Agency Information Collection Activities: Submission for Office of Management and Budget (OMB) Review; Comment Request, 42091-42099 [2013-16794]

Download as PDF 42091 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices instruments must be requested in writing. Proposed Collection: NIH Office of Intramural Training & Education Application, 0925–0299 Revision, Office of the Director (OD), National Institutes of Health (NIH). Need and Use of Information Collection: The Office of Intramural Training & Education (OITE) administers a variety of programs and initiatives to recruit pre-college through post-doctoral educational level individuals into the National Institutes of Health Intramural Research Program (NIH–IRP) to facilitate develop into future biomedical scientists. The proposed information collection is necessary in order to determine the eligibility and quality of potential awardees for traineeships in these programs. The applications for admission consideration include key areas such as: Personal information, eligibility criteria, contact information, student identification number, training program selection, scientific discipline interests, educational history, standardized examination scores, reference information, resume components, employment history, employment interests, dissertation research details, letters of recommendation, financial aid history, sensitive data, future networking contact, travel information, as well as feedback questions about interviews and application submission experiences. Sensitive data collected on the applicants, race, gender, ethnicity, disability, and recruitment method, are made available only to OITE staff members or in aggregate form to select NIH offices and are not used by the admission committee for admission consideration; optional to submit. OMB approval is requested for 3 years. There are no costs to respondents other than their time. The total estimated annualized burden hours are 18,354.00. ESTIMATED ANNUALIZED BURDEN HOURS Estimated number of respondents Type of respondent Summer Internship Program in Biomedical Research (SIP) ........................... Biomedical Engineering Summer Internship Program (BESIP) ...................... Post-baccalaureate Training Program (PBT) .................................................. Community College Summer Enrichment Program (CCSEP) ........................ Technical Training Program (PBT) .................................................................. Graduate Partnerships Program (GPP)—Application (Select Institutional Partnerships) ................................................................................................ Graduate Partnerships Program (GPP)—Registration (Select Institutional Partnerships + Individual Partnership) ......................................................... National Graduate Student Research Conference (NGSRC) ......................... Undergraduate Scholarship Program (UGSP) ................................................ Alumni Database ............................................................................................. UGSP—Certificate of Eligibility (Completed by Applicant) .............................. UGSP—Certificate of Eligibility (Completed by University Staff) .................... UGSP—Deferment Form (Completed by Applicant) ....................................... UGSP—Deferment Form (Completed by University Staff) ............................. Reference Recommendation Letters for All Programs .................................... Survey—Race-Ethnicity-Gender-Birth Year (25% Response Rate) ................ Survey—Time to Complete Application Form (4% Response Rate) .............. Survey—GPP Interview Experience (60% Response Rate) ........................... Totals ........................................................................................................ Dated: July 1, 2013. Richard Wyatt, Executive Director, Office of Intramural Research, OD, National Institutes of Health. [FR Doc. 2013–16887 Filed 7–12–13; 8:45 am] BILLING CODE 4140–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES tkelley on DSK3SPTVN1PROD with NOTICES National Cancer Institute; Amended Notice of Meeting 1.0 1.0 1.0 1.0 1.0 6,820.00 80.00 1,885.00 100.00 115.00 250.0 1.0 1.0 250.00 140.0 800.0 200.0 1,900.0 200.0 200.0 40.0 40.0 23,235.0 3,073.0 492.0 30.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 1.0 3/60 15/60 3/60 15/60 15/60 3/60 3/60 10/60 140.00 800.00 200.00 1,900.00 10.00 50.00 2.00 10.00 5,808.75 153.65 24.60 5.0 39,600.0 N/A N/A 18,354.00 20850 which was published in the Federal Register on June 17, 2013, 78FR36201. This notice is being amended to change the meeting format from a face to face meeting to a teleconference. Also the meeting date and time are now 10:30 a.m. to 12:00 p.m. on August 12, 2013. The meeting is closed to the public. VerDate Mar<15>2010 18:53 Jul 12, 2013 Jkt 229001 BILLING CODE 4140–01–P PO 00000 Frm 00055 Fmt 4703 Sfmt 4703 Estimated total annual burden hours 1.0 1.0 1.0 1.0 1.0 [FR Doc. 2013–16791 Filed 7–12–13; 8:45 am] Notice is hereby given of a change in the meeting of the National Cancer Institute Special Emphasis Panel, July 30, 2013, 9:00 a.m.–4:00 p.m., National Cancer Institute, 9609 Medical Center Drive, Room 2W908 Rockville, MD, Estimated total annual burden hours 6,820.0 80.0 1,885.0 100.0 115.0 Dated: July 9, 2013. David Clary, Program Analyst, Office of Federal Advisory Committee Policy. National Institutes of Health Estimated number of responses annually per respondent DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Agency Information Collection Activities: Submission for Office of Management and Budget (OMB) Review; Comment Request Periodically, the Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information collection requests under OMB review, in compliance with the Government Paperwork Elimination Act (GPEA) 44 U.S.C. 3504. To request a copy of these documents, call the SAMHSA Reports Clearance Officer at (240) 276–1243. E:\FR\FM\15JYN1.SGM 15JYN1 42092 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices Project: Mandatory Guidelines for Federal Workplace Drug Testing Programs (OMB No. 0930–0158)— Revision tkelley on DSK3SPTVN1PROD with NOTICES SAMHSA will request OMB approval for the Federal Drug Testing Custody and Control Form (Federal CCF) for federal agency and federally regulated drug testing programs which must comply with the HHS Mandatory Guidelines for Federal Workplace Drug Testing Programs (73 FR 71858) dated November 25, 2008, and OMB approval for the information provided by test facilities (i.e., laboratories and Instrumented Initial Test Facilities, IITFs) for the National Laboratory Certification Program (NLCP). The Federal CCF is used by all federal agencies and employers regulated by the Department of Transportation (DOT) to document the collection and chain of custody of drug testing specimens at the collection site, for the test facility to VerDate Mar<15>2010 18:53 Jul 12, 2013 Jkt 229001 report results, and for the Medical Review Officer (MRO) to make a determination. The current OMBapproved Federal CCF has an August 31, 2013 expiration date. In accordance with the GPEA, OMB set terms of clearance for the extension of the current Federal CCF as follows: Prior to the next approval of this package, the Agency (SAMHSA) shall provide a progress update on adoption of electronic forms in an effort to reduce burden. SAMHSA is encouraged to explore ways to convert the Federal Drug Testing Custody and Control Form (Federal CCF) into an electronic form. In an effort to comply with the stated terms of the clearance requirement set forth by OMB, SAMHSA will authorize the use of an electronic Federal CCF. SAMHSA has resubmitted the Federal CCF with no content revisions to the form for OMB approval. The only revisions are to enable the form to be PO 00000 Frm 00056 Fmt 4703 Sfmt 4703 used as a paper form or as an electronic form. • The first change to the Federal CCF is to allow the Public Burden Statement to be a separate page of an electronic Federal CCF. The Public Burden Statement must appear on all federal government forms that place a reporting burden on gathering information. • The second change is to allow the Federal CCF instructions and the Privacy Act Statement to be on a separate page or pages of an electronic Federal CCF. • The third change is to allow the bottle labels/seals to be printed separately, and not as a part of Copy 1 of the Federal CCF. • The fourth change is to revise the Federal CCF Instructions to allow the use of an electronic form. Below is a copy of the Federal CCF: BILLING CODE 4162–20–P E:\FR\FM\15JYN1.SGM 15JYN1 42093 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices FEDERAL DRUG TESTING CUSTODY AND CONTROL FORM 1111111111111111111111111111111 0000001 SPECIMEN 10 NO. STEP 1: COMPLETED ElY COLLECTOR OR EMPLOYER REPRESENTATIVE A. Emplo)l!>f Name, Address, J.D. No. ACCESSION NO. EI. MRO Name, Address, Phone Nth and Fax No. C.oooorSSNor EmplO)l!>e 1.0.• _. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ o NRC DOT - Specify DOT Agency: 0 FMCSA 0 FAA 0 FAA 0 ITA 0 PHMSA 0 USCG E. R_onlor Tesl: 0 l're-llfllll!oylMRI 0 Random 0 RU$llnllblG Suspll::iooJCausG 0 Post Accident 0 R~lurn 10 !luly 0 FoIOOl4.Jp 0 OthGf (specilyl ______ F; Drug Tesls to be peflormad: 0 THC, COC, pcp, 01"1, AMP 0 THC & COC Only 0 Otoor (specify) _ _ _ _ _ _ _ _ _ _ _ _ __ D. Sprelly Testing AUl!lorny. G. Collection Site Addmss: Collector Phona No. _ _ _ _ _ _ _ _ _ _ __ RECEIVED AT IITF: X DMDMA o DILUTE o REJECTED FOR TESTING REMARK~ o ADULTERATED o SUBSTITUTED o INVALID RESULT _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ STEP 5B: COMPLETED BY SPLlTTESTlNG LABORATORY o SPLIT SPECIMEN TESTED; SEE LABORATORY REPORT 0000001 A SPECIMEN BOTTLE SEAL 0000001 B tkelley on DSK3SPTVN1PROD with NOTICES SP!;CI~AEN ID NO. Paper CCF: Back of Copy 1–4 Electronic CCF: Separate Page Public Burden Statement Public Burden Statement: An agency may not conduct or sponsor, and a VerDate Mar<15>2010 18:53 Jul 12, 2013 Jkt 229001 person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0930–0158. Public reporting burden for this collection of PO 00000 Frm 00057 Fmt 4703 Sfmt 4703 information is estimated to average: 5 minutes/donor; 4 minutes/collector; 3 minutes/test facility; and 3 minutes/ Medical Review Officer. Send comments regarding this burden estimate or any other aspect of this E:\FR\FM\15JYN1.SGM 15JYN1 EN15JY13.000</GPH> SPECIMEN BOTTLE SEAL (SPuT) 42094 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 2–1057, Rockville, Maryland, 20857. FEDERAL DRUG TESTING CUSTODY AND CONTROL FORM SPl'iCIMEN ID NO. C. Dooor SSN '" Empklye" til D. Specify Tem".,,, 1wII>",ity: 0 HHS E. A"""",n fi:Jr Teol: 0 ~aym<ml F. D,ug Tams to be PllOOmle<i; 0 0000001 o 0 NAC OCT -SpeclfyOOT At:t<>n"l': 0 !'MCSA 0 FAA 0 FAA 0 FTA 0 PHMSA 0 USCG R""o.m 0 !'te.o""".bl" 5I1Op.,i""/(;""",, 0 Pool Accident 0 Rolum to Duly 0 FaU".,-up 0 Other (JIjl'oi[y) _ _ _ _ __ THe, CQC, PCF\ CPI, AMP 0 THe &. CDC Only 0 0100, (spe<Jlfyl _ _ _ _ _ _ _ _ _ _ _ _ __ 0 G. CoII",,1loo Sit" Add,,,,,,,: COllectorpt,"''''No. _ _ _ _ _ _ _ _ _ _ __ In """"m,,,,,,,, ..,til app/i""b!<> F"'*-i ..quir"""",1l!, my ~Iio<l Ill: ONEGATl\IE POSmI/Efo" 0 o TEST CANCELLED o REFUSAL 10 TEST be""""" - chedk "",,,,,,n{,,) "'ek",,; o ADULTERATED (Ildullemnt/,euon): o SUBSTITUTED DOTHER; REMARKS: X 1lI_l>f _ _ _ 'wOflicor tI'!IIIIITl_"'" _0IIIt:0<._1Rr0l, ilL L••ll - ~v...Iiif~ STEP 1: COMPLETED BY MEDICAL REVIEW OFFICER SPLIT SPECIMEN In """orda""" ..,til app/ioab!<> F~I "'~!1Il!, my ~Iioo for Ill" opiil spoofmen (ff 1ss1«l) ill: o RECONFIRMED tor: o FAILED 10 RECONFIRM tor: ""' ""''''''', D TEST CANCELLED X VerDate Mar<15>2010 lI'illRTj _ _ ~'._'!l'i.tlil' [soil ~~OlMOOi_~w~ 18:53 Jul 12, 2013 Jkt 229001 PO 00000 Frm 00058 Fmt 4703 Sfmt 4725 E:\FR\FM\15JYN1.SGM 15JYN1 ~ilil~'! EN15JY13.001</GPH> tkelley on DSK3SPTVN1PROD with NOTICES . 42095 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices FEDERAL DRUG TESTING CUSTODY AND CONTROL FORM 0000001 SPECIMEN ID NO~ STEP 1: COMPLETED BY COLLECTOR OR EMPLOYER REPRESENTATIVE ACCESSION NO. c, 0000' SSN <If Empl<lY"" 1.11 N<I. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ D. Sped" T.,,,ting Alilherity: 0 HHS 0 NRC o oor ~ Specify OOT Agency: 0 FMCSA 0 FAA 0 FAA 0 IFfA 0 PHMSA 0 USCG E. R"""on for r",,1; 0 P~O'fment 0 ROl1<bn 0 R_nahle S""pi::iM!C_" O!'o!!! kciden! 0 Rt1lum t. tlu1y 0 F.~up 0 Other(iij>.oifyl ______ IF Drug rei'll" to be Pe"orrrn;d: 0 THe, cae, pcp, OPI, AMP 0 THe &. CDC Only 0 Other G. conect;"" Site Add"""" CoIIed",PhOl1e 1'«.'),, _ _ _ _ _ _ _ _ _ _ __ In """".,-d.,n"" willl ~<ItlbIe Frodeml "'~ my 1ffrii<l,,!100 is; o NEGATIve POSmYE"'" 0 o REFUSAL TO TEST boo"""" ~ "heok "",,,,,..(s} bel"",: o .ADULTERATED (."lutl"""flIf,,,,,,,OI1}: o SUBSTITUTED o OTHER; o TEST CANCELLED REMARKS: Ix SI_m_ooI' II'flIIlT _ " " _... . STEP 1: COMPLETED BY MEDICAL REVIEW OFFICER SPLIT SPECIMEN In"oo~ willl ~"""'" Frodeml "'~"'" my 1ffrii<l,,!100 IDr Ill.. ""Iii! ~mm (if ,,,,,led) is; 0fIl00r·._ i flr"'M~La.f o RECONFIRMED lor: o FAILED TO RECONFIRMl"" I o...~_, o TEST CANCELLED REMARKS: VerDate Mar<15>2010 i!§gnatme 18:53 Jul 12, 2013 a DiaiCil ~W:mfi£lf Jkt 229001 PO 00000 tpRfilj ~ Rw:ieWi.':i~reRiliiH ~Fis1. lilt E.Mij Frm 00059 Fmt 4703 Sfmt 4725 E:\FR\FM\15JYN1.SGM 15JYN1 ~1liI~'i EN15JY13.002</GPH> tkelley on DSK3SPTVN1PROD with NOTICES It 42096 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices FEDERAL DRUG TESTING CUSTODY AND CONTROL FORM SPECIMEN ID 1\10, 0000001 STEP 1: COMPLETED BV COLLEClOR OR EMPLOYER REPRESENTATIVE C,O""", SSNm Eml>~" ACCESSION NO, UJ,N"' _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ o USCG 0 HHS 0 NRC DOT - Sp"cify OOT Aoenqr: 0 FMCSA 0 FAA 0 FAA 0 ITA 0 PHMSA E, Re"""" br Telll: 0 ~'"fll1"nt 0 R""dorn 0 R""""",oble SUIlpi::;",,''C'"'''' 0 Po!iIl\.ecidenl 0 RelUlft io!My 0 FolwLll' 0 (opocify) _ _ _ _ _ __ " Drug T""181o be Perl","",d: 0 THe, COO, PCp, OPI, AMI' 0 THe 3: COC Only 0 OIhe, {"pooifyl _ _ _ _ _ _ _ _ _ _ _ _ __ Q, ColIeclioo Sit" Add",,,,,: 11 Sp""ify T"stin[l AMlhOl'iIy: Oth., CoUe"'",pt,,,,,,, No, _ _ _ _ _ _ _ _ _ _ __ In "OO~ will!~ 1""""",1 ~""""''''' my ""rifklalion is: o NEGATIVE POSITIVE br: 0 o REFUSALlOTEST because - "heck fm..,nls} below: o ADULTERATED (aduflel'1IDl/realloo): o SOOSTITUTED o OTHER: o TEST CANCELLED HEMARKS: Sii_.<>If_OOI_O_ X STEP l' COMPLETED BY MEDICAL REVIEW OFFICER . SPLIT SPECIMEN l'mIffl _ _ ow 001<:01"._ Rr.~ II~ \.stoll ---1---1 llmTllollla!llY' In aooadiiinoo will!~1<> [="""",1 ,..~"""" my ~~Iion f<JF II,,, ""iii ~m"" (if !elJ!1Iiid) ''''' o RECONFIRMED o FAILED 10 RECONFIRM m DTEST CANCELLED !OI'; REMARKS: VerDate Mar<15>2010 "'_. 18:53 Jul 12, 2013 (!'!IIm !.Iiiilki!I !l'iiilO\ii Qfl"",,,,'. Hiiiiiii (Ri.... fil~ LiI.1j Jkt 229001 PO 00000 Frm 00060 Fmt 4703 Sfmt 4725 E:\FR\FM\15JYN1.SGM 15JYN1 I I wml"''''''''IIIn] EN15JY13.003</GPH> tkelley on DSK3SPTVN1PROD with NOTICES X 42097 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices FEDERAL DRUG TESTING CUSTODY AND CONTROL FORM 0000001 SPECIMEN ID NO. STEP 1: COMPLETED BY COLLECTOR OR EMPLOYER REPRESENTATIVE ACCESSION NO, C.lJooor SSN or E"nployeeUl 1'10. _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __ 11 Specify TeWng Authority: 0 HHS 0 NRC 0 DOT - Speoify DOT Agency: 0 !'MCSA 0 FAA. 0 D!=TiI. 0 FAA PHMSA 0 USCG E. ReMon fer T"IlI: 0 Pre-etTpl"l'menI 0 IlMoorn 0 RaruI,onoble SuspiilioNC!iII$e 0 Post Accident 0 Return tQ tlul:v 0 Folbw-up 0 DIner (specify) _ _ _ _ __ F. Drug reD!o b" P"lfofrfle.:i: 0 THe, COC, PCp, OPI, AMP 0 THe & coe Only 0 Other (spooifyJ _ _ _ _ _ _ _ _ _ _ _ _ __ G. CoNeolien Site Address: C"lleGiorPhooe 1\10, _ _ _ _ _ _ _ _ _ _ __ l:n"oo~with"Pl'iiCliibfeF~I"'~ my ~Ii<",i", o NEGATIVE POSmVEror: 0 o REFUSAL TO TEST b"""""" - "heck ........,nls} bei"",,: o ADULTERATED (rulullel>lJ1li,eM""): o SUBSTITUTED Ix Ilil_ 0IIi_ . o TEST CANCELLED PIllm -""'-"'01&0<'$14..". _tli!~L••tl ! I 1MIo1lil_.lVrl STEP 7: COMPLETED BY MEDICAL REVIEW OFFICER SPLIT SPECIMEN In 1Il""~ with ~Ie F~I re<;llJifem",,'" my ~fim, far the "PIN $"""""""" (if teoled) is: tkelley on DSK3SPTVN1PROD with NOTICES X VerDate Mar<15>2010 o TEST CANCELlED iIil~"ID8iiIiiiiI_~ 18:53 Jul 12, 2013 Jkt 229001 PO 00000 !'mIIlj_"_~lill.... ll'b\IiI~"Oij Frm 00061 Fmt 4703 Sfmt 4725 E:\FR\FM\15JYN1.SGM 15JYN1 ------6.1l1~i EN15JY13.004</GPH> o RECONFIRMED for: o FAILED TO RECONFIRM lor; 42098 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices BILLING CODE 4162–20–C Paper CCF: Back of Copy 5 Electronic CCF: Separate Page Instructions for Completing the Federal Drug Testing Custody and Control Form for Urine Specimen Collection When Making Entries on a Paper CCF, use Black or Blue ink pen and Press Firmly Collector ensures that the name and address of the HHS-certified Instrumented Initial Test Facility (IITF) or HHS-certified laboratory are on the top of the Federal CCF and the Specimen Identification (I.D.) number on the top of the Federal CCF matches the Specimen I.D. number on the labels/ seals. tkelley on DSK3SPTVN1PROD with NOTICES STEP 1: • Collector ensures that the required information is in STEP 1. Collector enters a remark in STEP 2 if Donor refuses to provide his/her SSN or Employee I.D. number. • Collector gives collection container to Donor and instructs Donor to provide a specimen. Collector notes any unusual behavior or appearance of Donor in the remarks line in STEP 2. If the Donor’s conduct at any time during the collection process clearly indicates an attempt to tamper with the specimen, Collector notes the conduct in the remarks line in STEP 2 and takes action as required. STEP 2: • Collector checks specimen temperature within 4 minutes after receiving the specimen from Donor, and marks the appropriate temperature box in STEP 2. If the temperature is outside the acceptable range, Collector enters a remark in STEP 2 and takes action as required. • Collector inspects the specimen and notes any unusual findings in the remarks line in STEP 2 and takes action as required. Any specimen with unusual physical characteristics (e.g., unusual color, presence of foreign objects or material, unusual odor) cannot be sent to an IITF and must be sent to an HHScertified laboratory for testing, as required. • Collector determines the volume of specimen in the collection container. If the volume is acceptable, Collector proceeds with the collection. If the volume is less than required by the federal agency, Collector takes action as required, and enters remarks in STEP 2. If no specimen is collected by the end of the collection process, Collector checks the None Provided box, enters a remark in STEP 2, discards Copy 1, and VerDate Mar<15>2010 18:53 Jul 12, 2013 Jkt 229001 distributes remaining copies as required. • Collector checks the Split or Single specimen collection box. If the collection is observed, Collector checks the Observed box and enters a remark in STEP 2. STEP 3: • Donor watches Collector pour the specimen from the collection container into the specimen bottle(s), place the cap(s) on the specimen bottle(s), and affix the label(s)/seal(s) on the specimen bottle(s). • Collector dates the specimen bottle label(s) after placement on the specimen bottle(s). • Donor initials the specimen bottle label(s) after placement on the specimen bottle(s). • Collector instructs the Donor to read and complete the certification statement in STEP 5 on Copy 2 (signature, printed name, date, phone numbers, and date of birth). If Donor refuses to sign the certification statement, Collector enters a remark in STEP 2 on Copy 1. STEP 4: • Collector completes STEP 4 on Copy 1 (signature, printed name, date, time of collection, and name of delivery service) and places the sealed specimen bottle(s) in a leak-proof plastic bag. • Paper CCF: Collector places Copy 1 in the leak-proof plastic bag. Electronic CCF: Collector places printed copy of Copy 1 in the leak-proof plastic bag and/ or places package label (with Specimen I.D., test facility name and contact information, and collection site name and contact information) on the outside of the bag. • Collector seals the bag, prepares the specimen package for shipment, and distributes the remaining CCF copies as required. Privacy Act Statement: (For Federal Employees Only) Submission of the information on the Federal Drug Testing Custody and Control Form is voluntary. However, incomplete submission of the information, refusal to provide a specimen, or substitution or adulteration of a specimen may result in delay or denial of your application for employment/appointment or may result in removal from the federal service or other disciplinary action. The authority for obtaining the specimen and identifying information contained herein is Executive Order 12564 (‘‘Drug-Free Federal Workplace’’), 5 U.S.C. 3301 (2), 5 U.S.C. 7301, and Section 503 of Public Law 100–71, 5 PO 00000 Frm 00062 Fmt 4703 Sfmt 4703 U.S.C. 7301 note. Under provisions of Executive Order 12564 and 5 U.S.C. 7301, test results may only be disclosed to agency officials on a need-to-know basis. This may include the agency Medical Review Officer (MRO), the administrator of the Employee Assistance Program, and a supervisor with authority to take adverse personnel action. This information may also be disclosed to a court where necessary to defend against a challenge to an adverse personnel action. Submission of your SSN is not required by law and is voluntary. Your refusal to furnish your number will not result in the denial of any right, benefit, or privilege provided by law. Your SSN is solicited, pursuant to Executive Order 9397, for purposes of associating information in agency files relating to you and for purposes of identifying the specimen provided for testing for the presence of illegal drugs. If you refuse to indicate your SSN, a substitute number or other identifier will be assigned, as required, to process the specimen. Public Burden Statement Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this project is 0930–0158. Public reporting burden for this collection of information is estimated to average: 5 minutes/donor; 4 minutes/collector; 3 minutes/test facility; and 3 minutes/ Medical Review Officer. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 2–1057, Rockville, Maryland, 20857. The number of respondents has been reduced from 7.1 to a total of 6.1 million; which reduces the total burden hours of ¥240,480. Prior to an inspection, each test facility is required to submit specific information regarding its procedures. Collecting this information prior to an inspection allows the inspectors to thoroughly review and understand the testing procedures before arriving at the test facility. The NLCP application form has not been revised compared to the previous form. The annual total burden estimates for the Federal Drug Testing Custody and Control Form, the NLCP application, the NLCP inspection checklist, and NLCP E:\FR\FM\15JYN1.SGM 15JYN1 42099 Federal Register / Vol. 78, No. 135 / Monday, July 15, 2013 / Notices recordkeeping requirements are shown in the following table. Burden/responses (hours) Number of form/respondents Responses/ respondent Total burden hours Custody and Control Form Donor .................................................................................................................................... Collector ................................................................................................................................ Laboratory ............................................................................................................................. Medical Review Officer ......................................................................................................... Laboratory Application ................................................................................................................. Laboratory Inspection Checklist .................................................................................................. Laboratory Recordkeeping .......................................................................................................... .08 .07 .05 .05 3.0 2.0 250.0 6,150,000 6,150,000 6,150,000 6,150,000 3 35 35 512,500 410,000 307,500 307,500 9 70 8750 Total ............................................................................................................................... ........................ ........................ 1,546,329 Written comments and recommendations concerning the proposed information collection should be sent by August 14, 2013 to the SAMHSA Desk Officer at the Office of Information and Regulatory Affairs, Office of Management and Budget (OMB). To ensure timely receipt of comments, and to avoid potential delays in OMB’s receipt and processing of mail sent through the U.S. Postal Service, commenters are encouraged to submit their comments to OMB via email to: OIRA_Submission@omb.eop.gov. Although commenters are encouraged to send their comments via email, commenters may also fax their comments to: 202–395–7285. Commenters may also mail them to: Office of Management and Budget, Office of Information and Regulatory Affairs, New Executive Office Building, Room 10102, Washington, DC 20503. Summer King, Statistician. [FR Doc. 2013–16794 Filed 7–12–13; 8:45 am] BILLING CODE 4162–20–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Announcement of Requirements and Registration for the ‘‘Stay Covered Challenge’’ and the ‘‘Churn Marketing Research Methodology Development Challenge’’ Authority: 15 U.S.C. 3719. Substance Abuse and Mental Health Services Administration, HHS. ACTION: Notice. tkelley on DSK3SPTVN1PROD with NOTICES AGENCY: The Substance Abuse and Mental Health Services Administration (SAMHSA), an operating division of the U.S. Department of Health and Human Services, is announcing a new SUMMARY: VerDate Mar<15>2010 18:53 Jul 12, 2013 Jkt 229001 opportunity for individuals and organizations to help solve a critical problem in today’s health environment. Specifically, there are high levels of involuntary breaks in health insurance coverage among the non-elderly population in the United States. These breaks are referred to as ‘‘churning’’— when people transition from one source of insurance coverage to another when eligibility for assistance changes. Churning makes programs more complicated and costly to administer and can interrupt continuity of care, create gaps in coverage, reduce health plans’ incentive to invest in their members’ long-term wellness, and interfere with the accurate and comprehensive measurement of health care quality. According to a study by the Urban Institute, a total of 29.4 million people will have their eligibility status change each year beginning in 2014 1. This challenge aligns with SAMHSA’s mission to reduce the impact of mental and substance use disorders on America’s communities. SAMHSA recognizes that enrollment in health insurance plays a significant role in fulfilling this mission, from preventive health care to behavioral health treatment and recovery. The National Survey on Drug Use and Health estimates that of the individuals currently uninsured and expected to be covered under the Affordable Care Act, 11 million will have a behavioral health need. The literature on the causes of breaks in coverage (i.e., income, housing volatility), and the high prevalence of behavioral health conditions among the uninsured, points to an interrelationship between behavioral health symptoms and difficulties complying with administrative requirements in applying for and maintaining continuous coverage. Additionally, churning has a significant amount of administrative as well as health costs, and there is a PO 00000 Frm 00063 Fmt 4703 Sfmt 4703 disproportionate impact of this problem among individuals with behavioral health disorders. Therefore, SAMHSA is announcing two challenge projects to help develop innovative solutions to the barriers to developing a communications strategy targeting individuals who experience churn. The statutory authority for this challenge competition is section 105 of the America Creating Opportunities to Meaningfully Promote Excellence in Technology, Education, and Science Reauthorization Act of 2010 (COMPETES Act). DATES: Challenge submissions accepted until August 31, 2013. FOR FURTHER INFORMATION CONTACT: Kevin J. Malone, 1 Choke Cherry Road, Room 8–1014, Rockville, MD 20857, Office: 240.276.2239, Email: kevin.malone@samhsa.hhs.gov. SUPPLEMENTARY INFORMATION: Subject of Challenge Competitions SAMHSA is interested in identifying individuals from a marketing perspective who experience churn, and in developing innovative strategies for targeting them. SAMHSA has access to relatively good data on the individuals who are covered by Medicaid, based on disability, and the providers and community-based organizations that serve them. However, SAMHSA has very little capacity to identify the individuals among the uninsured who were disenrolled but remain eligible. SAMHSA’s strategy is to use the following two challenges to strengthen communication with individuals in both phases of the process (prior to losing coverage, and once an individual has been disenrolled), thereby reducing incidences of churn and minimizing the period between coverage if it does happen. 1. The ‘‘Stay Covered Challenge’’ calls for the development of a marketing/ outreach campaign designed for use by E:\FR\FM\15JYN1.SGM 15JYN1

Agencies

[Federal Register Volume 78, Number 135 (Monday, July 15, 2013)]
[Notices]
[Pages 42091-42099]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-16794]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Agency Information Collection Activities: Submission for Office 
of Management and Budget (OMB) Review; Comment Request

    Periodically, the Substance Abuse and Mental Health Services 
Administration (SAMHSA) will publish a summary of information 
collection requests under OMB review, in compliance with the Government 
Paperwork Elimination Act (GPEA) 44 U.S.C. 3504. To request a copy of 
these documents, call the SAMHSA Reports Clearance Officer at (240) 
276-1243.

[[Page 42092]]

Project: Mandatory Guidelines for Federal Workplace Drug Testing 
Programs (OMB No. 0930-0158)--Revision

    SAMHSA will request OMB approval for the Federal Drug Testing 
Custody and Control Form (Federal CCF) for federal agency and federally 
regulated drug testing programs which must comply with the HHS 
Mandatory Guidelines for Federal Workplace Drug Testing Programs (73 FR 
71858) dated November 25, 2008, and OMB approval for the information 
provided by test facilities (i.e., laboratories and Instrumented 
Initial Test Facilities, IITFs) for the National Laboratory 
Certification Program (NLCP).
    The Federal CCF is used by all federal agencies and employers 
regulated by the Department of Transportation (DOT) to document the 
collection and chain of custody of drug testing specimens at the 
collection site, for the test facility to report results, and for the 
Medical Review Officer (MRO) to make a determination. The current OMB-
approved Federal CCF has an August 31, 2013 expiration date. In 
accordance with the GPEA, OMB set terms of clearance for the extension 
of the current Federal CCF as follows: Prior to the next approval of 
this package, the Agency (SAMHSA) shall provide a progress update on 
adoption of electronic forms in an effort to reduce burden. SAMHSA is 
encouraged to explore ways to convert the Federal Drug Testing Custody 
and Control Form (Federal CCF) into an electronic form.
    In an effort to comply with the stated terms of the clearance 
requirement set forth by OMB, SAMHSA will authorize the use of an 
electronic Federal CCF. SAMHSA has resubmitted the Federal CCF with no 
content revisions to the form for OMB approval. The only revisions are 
to enable the form to be used as a paper form or as an electronic form.
     The first change to the Federal CCF is to allow the Public 
Burden Statement to be a separate page of an electronic Federal CCF. 
The Public Burden Statement must appear on all federal government forms 
that place a reporting burden on gathering information.
     The second change is to allow the Federal CCF instructions 
and the Privacy Act Statement to be on a separate page or pages of an 
electronic Federal CCF.
     The third change is to allow the bottle labels/seals to be 
printed separately, and not as a part of Copy 1 of the Federal CCF.
     The fourth change is to revise the Federal CCF 
Instructions to allow the use of an electronic form.
    Below is a copy of the Federal CCF:
BILLING CODE 4162-20-P

[[Page 42093]]

[GRAPHIC] [TIFF OMITTED] TN15JY13.000

Paper CCF: Back of Copy 1-4

Electronic CCF: Separate Page

Public Burden Statement

    Public Burden Statement: An agency may not conduct or sponsor, and 
a person is not required to respond to, a collection of information 
unless it displays a currently valid OMB control number. The OMB 
control number for this project is 0930-0158. Public reporting burden 
for this collection of information is estimated to average: 5 minutes/
donor; 4 minutes/collector; 3 minutes/test facility; and 3 minutes/
Medical Review Officer. Send comments regarding this burden estimate or 
any other aspect of this

[[Page 42094]]

collection of information, including suggestions for reducing this 
burden, to SAMHSA Reports Clearance Officer, 1 Choke Cherry Road, Room 
2-1057, Rockville, Maryland, 20857.
[GRAPHIC] [TIFF OMITTED] TN15JY13.001


[[Page 42095]]


[GRAPHIC] [TIFF OMITTED] TN15JY13.002


[[Page 42096]]


[GRAPHIC] [TIFF OMITTED] TN15JY13.003


[[Page 42097]]


[GRAPHIC] [TIFF OMITTED] TN15JY13.004


[[Page 42098]]


BILLING CODE 4162-20-C

Paper CCF: Back of Copy 5

Electronic CCF: Separate Page

Instructions for Completing the Federal Drug Testing Custody and 
Control Form for Urine Specimen Collection

When Making Entries on a Paper CCF, use Black or Blue ink pen and Press 
Firmly

    Collector ensures that the name and address of the HHS-certified 
Instrumented Initial Test Facility (IITF) or HHS-certified laboratory 
are on the top of the Federal CCF and the Specimen Identification 
(I.D.) number on the top of the Federal CCF matches the Specimen I.D. 
number on the labels/seals.
STEP 1:
     Collector ensures that the required information is in STEP 
1. Collector enters a remark in STEP 2 if Donor refuses to provide his/
her SSN or Employee I.D. number.
     Collector gives collection container to Donor and 
instructs Donor to provide a specimen. Collector notes any unusual 
behavior or appearance of Donor in the remarks line in STEP 2. If the 
Donor's conduct at any time during the collection process clearly 
indicates an attempt to tamper with the specimen, Collector notes the 
conduct in the remarks line in STEP 2 and takes action as required.
STEP 2:
     Collector checks specimen temperature within 4 minutes 
after receiving the specimen from Donor, and marks the appropriate 
temperature box in STEP 2. If the temperature is outside the acceptable 
range, Collector enters a remark in STEP 2 and takes action as 
required.
     Collector inspects the specimen and notes any unusual 
findings in the remarks line in STEP 2 and takes action as required. 
Any specimen with unusual physical characteristics (e.g., unusual 
color, presence of foreign objects or material, unusual odor) cannot be 
sent to an IITF and must be sent to an HHS-certified laboratory for 
testing, as required.
     Collector determines the volume of specimen in the 
collection container. If the volume is acceptable, Collector proceeds 
with the collection. If the volume is less than required by the federal 
agency, Collector takes action as required, and enters remarks in STEP 
2. If no specimen is collected by the end of the collection process, 
Collector checks the None Provided box, enters a remark in STEP 2, 
discards Copy 1, and distributes remaining copies as required.
     Collector checks the Split or Single specimen collection 
box. If the collection is observed, Collector checks the Observed box 
and enters a remark in STEP 2.
STEP 3:
     Donor watches Collector pour the specimen from the 
collection container into the specimen bottle(s), place the cap(s) on 
the specimen bottle(s), and affix the label(s)/seal(s) on the specimen 
bottle(s).
     Collector dates the specimen bottle label(s) after 
placement on the specimen bottle(s).
     Donor initials the specimen bottle label(s) after 
placement on the specimen bottle(s).
     Collector instructs the Donor to read and complete the 
certification statement in STEP 5 on Copy 2 (signature, printed name, 
date, phone numbers, and date of birth). If Donor refuses to sign the 
certification statement, Collector enters a remark in STEP 2 on Copy 1.
STEP 4:
     Collector completes STEP 4 on Copy 1 (signature, printed 
name, date, time of collection, and name of delivery service) and 
places the sealed specimen bottle(s) in a leak-proof plastic bag.
     Paper CCF: Collector places Copy 1 in the leak-proof 
plastic bag. Electronic CCF: Collector places printed copy of Copy 1 in 
the leak-proof plastic bag and/or places package label (with Specimen 
I.D., test facility name and contact information, and collection site 
name and contact information) on the outside of the bag.
     Collector seals the bag, prepares the specimen package for 
shipment, and distributes the remaining CCF copies as required.

Privacy Act Statement: (For Federal Employees Only)

    Submission of the information on the Federal Drug Testing Custody 
and Control Form is voluntary. However, incomplete submission of the 
information, refusal to provide a specimen, or substitution or 
adulteration of a specimen may result in delay or denial of your 
application for employment/appointment or may result in removal from 
the federal service or other disciplinary action.
    The authority for obtaining the specimen and identifying 
information contained herein is Executive Order 12564 (``Drug-Free 
Federal Workplace''), 5 U.S.C. 3301 (2), 5 U.S.C. 7301, and Section 503 
of Public Law 100-71, 5 U.S.C. 7301 note. Under provisions of Executive 
Order 12564 and 5 U.S.C. 7301, test results may only be disclosed to 
agency officials on a need-to-know basis. This may include the agency 
Medical Review Officer (MRO), the administrator of the Employee 
Assistance Program, and a supervisor with authority to take adverse 
personnel action. This information may also be disclosed to a court 
where necessary to defend against a challenge to an adverse personnel 
action.
    Submission of your SSN is not required by law and is voluntary. 
Your refusal to furnish your number will not result in the denial of 
any right, benefit, or privilege provided by law. Your SSN is 
solicited, pursuant to Executive Order 9397, for purposes of 
associating information in agency files relating to you and for 
purposes of identifying the specimen provided for testing for the 
presence of illegal drugs. If you refuse to indicate your SSN, a 
substitute number or other identifier will be assigned, as required, to 
process the specimen.

Public Burden Statement

    Public Burden Statement: An agency may not conduct or sponsor, and 
a person is not required to respond to, a collection of information 
unless it displays a currently valid OMB control number. The OMB 
control number for this project is 0930-0158. Public reporting burden 
for this collection of information is estimated to average: 5 minutes/
donor; 4 minutes/collector; 3 minutes/test facility; and 3 minutes/
Medical Review Officer. Send comments regarding this burden estimate or 
any other aspect of this collection of information, including 
suggestions for reducing this burden, to SAMHSA Reports Clearance 
Officer, 1 Choke Cherry Road, Room 2-1057, Rockville, Maryland, 20857.
    The number of respondents has been reduced from 7.1 to a total of 
6.1 million; which reduces the total burden hours of -240,480.
    Prior to an inspection, each test facility is required to submit 
specific information regarding its procedures. Collecting this 
information prior to an inspection allows the inspectors to thoroughly 
review and understand the testing procedures before arriving at the 
test facility.
    The NLCP application form has not been revised compared to the 
previous form.
    The annual total burden estimates for the Federal Drug Testing 
Custody and Control Form, the NLCP application, the NLCP inspection 
checklist, and NLCP

[[Page 42099]]

recordkeeping requirements are shown in the following table.

----------------------------------------------------------------------------------------------------------------
                                                                      Burden/
                   Number of form/respondents                        responses      Responses/     Total burden
                                                                      (hours)       respondent         hours
----------------------------------------------------------------------------------------------------------------
Custody and Control Form
    Donor.......................................................             .08       6,150,000         512,500
    Collector...................................................             .07       6,150,000         410,000
    Laboratory..................................................             .05       6,150,000         307,500
    Medical Review Officer......................................             .05       6,150,000         307,500
Laboratory Application..........................................             3.0               3               9
Laboratory Inspection Checklist.................................             2.0              35              70
Laboratory Recordkeeping........................................           250.0              35            8750
                                                                 -----------------------------------------------
        Total...................................................  ..............  ..............       1,546,329
----------------------------------------------------------------------------------------------------------------

    Written comments and recommendations concerning the proposed 
information collection should be sent by August 14, 2013 to the SAMHSA 
Desk Officer at the Office of Information and Regulatory Affairs, 
Office of Management and Budget (OMB). To ensure timely receipt of 
comments, and to avoid potential delays in OMB's receipt and processing 
of mail sent through the U.S. Postal Service, commenters are encouraged 
to submit their comments to OMB via email to: OIRA_Submission@omb.eop.gov. Although commenters are encouraged to send 
their comments via email, commenters may also fax their comments to: 
202-395-7285. Commenters may also mail them to: Office of Management 
and Budget, Office of Information and Regulatory Affairs, New Executive 
Office Building, Room 10102, Washington, DC 20503.

Summer King,
Statistician.
[FR Doc. 2013-16794 Filed 7-12-13; 8:45 am]
BILLING CODE 4162-20-P