Agency Information Collection Activities; Submission to OMB for Review and Approval; Public Comment Request, 41406-41407 [2013-16604]
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41406
Federal Register / Vol. 78, No. 132 / Wednesday, July 10, 2013 / Notices
Information Collection Request Title:
Scholarships for Disadvantaged
Students Program OMB No. 0915–
0149—Renewal
The purpose of the Scholarships for
Disadvantaged Students (SDS) Program
is to provide funds to eligible schools to
provide scholarships to full-time,
financially needy students from
disadvantaged backgrounds enrolled in
health professions and nursing
programs.
To qualify for participation in the SDS
program, a school must be carrying out
a program for recruiting and retaining
students from disadvantaged
backgrounds, including students who
are members of racial and ethnic
minority groups (section 737(d)(1)(B) of
the PHS Act). A school must meet the
eligibility criteria to demonstrate that
the program has achieved success based
on the number and/or percentage of
disadvantaged students who graduate
from the school. In awarding SDS funds
to eligible schools, funding points must
be given to schools based on the
proportion of graduating students going
into primary care, the proportion of
underrepresented minority students,
and the proportion of graduates working
in medically underserved communities
(section 737(c) of the PHS Act).
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose or provide the information
requested. This includes the time
needed to review instructions; to
develop, acquire, install and utilize
technology and systems for the purpose
of collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information; to train
personnel and to be able to respond to
a collection of information; to search
data sources; to complete and review
the collection of information; and to
transmit or otherwise disclose the
information. The total annual burden
hours estimated for this Information
Collection Request are summarized in
the table below.
TOTAL ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents
Form
Number of
responses per
respondent
Total
responses
Hours per
response
Total hour
burden
Application ............................................................................
400
1
400
13
5,200
Total ..............................................................................
400
1
400
13
5,200
HRSA specifically requests comments
on (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.
Dated: July 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information
Coordination.
[FR Doc. 2013–16559 Filed 7–9–13; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
TKELLEY on DSK3SPTVN1PROD with NOTICES
Agency Information Collection
Activities; Submission to OMB for
Review and Approval; Public Comment
Request
Health Resources and Services
Administration, HHS.
ACTION: Notice.
AGENCY:
In compliance with Section
3507(a)(1)(D) of the Paperwork
Reduction Act of 1995, the Health
Resources and Services Administration
(HRSA) has submitted an Information
SUMMARY:
VerDate Mar<15>2010
17:42 Jul 09, 2013
Jkt 229001
Collection Request (ICR) to the Office of
Management and Budget (OMB) for
review and approval. Comments
submitted during the first public review
of this ICR will be provided to OMB.
OMB will accept further comments from
the public during the review and
approval period.
DATES: Comments on this ICR should be
received within 30 days of this notice.
ADDRESSES: Submit your comments,
including the Information Collection
Request Title, to the desk officer for
HRSA, either by email to
OIRA_submission@omb.eop.gov or by
fax to 202–395–5806.
FOR FURTHER INFORMATION CONTACT: To
request a copy of the clearance requests
submitted to OMB for review, email the
HRSA Information Collection Clearance
Officer at paperwork@hrsa.gov or call
(301) 443–1984.
SUPPLEMENTARY INFORMATION:
Information Collection Request Title:
Health Center Program Application
Forms
OMB No. 0915–0285—Revision
Abstract: Health centers (section 330
grant funded and Federally Qualified
Health Center Look-Alikes) deliver
comprehensive, high quality, costeffective primary health care to patients
regardless of their ability to pay. Health
centers have become an essential
primary care provider for America’s
most vulnerable populations. Health
centers advance the preventive and
primary medical/health care home
PO 00000
Frm 00055
Fmt 4703
Sfmt 4703
model of coordinated, comprehensive,
and patient-centered care, coordinating
a wide range of medical, dental,
behavioral, and social services. More
than 1,200 health centers operate nearly
9,000 service delivery sites that provide
care in every state, the District of
Columbia, Puerto Rico, the U.S. Virgin
Islands, and the Pacific Basin.
The Health Centers Program is
administered by HRSA’s Bureau of
Primary Health Care (BPHC). HRSA/
BPHC uses the following application
forms to oversee the Health Center
Program. These application forms are
used by new and existing health centers
to apply for various grant and non-grant
opportunities, renew their grant or nongrant designation, and change their
scope of project.
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose or provide the information
requested. This includes the time
needed to review instructions; to
develop, acquire, install and utilize
technology and systems for the purpose
of collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information; to train
personnel and to be able to respond to
a collection of information; to search
data sources; to complete and review
the collection of information; and to
transmit or otherwise disclose the
information. The total annual burden
E:\FR\FM\10JYN1.SGM
10JYN1
41407
Federal Register / Vol. 78, No. 132 / Wednesday, July 10, 2013 / Notices
hours estimated for this ICR are
summarized in the table below.
TOTAL ESTIMATED ANNUALIZED BURDEN—HOURS
Number of
respondents
Type of application form
Number of
responses per
respondent
Total
responses
Average
burden per
response
(in hours)
Total burden
hours
Form 1A: General Information Worksheet ...........................
Form 1B: BPHC Funding Request Summary ......................
Form 1C: Documents on File ..............................................
Form 2: Staffing Profile ........................................................
Form 3: Income Analysis .....................................................
Form 4: Community Characteristics ....................................
Form 5A: Services Provided ................................................
Form 5B: Service Sites ........................................................
Form 5C: Other Activities/Locations ....................................
Form 6A: Current Board Member Characteristics ...............
Form 6B: Request for Waiver of Governance Requirements ................................................................................
Form 8: Health Center Agreements ....................................
Form 9: Need for Assistance Worksheet ............................
Form 10: Annual Emergency Preparedness Report ...........
Form 12: Organization Contacts ..........................................
Clinical Performance Measures ...........................................
Financial Performance Measures ........................................
Checklist for Adding a New Service Delivery Site ..............
Checklist for Deleting Existing Service Delivery Site ..........
Checklist for Adding New Service .......................................
Checklist for Deleting Existing Service ................................
Checklist for Replacing Existing Service Delivery Site .......
Proposal Cover Page ...........................................................
Project Cover Page ..............................................................
Equipment List .....................................................................
Other Requirements for Sites ..............................................
Checklist for Adding a New Target Population ...................
Increased Demand for Services ..........................................
Funding Sources ..................................................................
Project Qualification Criteria ................................................
Implementation Plan ............................................................
Project Work Plan ................................................................
Verification Checklist ............................................................
EHR Readiness Checklist ....................................................
Look Alike Budget ................................................................
O&E Supplemental ..............................................................
O&E Progress Report ..........................................................
1,700
400
650
1,600
1,600
650
1,600
1,600
1,600
1,600
1
1
1
1
1
1
1
1
1
1
1,700
400
650
1,600
1,600
650
1,600
1,600
1,600
1,600
2.0
1.0
1.0
2.0
3.0
1.0
1.0
1.0
0.5
1.0
3,400
400
650
3,200
4,800
650
1,600
1,600
800
1,600
150
250
650
1,600
1,600
1,600
1,600
700
700
700
700
700
400
400
400
400
50
1,200
400
400
400
100
200
50
100
1,200
1,200
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
150
250
650
1,600
1,600
1,600
1,600
700
700
700
700
700
400
400
400
400
50
1,200
400
400
400
100
200
50
100
1,200
1,200
1.0
1.0
5.0
1.0
0.5
2
1
2.0
2.0
2.0
2.0
2.0
1.0
1.0
1.0
0.5
1.0
1
0.5
1.0
3.0
4.0
0.5
0.5
1.0
1.0
1.0
150
250
3,250
1,600
800
3,200
1,600
1,400
1,400
1,400
1,400
1,400
400
400
400
200
50
1,200
200
400
1,200
400
100
25
100
1,200
1,200
Total ..............................................................................
30,850
........................
30,850
........................
44,025
Dated: July 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information
Coordination.
[FR Doc. 2013–16604 Filed 7–9–13; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
TKELLEY on DSK3SPTVN1PROD with NOTICES
Health Resources and Services
Administration
Agency Information Collection
Activities; Proposed Collection; Public
Comment Request
Health Resources and Services
Administration, HHS.
ACTION: Notice.
AGENCY:
VerDate Mar<15>2010
17:42 Jul 09, 2013
Jkt 229001
In compliance with the
requirement for opportunity for public
comment on proposed data collection
projects (Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995), the
Health Resources and Services
Administration (HRSA) announces
plans to submit an Information
Collection Request (ICR), described
below, to the Office of Management and
Budget (OMB). Prior to submitting the
ICR to OMB, HRSA seeks comments
from the public regarding the burden
estimate, below, or any other aspect of
the ICR.
SUMMARY:
Comments on this Information
Collection Request must be received
within 60 days of this notice.
DATES:
Information Collection Clearance
Officer, Room 10–29, Parklawn
Building, 5600 Fishers Lane, Rockville,
MD 20857.
To
request more information on the
proposed project or to obtain a copy of
the data collection plans and draft
instruments, email paperwork@hrsa.gov
or call the HRSA Information Collection
Clearance Officer at (301) 443–1984.
FOR FURTHER INFORMATION CONTACT:
When
submitting comments or requesting
information, please include the
information request collection title for
reference.
SUPPLEMENTARY INFORMATION:
Submit your comments to
paperwork@hrsa.gov or mail the HRSA
ADDRESSES:
PO 00000
Frm 00056
Fmt 4703
Sfmt 4703
E:\FR\FM\10JYN1.SGM
10JYN1
]]>Agencies
[Federal Register Volume 78, Number 132 (Wednesday, July 10, 2013)]
[Notices]
[Pages 41406-41407]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-16604]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities; Submission to OMB for
Review and Approval; Public Comment Request
AGENCY: Health Resources and Services Administration, HHS.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with Section 3507(a)(1)(D) of the Paperwork
Reduction Act of 1995, the Health Resources and Services Administration
(HRSA) has submitted an Information Collection Request (ICR) to the
Office of Management and Budget (OMB) for review and approval. Comments
submitted during the first public review of this ICR will be provided
to OMB. OMB will accept further comments from the public during the
review and approval period.
DATES: Comments on this ICR should be received within 30 days of this
notice.
ADDRESSES: Submit your comments, including the Information Collection
Request Title, to the desk officer for HRSA, either by email to OIRA_submission@omb.eop.gov or by fax to 202-395-5806.
FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance
requests submitted to OMB for review, email the HRSA Information
Collection Clearance Officer at paperwork@hrsa.gov or call (301) 443-
1984.
SUPPLEMENTARY INFORMATION:
Information Collection Request Title: Health Center Program Application
Forms
OMB No. 0915-0285--Revision
Abstract: Health centers (section 330 grant funded and Federally
Qualified Health Center Look-Alikes) deliver comprehensive, high
quality, cost-effective primary health care to patients regardless of
their ability to pay. Health centers have become an essential primary
care provider for America's most vulnerable populations. Health centers
advance the preventive and primary medical/health care home model of
coordinated, comprehensive, and patient-centered care, coordinating a
wide range of medical, dental, behavioral, and social services. More
than 1,200 health centers operate nearly 9,000 service delivery sites
that provide care in every state, the District of Columbia, Puerto
Rico, the U.S. Virgin Islands, and the Pacific Basin.
The Health Centers Program is administered by HRSA's Bureau of
Primary Health Care (BPHC). HRSA/BPHC uses the following application
forms to oversee the Health Center Program. These application forms are
used by new and existing health centers to apply for various grant and
non-grant opportunities, renew their grant or non-grant designation,
and change their scope of project.
Burden Statement: Burden in this context means the time expended by
persons to generate, maintain, retain, disclose or provide the
information requested. This includes the time needed to review
instructions; to develop, acquire, install and utilize technology and
systems for the purpose of collecting, validating and verifying
information, processing and maintaining information, and disclosing and
providing information; to train personnel and to be able to respond to
a collection of information; to search data sources; to complete and
review the collection of information; and to transmit or otherwise
disclose the information. The total annual burden
[[Page 41407]]
hours estimated for this ICR are summarized in the table below.
Total Estimated Annualized Burden--Hours
----------------------------------------------------------------------------------------------------------------
Average
Number of Number of Total burden per Total burden
Type of application form respondents responses per responses response (in hours
respondent hours)
----------------------------------------------------------------------------------------------------------------
Form 1A: General Information 1,700 1 1,700 2.0 3,400
Worksheet......................
Form 1B: BPHC Funding Request 400 1 400 1.0 400
Summary........................
Form 1C: Documents on File...... 650 1 650 1.0 650
Form 2: Staffing Profile........ 1,600 1 1,600 2.0 3,200
Form 3: Income Analysis......... 1,600 1 1,600 3.0 4,800
Form 4: Community 650 1 650 1.0 650
Characteristics................
Form 5A: Services Provided...... 1,600 1 1,600 1.0 1,600
Form 5B: Service Sites.......... 1,600 1 1,600 1.0 1,600
Form 5C: Other Activities/ 1,600 1 1,600 0.5 800
Locations......................
Form 6A: Current Board Member 1,600 1 1,600 1.0 1,600
Characteristics................
Form 6B: Request for Waiver of 150 1 150 1.0 150
Governance Requirements........
Form 8: Health Center Agreements 250 1 250 1.0 250
Form 9: Need for Assistance 650 1 650 5.0 3,250
Worksheet......................
Form 10: Annual Emergency 1,600 1 1,600 1.0 1,600
Preparedness Report............
Form 12: Organization Contacts.. 1,600 1 1,600 0.5 800
Clinical Performance Measures... 1,600 1 1,600 2 3,200
Financial Performance Measures.. 1,600 1 1,600 1 1,600
Checklist for Adding a New 700 1 700 2.0 1,400
Service Delivery Site..........
Checklist for Deleting Existing 700 1 700 2.0 1,400
Service Delivery Site..........
Checklist for Adding New Service 700 1 700 2.0 1,400
Checklist for Deleting Existing 700 1 700 2.0 1,400
Service........................
Checklist for Replacing Existing 700 1 700 2.0 1,400
Service Delivery Site..........
Proposal Cover Page............. 400 1 400 1.0 400
Project Cover Page.............. 400 1 400 1.0 400
Equipment List.................. 400 1 400 1.0 400
Other Requirements for Sites.... 400 1 400 0.5 200
Checklist for Adding a New 50 1 50 1.0 50
Target Population..............
Increased Demand for Services... 1,200 1 1,200 1 1,200
Funding Sources................. 400 1 400 0.5 200
Project Qualification Criteria.. 400 1 400 1.0 400
Implementation Plan............. 400 1 400 3.0 1,200
Project Work Plan............... 100 1 100 4.0 400
Verification Checklist.......... 200 1 200 0.5 100
EHR Readiness Checklist......... 50 1 50 0.5 25
Look Alike Budget............... 100 1 100 1.0 100
O&E Supplemental................ 1,200 1 1,200 1.0 1,200
O&E Progress Report............. 1,200 1 1,200 1.0 1,200
-------------------------------------------------------------------------------
Total....................... 30,850 .............. 30,850 .............. 44,025
----------------------------------------------------------------------------------------------------------------
Dated: July 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-16604 Filed 7-9-13; 8:45 am]
BILLING CODE 4165-15-P
