OS-0990-0258]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Office of the Secretary.
In compliance with the requirement of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the Office of the Secretary (OS),
Department of Health and Human Services, 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.
Type of Information Collection Request: Extension of Currently
Approved Collection.
Title of Information Collection: National Study of Stroke Post
Acute Care: Outcomes and Costs.
Form/OMB No.: OS-0990-0258.
Use: This study will provide information on Medicare outcomes and
costs of care for Medicare beneficiaries who suffer a stroke and
received treatment in a post acute care setting skilled nursing
facility, home health, or rehabilitation hospital.
Frequency: Reporting on occasion.
Affected Public: Business or other for-profit, not-for-profit
institutions; and individuals or households.
Annual Number of Respondents: 350.
Total Annual Responses: 350.
Average Burden Per Response: 1 hour.
Total Annual Hours: 298.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access the HHS
Web site address at https://www.hhs.gov/oirm/infocollect/pending/ or e-
mail your request, including your address, phone number, OMB number,
and OS document identifier, to naomi.cook@hhs.gov, or call the Reports
Clearance Office on (202) 690-6162. Written comments and
recommendations for the proposed information collections must be mailed
within 60 days of this notice directly to the OS Paperwork Clearance
Officer designated at the following address: Department of Health and
Human Services, Office of the Secretary, Assistant Secretary for
Budget, Technology, and Finance, Office of Information and Resource
Management, Attention: Naomi Cook (0990-0258), Room 531-H, 200
Independence Avenue, SW., Washington, DC 20201.
Dated: May 20, 2005.
Robert E. Polson,
Office of the Secretary, Paperwork Reduction Act Reports Clearance
Officer.
[FR Doc. 05-10981 Filed 6-1-05; 8:45 am]
BILLING CODE 4168-17-P
