Agency Information Collection Activities; Submission to OMB for Review and Approval; Public Comment Request, 41406-41407 [2013-16604]

Download as PDF 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]


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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