Agency Forms Undergoing Paperwork Reduction Act Review, 45201-45203 [2013-17957]
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Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices
Prevention Program. The evaluation is
designed to determine best practices
and gender responsive strategies for atrisk girls between the ages of nine and
17 years. Data will continue to be
collected from program participants
(girls), parents of program participants,
program staff (i.e. program directors and
program staff), program partners, and
community residents. Collected data
will be submitted to OWH on a
quarterly basis. Primarily private nonprofit organizations and girls and
adolescents participating in the program
and their parents will be affected by this
data collection.
Need and Proposed Use of the
Information: The purpose of the
extended data collection is to add to the
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 ICR are
summarized in the table below.
evaluation database. The Girls at Greater
Risk Program is in its final year and the
data collected from participants will
add another full data cohort to the
evaluation.
Likely Respondents: The respondents
are primarily private non-profit
organizations, girls and adolescent
females participating in funded ‘‘Girls at
Greater Risk for Juvenile Delinquency
and HIV Prevention Programs’’, parents
of program participants, program staff
(i.e. program directors and program
staff), program partners, and community
residents that participate in community
events sponsored by the Girls at Greater
Risk Program.
Burden Statement: Burden in this
context means the time expended by
TOTAL ESTIMATED ANNUALIZED BURDEN—HOURS
Average burden per response
(in hours)
Number of respondents
Form name
Number of responses per
respondent
750
2
2
3,000
120
1
1.5
180
Total burden
hours
Prevention Education Questionnaire (Girls and Female Adolescents) ...........
Girls at Greater Risk Focus Group Protocol for Program Participants and
Background Information for Participant Focus Group .................................
Girls at Greater Risk Focus Group Protocol for Parents/Legal Guardians of
Participants and Background Information for Parent Focus Group .............
Girls at Greater Risk Focus Group Protocol for Partners and Background
Information for Partners Focus Group .........................................................
Partners: Process Evaluation Questionnaire ...................................................
Program Staff: Process Evaluation Questionnaire ..........................................
Program Directors: Process Evaluation Questionnaire ...................................
Program Staff data capture (entry) into data portal ........................................
Community Event Survey ................................................................................
120
1
1.5
180
120
60
10
10
10
250
1
1
2
2
150
1
1.5
.75
.75
1.5
.5
.083
180
45
15
30
750
21
Total ..........................................................................................................
1450
........................
........................
4,401
Office of the Secretary 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.
Darius Taylor,
Deputy Information Collection Clearance
Officer.
[FR Doc. 2013–17920 Filed 7–25–13; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day-13–12QU]
Agency Forms Undergoing Paperwork
Reduction Act Review
The Centers for Disease Control and
Prevention (CDC) publishes a list of
information collection requests under
review by the Office of Management and
Budget (OMB) in compliance with the
Paperwork Reduction Act (44 U.S.C.
Chapter 35). To request a copy of these
requests, call the CDC Reports Clearance
Officer at (404) 639–7570 or send an
email to omb@cdc.gov. Send written
comments to CDC Desk Officer, Office of
Management and Budget, Washington,
DC or by fax to (202) 395–5806. Written
comments should be received within 30
days of this notice.
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Proposed Project
Impact Evaluation of CDC’s Colorectal
Cancer Control Program (CRCCP)—
New—National Center for Chronic
Disease Prevention and Health
Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
Colorectal cancer (CRC) is the second
leading cause of cancer deaths in the
U.S.; however, screening can effectively
reduce CRC incidence and mortality.
CDC’s Colorectal Cancer Control
Program (CRCCP) was established to
increase population-level screening
rates to 80 percent. Currently, 25 states
and four tribal organizations receive
CDC funds to increase colorectal cancer
screening rates. The CRCCP is the first
cancer prevention and control program
funded by CDC emphasizing both the
direct provision of screening services
and broader screening promotion.
CRCCP grantees are required to establish
evidence-based colorectal cancer
screening delivery programs for persons
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Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices
50–64 years of age, focusing on
asymptomatic persons at average risk for
CRC with low incomes and inadequate
or no health insurance coverage for CRC
screening. Approximately 33 percent of
each grantee award may be used to fund
the provision of screening and
diagnostic tests. Additional program
activities such as patient recruitment,
patient navigation, provider education,
quality assurance, and data management
are also supported under this
component of the program.
The CRCCP offers a unique and
important opportunity to evaluate the
efficacy of this new public health
model. CDC plans to conduct an impact
evaluation to determine whether CRCCP
program activities increase state-level
colorectal cancer screening rates and
other proximal outcomes. The impact
evaluation will use a quasiexperimental, control group design with
pre- and post-tests involving a total of
six states: three CRCCP grantee states
(Alabama, Nebraska, and Washington)
represent the intervention programs and
three non-CRCCP states (Tennessee,
Oklahoma, and Wisconsin) represent
the control states.
CDC plans to complete two cycles of
information collection over a three-year
colorectal cancer screening guidelines
and screening quality, office systems
that support screening, and patterns of
referrals to screening. The estimated
burden per response is 12 minutes. For
the case studies, interview guides will
be used to conduct interviews with
program staff and stakeholders to gather
detailed information about colorectal
cancer screening provision and
promotion efforts. The estimated burden
for each interview is one hour to one
hour and 15 minutes. Evaluation staff
will also collect information through
document review and field observation.
period. The first information collection
will be initiated in 2013 and the second
information collection will be initiated
in 2015. Three types of information will
be collected at each time, including: (1)
A general population survey
administered by telephone with a statebased, representative, cross-sectional,
random sample of adults aged 50–75
(population survey); (2) a mail-back,
written, survey of a state-based,
representative sample of primary care
providers (provider survey); and (3)
qualitative case studies of program
implementation (case studies) based on
interviews with Colorectal Control
Program staff, program evaluators, and
state and local partners in both grantee
and non-grantee states. Information will
be collected from each site to identify
interviewees and prepare for the site
visit.
The general population survey
includes questions related to knowledge
of and attitudes toward colorectal
cancer, history of colorectal cancer
screening and intentions for future
screening, and barriers to screening. The
estimated burden per response is 23
minutes. The provider survey of
primary care physicians includes
questions related to knowledge of
The information to be collected will
be used to assess the impact of the
CRCCP in improving proximal outcomes
(e.g., provider knowledge, population
attitudes) and in increasing populationlevel CRC screening rates. Results of the
evaluation will be used to improve
program performance, plan future
public health programs, and improve
efficiencies. OMB approval is requested
for three years. The total estimated
annualized burden hours are 2,425.
There are no costs to respondents other
than their time.
ESTIMATED ANNUALIZED BURDEN HOURS
Form Name
General Population .........................................
Non-grantee State and Local Partners ...........
Non-grantee Private Sector Partners .............
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Number of responses per
respondent
9,600
1
5/60
3,200
1
23/60
1,600
4
4
12
4
4
4
12
4
1
1
1
1
1
1
1
1
1
12/60
1
5
75/60
1
1
1
75/60
1
4
4
1
1
1
1
Screener for the Colorectal Cancer Population Survey.
Colorectal Cancer Population Survey ............
General Population Eligible Individuals ages
50–75 years.
Primary Care Providers ..................................
CRCCP and Non-Grantee Program Director
CRCCP and Non-Grantee Program Directors
CRCCP Grantee Program Staff ......................
CRCCP Grantee Evaluators ...........................
CRCCP State and Local Sector Partners ......
CRCCP Private Sector Partners .....................
Non-Grantee Program Staff ............................
Non-Grantee Evaluator ...................................
Survey of Primary Care Providers .................
Suggested Interviewees Form .......................
Site Visit Instructions Template .....................
Interview Guide: Grantee Program Staff .......
Interview Guide: Grantee Program Evaluator
Interview Guide: Grantee Partner ..................
Interview Guide: Grantee Partner ..................
Interview Guide: Non-grantee Program Staff
Interview Guide: Non-grantee Program Evaluator.
Interview Guide: Non-grantee Partner ...........
Interview Guide: Non-grantee Partner ...........
Leroy A. Richardson,
Chief, Information Collection Review Office,
Office of Scientific Integrity, Office of the
Associate Director for Science, Office of the
Director, Centers for Disease Control and
Prevention.
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Average burden per response
(in hr)
Number of respondents
Type of respondent
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Federal Register / Vol. 78, No. 144 / Friday, July 26, 2013 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifiers CMS–R–13, CMS–R–
297, CMS–10088, CMS–10293, CMS–10477,
CMS–855(POH), CMS–2552–10, CMS–10185
and CMS–10463]
1. Access CMS’ Web site address at
https://www.cms.hhs.gov/
PaperworkReductionActof1995.
2. Email your request, including your
address, phone number, OMB number,
and CMS document identifier, to
Paperwork@cms.hhs.gov.
3. Call the Reports Clearance Office at
(410) 786–1326.
FOR FURTHER INFORMATION CONTACT:
Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
ACTION:
Reports Clearance Office at (410) 786–
1326.
The Centers for Medicare &
Medicaid Services (CMS) is announcing
an opportunity for the public to
comment on CMS’ intention to collect
information from the public. Under the
Paperwork Reduction Act of 1995
(PRA), federal agencies are required to
publish notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, and to allow
a second opportunity for public
comment on the notice. Interested
persons are invited to send comments
regarding the 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.
SUMMARY:
Comments on the collection(s) of
information must be received by the
OMB desk officer by August 26, 2013:
DATES:
When commenting on the
proposed information collections,
please reference the document identifier
or OMB control number. To be assured
consideration, comments and
recommendations must be received by
the OMB desk officer via one of the
following transmissions: OMB, Office of
Information and Regulatory Affairs,
Attention: CMS Desk Officer, Fax
Number: (202) 395–6974 OR Email:
OIRA_submission@omb.eop.gov.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, you may make your request
using one of following:
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ADDRESSES:
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Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. The term ‘‘collection of
information’’ is defined in 44 U.S.C.
3502(3) and 5 CFR 1320.3(c) and
includes agency requests or
requirements that members of the public
submit reports, keep records, or provide
information to a third party. Section
3506(c)(2)(A) of the PRA (44 U.S.C.
3506(c)(2)(A)) requires federal agencies
to publish a 30-day notice in the
Federal Register concerning each
proposed collection of information,
including each proposed extension or
reinstatement of an existing collection
of information, before submitting the
collection to OMB for approval. To
comply with this requirement, CMS is
publishing this notice that summarizes
the following proposed collection(s) of
information for public comment:
1. Type of Information Collection
Request: Reinstatement with change of a
previously approved collection; Title of
Information Collection: Conditions of
Coverage for Organ Procurement
Organizations and Supporting
Regulations; Use: Section 1138(b) of the
Social Security Act, as added by section
9318 of the Omnibus Budget
Reconciliation Act of 1986 (Pub. L. 99–
509), sets forth the statutory
qualifications and requirements that
organ procurement organizations
(OPOs) must meet in order for the costs
of their services in procuring organs for
transplant centers to be reimbursable
under the Medicare and Medicaid
programs. An OPO must be certified and
designated by the Secretary as an OPO
and must meet performance-related
standards prescribed by the Secretary.
The corresponding regulations are
found at 42 CFR Part 486 (Conditions
for Coverage of Specialized Services
Furnished by Suppliers) under subpart
G (Requirements for Certification and
Designation and Conditions for
SUPPLEMENTARY INFORMATION:
Notice.
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45203
Coverage: Organ Procurement
Organizations).
Since each OPO has a monopoly on
organ procurement within its designated
service area (DSA), we must hold OPOs
to high standards. Collection of this
information is necessary for us to assess
the effectiveness of each OPO and
determine whether it should continue to
be certified as an OPO and designated
for a particular donation service area by
the Secretary or replaced by an OPO
that can more effectively procure organs
within that DSA. Form Number: CMS–
R–13 (OCN: 0938–0688); Frequency:
Occasionally; Affected Public: Private
sector—Not-for-profit institutions;
Number of Respondents: 58; Total
Annual Responses: 58; Total Annual
Hours: 14,453. (For policy questions
regarding this collection contact Diane
Corning at 410–786–8486.)
2. Type of Information Collection
Request: Extension without change of a
currently approved collection; Title of
Information Collection: Request for
Employment Information; Use: The
Social Security Administration uses this
form to obtain information from
employers regarding whether a
Medicare beneficiary’s coverage under a
group health plan is based on current
employment status. Form Number:
CMS–R–297 (OCN: 0938–0787);
Frequency: Once; Affected Public:
Private sector—Business or other forprofit and Not-for-profit institutions;
Number of Respondents: 15,000; Total
Annual Responses: 15,000; Total
Annual Hours: 3,750. (For policy
questions regarding this collection
contact Lindsay Smith at 410–786–
6843.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Notification of
Fiscal Intermediaries (FIs) and CMS of
Co-located Medicare Providers and
Supporting Regulations; Use: Many
long-term care hospitals (LTCHs) are colocated with other Medicare providers
(acute care hospitals, inpatient
rehabilitation facilities, skilled nursing
facilities, and psychiatric facilities),
which leads to potential gaming of the
Medicare system based on patient
shifting. We require that LTCHs notify
FIs, Medicare administrative contractors
(MACs), and CMS of co-located
providers and establish policies to limit
payment abuse that will be based on FIs
and MACs tracking patient movement
among these co-located providers under
42 CFR 412.22(e)(6) and (h)(5).
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]]>Agencies
[Federal Register Volume 78, Number 144 (Friday, July 26, 2013)]
[Notices]
[Pages 45201-45203]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2013-17957]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[30Day-13-12QU]
Agency Forms Undergoing Paperwork Reduction Act Review
The Centers for Disease Control and Prevention (CDC) publishes a
list of information collection requests under review by the Office of
Management and Budget (OMB) in compliance with the Paperwork Reduction
Act (44 U.S.C. Chapter 35). To request a copy of these requests, call
the CDC Reports Clearance Officer at (404) 639-7570 or send an email to
omb@cdc.gov. Send written comments to CDC Desk Officer, Office of
Management and Budget, Washington, DC or by fax to (202) 395-5806.
Written comments should be received within 30 days of this notice.
Proposed Project
Impact Evaluation of CDC's Colorectal Cancer Control Program
(CRCCP)--New--National Center for Chronic Disease Prevention and Health
Promotion (NCCDPHP), Centers for Disease Control and Prevention (CDC).
Background and Brief Description
Colorectal cancer (CRC) is the second leading cause of cancer
deaths in the U.S.; however, screening can effectively reduce CRC
incidence and mortality. CDC's Colorectal Cancer Control Program
(CRCCP) was established to increase population-level screening rates to
80 percent. Currently, 25 states and four tribal organizations receive
CDC funds to increase colorectal cancer screening rates. The CRCCP is
the first cancer prevention and control program funded by CDC
emphasizing both the direct provision of screening services and broader
screening promotion. CRCCP grantees are required to establish evidence-
based colorectal cancer screening delivery programs for persons
[[Page 45202]]
50-64 years of age, focusing on asymptomatic persons at average risk
for CRC with low incomes and inadequate or no health insurance coverage
for CRC screening. Approximately 33 percent of each grantee award may
be used to fund the provision of screening and diagnostic tests.
Additional program activities such as patient recruitment, patient
navigation, provider education, quality assurance, and data management
are also supported under this component of the program.
The CRCCP offers a unique and important opportunity to evaluate the
efficacy of this new public health model. CDC plans to conduct an
impact evaluation to determine whether CRCCP program activities
increase state-level colorectal cancer screening rates and other
proximal outcomes. The impact evaluation will use a quasi-experimental,
control group design with pre- and post-tests involving a total of six
states: three CRCCP grantee states (Alabama, Nebraska, and Washington)
represent the intervention programs and three non-CRCCP states
(Tennessee, Oklahoma, and Wisconsin) represent the control states.
CDC plans to complete two cycles of information collection over a
three-year period. The first information collection will be initiated
in 2013 and the second information collection will be initiated in
2015. Three types of information will be collected at each time,
including: (1) A general population survey administered by telephone
with a state-based, representative, cross-sectional, random sample of
adults aged 50-75 (population survey); (2) a mail-back, written, survey
of a state-based, representative sample of primary care providers
(provider survey); and (3) qualitative case studies of program
implementation (case studies) based on interviews with Colorectal
Control Program staff, program evaluators, and state and local partners
in both grantee and non-grantee states. Information will be collected
from each site to identify interviewees and prepare for the site visit.
The general population survey includes questions related to
knowledge of and attitudes toward colorectal cancer, history of
colorectal cancer screening and intentions for future screening, and
barriers to screening. The estimated burden per response is 23 minutes.
The provider survey of primary care physicians includes questions
related to knowledge of colorectal cancer screening guidelines and
screening quality, office systems that support screening, and patterns
of referrals to screening. The estimated burden per response is 12
minutes. For the case studies, interview guides will be used to conduct
interviews with program staff and stakeholders to gather detailed
information about colorectal cancer screening provision and promotion
efforts. The estimated burden for each interview is one hour to one
hour and 15 minutes. Evaluation staff will also collect information
through document review and field observation.
The information to be collected will be used to assess the impact
of the CRCCP in improving proximal outcomes (e.g., provider knowledge,
population attitudes) and in increasing population-level CRC screening
rates. Results of the evaluation will be used to improve program
performance, plan future public health programs, and improve
efficiencies. OMB approval is requested for three years. The total
estimated annualized burden hours are 2,425. There are no costs to
respondents other than their time.
Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of Average burden
Type of respondent Form Name Number of responses per per response
respondents respondent (in hr)
----------------------------------------------------------------------------------------------------------------
General Population.................... Screener for the 9,600 1 5/60
Colorectal Cancer
Population Survey.
General Population Eligible Colorectal Cancer 3,200 1 23/60
Individuals ages 50-75 years. Population Survey.
Primary Care Providers................ Survey of Primary Care 1,600 1 12/60
Providers.
CRCCP and Non-Grantee Program Director Suggested Interviewees 4 1 1
Form.
CRCCP and Non-Grantee Program Site Visit Instructions 4 1 5
Directors. Template.
CRCCP Grantee Program Staff........... Interview Guide: Grantee 12 1 75/60
Program Staff.
CRCCP Grantee Evaluators.............. Interview Guide: Grantee 4 1 1
Program Evaluator.
CRCCP State and Local Sector Partners. Interview Guide: Grantee 4 1 1
Partner.
CRCCP Private Sector Partners......... Interview Guide: Grantee 4 1 1
Partner.
Non-Grantee Program Staff............. Interview Guide: Non- 12 1 75/60
grantee Program Staff.
Non-Grantee Evaluator................. Interview Guide: Non- 4 1 1
grantee Program
Evaluator.
Non-grantee State and Local Partners.. Interview Guide: Non- 4 1 1
grantee Partner.
Non-grantee Private Sector Partners... Interview Guide: Non- 4 1 1
grantee Partner.
----------------------------------------------------------------------------------------------------------------
Leroy A. Richardson,
Chief, Information Collection Review Office, Office of Scientific
Integrity, Office of the Associate Director for Science, Office of the
Director, Centers for Disease Control and Prevention.
[FR Doc. 2013-17957 Filed 7-25-13; 8:45 am]
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