Submission for OMB Review; Comment Request, 46284-46285 [2015-19001]

Download as PDF 46284 Federal Register / Vol. 80, No. 149 / Tuesday, August 4, 2015 / Notices ESTIMATED ANNUALIZED BURDEN HOURS—Continued Number of responses per respondent Form name Trainees participating in the Work@ Health® Program Wave 2. Work@Health® Instructors/Coaches Wave 2 Trainee Reaction Survey .... 200 1 15/60 50 Instructor/Coach Group Discussion Guide. .......................................................... 7 1 30/60 4 ........................ ........................ ........................ 1,064 Total ........................................... 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. 2015–19042 Filed 8–3–15; 8:45 am] BILLING CODE 4163–18–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services [Document Identifier CMS–224–14] Agency Information Collection Activities: Submission for OMB Review; Comment Request ACTION: Notice. 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. DATES: Comments on the collection(s) of information must be received by the OMB desk officer by September 3, 2015. ADDRESSES: When commenting on the proposed information collections, tkelley on DSK3SPTVN1PROD with NOTICES SUMMARY: VerDate Sep<11>2014 18:45 Aug 03, 2015 Jkt 235001 Number of respondents Avg. burden per response (in hrs.) Type of respondent 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) 395–5806 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: 1. Access CMS’ Web site address at http://www.cms.hhs.gov/Paperwork ReductionActof1995. 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: Reports Clearance Office at (410) 786– 1326. SUPPLEMENTARY INFORMATION: 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: New collection (Request for a new OMB control number); Title of PO 00000 Frm 00051 Fmt 4703 Sfmt 4703 Total burden (in hrs.) Information Collection: Federally Qualified Health Center Cost Report Form; Use: Providers of services participating in the Medicare program are required under sections 1815(a) and 1861(v)(1)(A) of the Act (42 U.S.C. 1395g) to submit annual information to achieve settlement of costs for health care services rendered to Medicare beneficiaries. In addition, regulations at 42 CFR 413.20 and 413.24 require adequate cost data and cost reports from providers on an annual basis. The form CMS–224–14 cost report is needed to determine a provider’s reasonable costs incurred in furnishing medical services to Medicare beneficiaries and reimbursement due to or from a provider. Form Number: CMS–224–14 (OMB control number 0938—New); Frequency: Yearly; Affected Public: Private sector—For-profit and Not-forprofit institutions; Number of Respondents: 1,296; Total Annual Responses: 1,296; Total Annual Hours: 75,168. (For policy questions regarding this collection contact Julie Stankivic at 410–786–5725). Dated: July 30, 2015. William N. Parham, III, Director, Paperwork Reduction Staff, Office of Strategic Operations and Regulatory Affairs. [FR Doc. 2015–19075 Filed 8–3–15; 8:45 am] BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for OMB Review; Comment Request Title: Initial Medical Exam Form and Initial Dental Exam Form. OMB No.: 0970–NEW. Description: The Administration for Children and Families’ Office of Refugee Resettlement (ORR) places unaccompanied minors in their custody in licensed care provider facilities until reunification with a qualified sponsor. Care provider facilities are required to provide children with services such as E:\FR\FM\04AUN1.SGM 04AUN1 46285 Federal Register / Vol. 80, No. 149 / Tuesday, August 4, 2015 / Notices classroom education, mental health services, and health care. Pursuant to Exhibit 1, part A.2 of the Flores Settlement Agreement (Jenny Lisette Flores, et al., v. Janet Reno, Attorney General of the United States, et al., Case No. CV 85–4544–RJK (C.D. Cal. 1996), care provider facilities, on behalf of ORR, shall arrange for appropriate routine medical and dental care, family planning services, and emergency health care services, including a complete medical examination (including screening for infectious disease) within 48 hours of admission, excluding weekends and holidays, unless the minor was recently examined at another facility; appropriate immunizations in accordance with the U.S. Public Health Service (PHS), Center for Disease Control; administration of prescribed medication and special diets; appropriate mental health interventions when necessary for each minor in their care. The forms are to be used as worksheets for clinicians, medical staff, and the health department to compile information that would otherwise have been collected during the initial medical or dental exam. Once completed, the forms will be given to shelter staff for data entry into ORR’s electronic data repository known as the ‘UAC Portal’. Data will be used to record UC health on admission and for case management of any identified illnesses/conditions. Respondents: Clinicians, Health Department staff, Office of Refugee Resettlement Grantee staff. ANNUAL BURDEN ESTIMATES Number of respondents Instrument Number of responses per respondent Average burden hours per response Total burden hours Estimated Respondent Burden for Responding Initial Medical Exam Form (including Appendix A: Supplemental TB Screening Form) ...................................................................................................... Initial Dental Exam Form ................................................................................. 150 150 270 27 0.17 0.08 6,885 324 Estimated Total Burden Hours: 7,209. ANNUAL BURDEN ESTIMATES Number of respondents Instrument Number of responses per respondent Average burden hours per response Total burden hours Estimated Respondent Burden for Recordkeeping tkelley on DSK3SPTVN1PROD with NOTICES Initial Medical Exam Form (including Appendix A: Supplemental TB Screening Form) ...................................................................................................... Initial Dental Exam Form ................................................................................. Estimated Total Annual Burden 3,564. Additional Information: Copies of the proposed collection may be obtained by writing to the Administration for Children and Families, Office of Planning, Research and Evaluation, 370 L’Enfant Promenade SW., Washington, DC 20447, Attn: ACF Reports Clearance Officer. All requests should be identified by the title of the information collection. Email address: infocollection@acf.hhs.gov. OMB Comment: OMB is required to make a decision concerning the collection of information between 30 and 60 days after publication of this document in the Federal Register. Therefore, a comment is best assured of having its full effect if OMB receives it within 30 days of publication. Written comments and recommendations for the proposed information collection should be sent directly to the following: Office of Management and Budget, Paperwork Reduction Project, Email: OIRA_ SUBMISSION@OMB.EOP.GOV, Attn: VerDate Sep<11>2014 18:45 Aug 03, 2015 Jkt 235001 150 150 Desk Officer for the Administration for Children and Families. Robert Sargis, Reports Clearance Officer. [FR Doc. 2015–19001 Filed 8–3–15; 8:45 am] BILLING CODE 4184–01–P DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families Submission for OMB Review; Comment Request Title: Trafficking Victim Assistance Program Data. OMB No.: 0970—NEW. Description: The Trafficking Victims Protection Act of 2000 (TVPA), as amended, authorizes the Secretary of Health and Human Services (HHS) to expand benefits and services to foreign nationals in the United States who are PO 00000 Frm 00052 Fmt 4703 Sfmt 4703 270 27 0.08 0.08 3,240 324 victims of severe forms of trafficking in persons. Such benefits and services may include services to assist potential victims of trafficking. (Section 107(b)(1)(B) of the TVPA, 22 U.S.C. 7105(b)(1)(B)). The Administration for Children and Families (ACF) intends to award cooperative agreements in fiscal year 2015 to approximately three organizations that will ensure national coverage. The awarded organization must provide comprehensive case management and referrals to qualified persons, either directly through its own organization or by partnering with other organizations through contracts or both. Persons qualified for services under this grant are victims of a severe form of trafficking in persons who have received certification from HHS; potential victims of a severe form of trafficking who are actively seeking to achieve HHS certification; family members with derivative T visas, and minor dependent children of foreign E:\FR\FM\04AUN1.SGM 04AUN1

Agencies

[Federal Register Volume 80, Number 149 (Tuesday, August 4, 2015)]
[Notices]
[Pages 46284-46285]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-19001]


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

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Submission for OMB Review; Comment Request

    Title: Initial Medical Exam Form and Initial Dental Exam Form.
    OMB No.: 0970-NEW.
    Description: The Administration for Children and Families' Office 
of Refugee Resettlement (ORR) places unaccompanied minors in their 
custody in licensed care provider facilities until reunification with a 
qualified sponsor. Care provider facilities are required to provide 
children with services such as

[[Page 46285]]

classroom education, mental health services, and health care. Pursuant 
to Exhibit 1, part A.2 of the Flores Settlement Agreement (Jenny 
Lisette Flores, et al., v. Janet Reno, Attorney General of the United 
States, et al., Case No. CV 85-4544-RJK (C.D. Cal. 1996), care provider 
facilities, on behalf of ORR, shall arrange for appropriate routine 
medical and dental care, family planning services, and emergency health 
care services, including a complete medical examination (including 
screening for infectious disease) within 48 hours of admission, 
excluding weekends and holidays, unless the minor was recently examined 
at another facility; appropriate immunizations in accordance with the 
U.S. Public Health Service (PHS), Center for Disease Control; 
administration of prescribed medication and special diets; appropriate 
mental health interventions when necessary for each minor in their 
care.
    The forms are to be used as worksheets for clinicians, medical 
staff, and the health department to compile information that would 
otherwise have been collected during the initial medical or dental 
exam. Once completed, the forms will be given to shelter staff for data 
entry into ORR's electronic data repository known as the `UAC Portal'. 
Data will be used to record UC health on admission and for case 
management of any identified illnesses/conditions.
    Respondents: Clinicians, Health Department staff, Office of Refugee 
Resettlement Grantee staff.

                                             Annual Burden Estimates
----------------------------------------------------------------------------------------------------------------
                                                                     Number of    Average burden
                   Instrument                        Number of     responses per     hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
                                   Estimated Respondent Burden for Responding
----------------------------------------------------------------------------------------------------------------
Initial Medical Exam Form (including Appendix A:             150             270            0.17           6,885
 Supplemental TB Screening Form)................
Initial Dental Exam Form........................             150              27            0.08             324
----------------------------------------------------------------------------------------------------------------

    Estimated Total Burden Hours: 7,209.

                                             Annual Burden Estimates
----------------------------------------------------------------------------------------------------------------
                                                                     Number of    Average burden
                   Instrument                        Number of     responses per     hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
                                  Estimated Respondent Burden for Recordkeeping
----------------------------------------------------------------------------------------------------------------
Initial Medical Exam Form (including Appendix A:             150             270            0.08           3,240
 Supplemental TB Screening Form)................
Initial Dental Exam Form........................             150              27            0.08             324
----------------------------------------------------------------------------------------------------------------

    Estimated Total Annual Burden 3,564.
    Additional Information: Copies of the proposed collection may be 
obtained by writing to the Administration for Children and Families, 
Office of Planning, Research and Evaluation, 370 L'Enfant Promenade 
SW., Washington, DC 20447, Attn: ACF Reports Clearance Officer. All 
requests should be identified by the title of the information 
collection. Email address: infocollection@acf.hhs.gov.
    OMB Comment: OMB is required to make a decision concerning the 
collection of information between 30 and 60 days after publication of 
this document in the Federal Register. Therefore, a comment is best 
assured of having its full effect if OMB receives it within 30 days of 
publication. Written comments and recommendations for the proposed 
information collection should be sent directly to the following: Office 
of Management and Budget, Paperwork Reduction Project, Email: 
OIRA_SUBMISSION@OMB.EOP.GOV, Attn: Desk Officer for the Administration 
for Children and Families.

Robert Sargis,
Reports Clearance Officer.
[FR Doc. 2015-19001 Filed 8-3-15; 8:45 am]
BILLING CODE 4184-01-P