Agency Information Collection Activities: Proposed Collection; Comment Request, 12965-12966 [2011-5365]
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Federal Register / Vol. 76, No. 46 / Wednesday, March 9, 2011 / Notices
from the ongoing BRFSS as well as
additional questions taken from
standardized scales or from other
surveys designed to measure anxiety,
depression, and potential stressassociated physical health effects.
The survey questionnaire was
developed by DBS in partnership with
the Substance Abuse and Mental Health
Services Administration (SAMHSA) and
state public health and mental health
departments from Louisiana,
Mississippi, Alabama, and Florida,
where the survey is being conducted.
Coastal counties within 32 miles of an
area where fishing was closed due to the
Deepwater Horizon Event were selected
for inclusion. These include the
following Gulf coast counties:
Louisiana: Assumption Parish,
Calcasieu Parish, Cameron Parish,
Iberia Parish, Jefferson Parish,
Jefferson Davis Parish, Lafourche
Parish, Orleans Parish, Plaquemines
Parish, St. Bernard Parish, St. Charles
Parish, St. Mary Parish, St. Tammany
Parish, Tangipahoa Parish,
Terrebonne Parish, Vermilion Parish
Mississippi: Hancock County, Harrison
County, Jackson County
Alabama: Baldwin County, Mobile
County
Florida: Escambia County, Okaloosa
County, Santa Rosa County, Walton
County
The telephone survey will collect data
from a random sample of telephone
households which include landline and
cellular phone telephones in the
selected counties. Approximately 2,500
interviews will be completed each
month in the targeted coastal areas and
approximately 1,250 interviews will be
completed in the comparison areas.
Adults 18 years or older will be asked
to take part in the survey, but only one
adult per household will be
interviewed. Potential respondents will
be notified through an introductory
script that participation is voluntary and
they will not be compensated for
participating. For those who agree to
participate, interviews should last
approximately 30 minutes.
Since the OMB emergency clearance
for the DBS Gulf States Population
Survey expires April 30, 2011, DBS is
submitting and information collection
request (ICR) to continue data collection
for one year.
Preliminary data from the survey will
be available to SAMHSA and
participating states monthly (pending
sample size). The final dataset and
analyses will be provided to SAMHSA
and participating states in January 2012.
There is no cost to respondents other
than their time. The total estimated
annual burden hours are 20,000.
Since the publication of the 60-day
Federal Register Notice, DBS proposes
to include the following modifications
to the Gulf States Population Survey.
• Addition of a Spanish translation of
the questionnaire.
• Minor modifications in the wording
of some survey questions to improve
respondent’s understanding of the
question.
• Extension of the sample area to the
entirety of the four states (AL, FL, LA,
MS), which will allow comparison of
results from the Gulf Coast counties to
non-Gulf Coast counties.
• Addition of cellular phones to the
sampling frame. Extension of the sample
area to the entirety of the four states
(AL, FL, LA, MS) will allow DBS to
sample cellular phone responses in
addition to land-line telephones. This
will improve the survey
representativeness because those who
have a cellular phone, but no land-line
telephone, have a demographic profile
that differs from those who do have
land-line telephones.
The objective of the survey is to
provide state health and mental health
departments, SAMHSA, and other
appropriate organizations data they
need to assess the need for mental and
behavioral health services in the
selected counties and to inform the
provision of those services.
ESTIMATED ANNUALIZED BURDEN HOURS
Number of respondents
Respondents
Form
Group
Individuals .....................................
GSPS .....................
Coastal Counties .........................
Comparison Group Counties .......
Catina Conner,
Acting Reports Clearance Officer, Centers for
Disease Control and Prevention.
[FR Doc. 2011–5294 Filed 3–8–11; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
Emcdonald on DSK2BSOYB1PROD with NOTICES
[Document Identifier: CMS–10232 and CMS–
R–211]
Agency Information Collection
Activities: Proposed Collection;
Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
AGENCY:
VerDate Mar<15>2010
18:04 Mar 08, 2011
Jkt 223001
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.
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30,000
10,000
Average burden per
pesponse
(in hours)
Number responses per
respondent
1
1
30/60
30/60
1. Type of Information Collection
Request: Revision of currently approved
collection; Title of Information
Collection: State Plan Template to
Implement Section 6062 of the Deficit
Reduction Act; Form No.: CMS–10232
(OMB#: 0938–1045); Use: The Deficit
Reduction Act (DRA) provides States
with numerous flexibilities in operating
their State Medicaid Programs. Section
6062 of the DRA (Opportunity for
families of Disabled Children to
Purchase Medicaid Coverage for Such
Children) provides States the
opportunity to provide Medicaid
benefits to disabled children who would
otherwise be ineligible because of
family income that is above the State’s
highest Medicaid eligibility standards
for children. States must establish a
State Plan for medical assistance to
implement this provision. To do this,
E:\FR\FM\09MRN1.SGM
09MRN1
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Federal Register / Vol. 76, No. 46 / Wednesday, March 9, 2011 / Notices
State Medicaid Agencies will complete
the template. CMS will review the
information to determine if the State has
met all the requirements of the DRA
provision; Frequency: Once; Affected
Public: State, Federal, or Tribal
Governments; Number of Respondents:
56; Total Annual Responses: 10; Total
Annual Hours: 60. (For policy questions
regarding this collection contact Barbara
Washington at 410–786–9964. For all
other issues call 410–786–1326.)
2. Type of Information Collection
Request: Revision of currently approved
collection; Title of Information
Collection: Model Application Template
and Instructions for State Child Health
Plan Under Title XXI of the Social
Security Act, State Children’s Health
Insurance Program; Form No.: CMS–R–
211 (OMB#: 0938–0707); Use: The
information will be used to assess State
plan performance and health outcomes
and to evaluate the amount of substitute
private coverage and the effect of
subsidies on access to coverage;
Frequency: Yearly, occasionally;
Affected Public: State, Federal, or Tribal
Governments; Number of Respondents:
40; Total Annual Responses: 40; Total
Annual Hours: 3,200. (For policy
questions regarding this collection
contact Nancy Goetschius at 410–786–
0707. For all other issues call 410–786–
1326.)
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections
referenced above, access CMS’ Web site
at https://www.cms.hhs.gov/
PaperworkReductionActof1995, or email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov, or call the
Reports Clearance Office at 410–786–
1326.
In commenting on the proposed
information collections please reference
the document identifier or OMB control
number. To be assured consideration,
comments and recommendations must
be submitted in one of the following
ways by May 9, 2011:
1. Electronically. You may submit
your comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) accepting comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number, Room C4–26–05, 7500
Security Boulevard, Baltimore,
Maryland 21244–1850.
Dated: February 28, 2011.
Michelle Shortt,
Director, Regulations Development Group,
Office of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2011–5365 Filed 3–4–11; 4:15 pm]
BILLING CODE 4120–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Title: Measurement Development:
Quality of Caregiver-Child Interactions
for Infants and Toddlers (Q–CCIIT).
OMB No.: New Collection.
Description: The Office of Planning,
Research and Evaluation (OPRE),
Administration for Children and
Families (ACE), U.S. Department of
Health and Human Services (HHS), is
proposing to develop a new observation
measure to assess the quality of child
care settings, specifically the quality of
caregiver-child interaction for infants
and toddlers in nonparental care. The
measure will be appropriate for use
across child care settings, center-based
and family child care settings as well as
single- and mixed-age classrooms.
The two-year data collection activity
will include two phases: (1) A pilot test
and (2) a psychometric field test. We
will request information about the child
care setting, its classrooms and families
for recruitment into the study.
Information will be collected through
observations, focus groups, and
questionnaires.
In the pilot and field tests, the new Q–
CCIIT observation measure will include
observing a small group activity
structured with a common task and
asking follow-up observation questions.
Caregivers observed will also complete
a background questionnaire. Focus
groups to obtain stakeholder input on
caregiver-child interactions will be
conducted separately with parents,
caregivers, and training and technical
assistance providers. Focus group
participants will also complete a
demographic questionnaire. Parents of
children served by caregivers will
complete a questionnaire on their
child’s competencies related to
cognitive, language/communication,
and social-emotional development.
Parents will complete this
questionnaire, which will also include
family and child characteristics, once in
the pilot test and twice in the field test,
at the start of the field test and 6 months
later to assess growth.
The purpose of this data collection is
to support the 2007 reauthorization of
the Head Start program (Pub. L. 110–
134), which calls for periodic
assessments of Head Start’s quality and
effectiveness.
Respondents: Child care setting
representatives (directors or owners),
caregivers (center-based and family
child care settings), parents of children
in those child care settings, and training
and technical assistance providers.
ANNUAL BURDEN ESTIMATES
Emcdonald on DSK2BSOYB1PROD with NOTICES
Child care setting recruitment form ...............................................................
Q–CCIIT measure-small group activity and follow-up ...................................
Caregiver background questionnaire .............................................................
Focus group interview guide .........................................................................
Parent focus group demographic questionnaire ...........................................
Caregiver focus group demographic questionnaire .......................................
Training and technical assistance provider focus group demographic questionnaire ......................................................................................................
Parent-report child competence questionnaire ..............................................
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Number of responses per
hour per respondent
Average burden
hour per response
Estimated annual burden
hours
190
290
520
20
10
5
1
1
1
1
1
1
0.5
0.25
0.25
1.90
0.10
0.10
95
73
130
38
1
1
5
880
1
2
0.10
0.75
1
1,320
Annual number of respondents
Instrument
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Agencies
[Federal Register Volume 76, Number 46 (Wednesday, March 9, 2011)]
[Notices]
[Pages 12965-12966]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2011-5365]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-10232 and CMS-R-211]
Agency Information Collection Activities: Proposed Collection;
Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
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 currently
approved collection; Title of Information Collection: State Plan
Template to Implement Section 6062 of the Deficit Reduction Act; Form
No.: CMS-10232 (OMB: 0938-1045); Use: The Deficit Reduction
Act (DRA) provides States with numerous flexibilities in operating
their State Medicaid Programs. Section 6062 of the DRA (Opportunity for
families of Disabled Children to Purchase Medicaid Coverage for Such
Children) provides States the opportunity to provide Medicaid benefits
to disabled children who would otherwise be ineligible because of
family income that is above the State's highest Medicaid eligibility
standards for children. States must establish a State Plan for medical
assistance to implement this provision. To do this,
[[Page 12966]]
State Medicaid Agencies will complete the template. CMS will review the
information to determine if the State has met all the requirements of
the DRA provision; Frequency: Once; Affected Public: State, Federal, or
Tribal Governments; Number of Respondents: 56; Total Annual Responses:
10; Total Annual Hours: 60. (For policy questions regarding this
collection contact Barbara Washington at 410-786-9964. For all other
issues call 410-786-1326.)
2. Type of Information Collection Request: Revision of currently
approved collection; Title of Information Collection: Model Application
Template and Instructions for State Child Health Plan Under Title XXI
of the Social Security Act, State Children's Health Insurance Program;
Form No.: CMS-R-211 (OMB: 0938-0707); Use: The information
will be used to assess State plan performance and health outcomes and
to evaluate the amount of substitute private coverage and the effect of
subsidies on access to coverage; Frequency: Yearly, occasionally;
Affected Public: State, Federal, or Tribal Governments; Number of
Respondents: 40; Total Annual Responses: 40; Total Annual Hours: 3,200.
(For policy questions regarding this collection contact Nancy
Goetschius at 410-786-0707. For all other issues call 410-786-1326.)
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS'
Web site at https://www.cms.hhs.gov/PaperworkReductionActof1995, 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 at 410-786-1326.
In commenting on the proposed information collections please
reference the document identifier or OMB control number. To be assured
consideration, comments and recommendations must be submitted in one of
the following ways by May 9, 2011:
1. Electronically. You may submit your comments electronically to
https://www.regulations.gov. Follow the instructions for ``Comment or
Submission'' or ``More Search Options'' to find the information
collection document(s) accepting comments.
2. By regular mail. You may mail written comments to the following
address: CMS, Office of Strategic Operations and Regulatory Affairs,
Division of Regulations Development, Attention: Document Identifier/OMB
Control Number, Room C4-26-05, 7500 Security Boulevard, Baltimore,
Maryland 21244-1850.
Dated: February 28, 2011.
Michelle Shortt,
Director, Regulations Development Group, Office of Strategic Operations
and Regulatory Affairs.
[FR Doc. 2011-5365 Filed 3-4-11; 4:15 pm]
BILLING CODE 4120-01-P