Agency Information Collection Activities: Proposed Collection: Public Comment Request: Information Collection Request Title: Health Center Program Forms, OMB No. 0915-0285-Revision, 13937-13938 [2019-06766]
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13937
Federal Register / Vol. 84, No. 67 / Monday, April 8, 2019 / Notices
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.
Amy P. McNulty,
Acting Director, Division of the Executive
Secretariat.
[FR Doc. 2019–06768 Filed 4–5–19; 8:45 am]
BILLING CODE 4165–15–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Agency Information Collection
Activities: Proposed Collection: Public
Comment Request: Information
Collection Request Title: Health Center
Program Forms, OMB No. 0915–0285—
Revision
Health Resources and Services
Administration (HRSA), Department of
Health and Human Services.
ACTION: Notice.
AGENCY:
In compliance with the
requirement for opportunity for public
comment on proposed data collection
projects of the Paperwork Reduction Act
of 1995, 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.
DATES: Comments on this ICR should be
received no later than June 7, 2019.
ADDRESSES: Submit your comments to
paperwork@hrsa.gov or mail the HRSA
Information Collection Clearance
Officer, Room 14N136B, 5600 Fishers
Lane, Rockville, MD 20857.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
SUMMARY:
proposed project or to obtain a copy of
the data collection plans and draft
instruments, email paperwork@hrsa.gov
or call Lisa Wright-Solomon, the HRSA
Information Collection Clearance
Officer, at (301) 443–1984.
SUPPLEMENTARY INFORMATION: When
submitting comments or requesting
information, please include the
information request collection title for
reference.
Information Collection Request Title:
Health Center Program Forms; OMB No.
0915–0285—Revision.
Abstract: The Health Center Program,
administered by HRSA, is authorized
under section 330 of the Public Health
Service (PHS) Act, most recently
amended by section 50901(b) of the
Bipartisan Budget Act of 2018, Public
Law 115–123. Health centers are
community-based and patient-directed
organizations that deliver affordable,
accessible, quality, and cost-effective
primary health care services to patients
regardless of their ability to pay. Nearly
1,400 health centers operate
approximately 12,000 service delivery
sites that provide primary health care to
more than 27 million people in every
U.S. state, the District of Columbia,
Puerto Rico, the U.S. Virgin Islands, and
the Pacific Basin. HRSA utilizes forms
for new and existing health centers and
other entities to apply for various grant
and non-grant opportunities, renew
grant and non-grant designations, report
progress, and change their scopes of
project.
Need and Proposed Use of the
Information: Health Center Programspecific forms are necessary for Health
Center Program award processes and
oversight. These forms provide HRSA
staff and objective review committee
panels with information essential for
application evaluation, funding
recommendation and approval,
designation, and monitoring. These
forms also provide HRSA staff with
information essential for evaluating
compliance with Health Center Program
legislative and regulatory requirements.
HRSA intends to make the following
changes to its forms:
• Modify the following forms to
streamline and clarify data currently
being collected: 1A, 1C, 2, 3, 3A, 4, 5A,
5C, 6A, 8, 12, Health Center Controlled
Networks (HCCN) Progress Report,
Program Specific Forms Instructions,
Project Narrative Update (Budget Period
Progress Report [BPR]), Project Work
Plan, and the Summary Page.
• Rename Substance Abuse Progress
Report to Health Center Program
Progress Report.
• Add the following forms necessary
for funding applications and program
monitoring: Capital Semi-Annual
Progress Report, HCCN Participating
Health Center List, Loan Guarantee
Application, Patient Target Question
Verification, Project Plan, and
Substance Use Disorder and Mental
Health Services (SUD–MH)
Supplemental Funding Progress Report.
• Remove the following forms to
further streamline information collected
by HRSA and reduce burden:
Alterations and Renovations Project
Cover Page, Form 9: Need for
Assistance, Form 10: Annual Emergency
Preparedness Report, HCCN Work Plan,
Outreach and Enrollment Supplemental,
and Zika Progress Report.
Likely Respondents: Health Center
Program award recipients (those funded
under section 330 of the PHS Act) and
Health Center Program look-alikes, state
and national technical assistance
organizations, and other organizations
seeking funding.
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 ICR are
summarized in the table below.
TOTAL ESTIMATED ANNUALIZED BURDEN HOURS
jbell on DSK30RV082PROD with NOTICES
Capital Semi-Annual Progress Report (New) .......................................................
Checklist for Adding a New Service .....................................................................
Checklist for Adding a New Service Delivery Site ................................................
Checklist for Adding a New Target Population .....................................................
Checklist for Deleting an Existing Service ............................................................
VerDate Sep<11>2014
17:45 Apr 05, 2019
Jkt 247001
Number of
responses per
respondent
Number of
respondents
Form name
PO 00000
Frm 00076
Fmt 4703
996
450
1,480
100
500
Sfmt 4703
1
1
1
1
1
E:\FR\FM\08APN1.SGM
Total
responses
996
450
1,480
100
500
08APN1
Average
burden per
response
(in hours)
1.00
1.00
1.50
0.50
1.00
Total burden
hours
996
450
2,220
50
500
13938
Federal Register / Vol. 84, No. 67 / Monday, April 8, 2019 / Notices
TOTAL ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Total
responses
Average
burden per
response
(in hours)
Total burden
hours
Checklist for Deleting an Existing Service Delivery Site ......................................
Clinical Performance Measures ............................................................................
Equipment List ......................................................................................................
Expanded Services Project Narrative) ..................................................................
Federal Object Class Categories ..........................................................................
Financial Performance Measures .........................................................................
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 3A: Look-Alike Budget Information ..............................................................
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 12: Organization Contacts ...........................................................................
Funding Sources ...................................................................................................
HCCN Participating Health Center List (NEW) .....................................................
HCCN Progress Report ........................................................................................
Health Center Program Progress Report (previously Substance Abuse
Progress Report) ...............................................................................................
Loan Guarantee Application (NEW) .....................................................................
Operational Plan Instructions ................................................................................
Other Requirements for Sites ...............................................................................
Patient Target Question Verification (NEW) .........................................................
Program Specific Form Instructions ......................................................................
Project Cover Page ...............................................................................................
Project Narrative Update (BPR) ............................................................................
Project Plan (NEW) ...............................................................................................
Project Qualification Criteria .................................................................................
Project Work Plan .................................................................................................
Proposal Cover Page ............................................................................................
SUD–MH Supplemental Funding Progress Report (NEW) ..................................
Summary Page .....................................................................................................
Supplemental Information .....................................................................................
500
1,058
1,375
1,058
735
1,058
1,058
1,000
1,058
1,058
1,058
50
1,058
1,058
1,508
1,058
1,058
1,058
1,058
1,058
735
90
90
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
500
1,058
1,375
1,058
735
1,058
1,058
1,000
1,058
1,058
1,058
50
1,058
1,058
1,508
1,058
1,058
1,058
1,058
1,058
735
90
90
1.00
3.50
1.00
1.00
0.25
1.00
1.00
0.75
0.50
1.00
2.50
1.00
1.00
1.00
0.75
0.50
0.50
1.00
0.75
0.50
0.50
1.00
25.00
500
3,703
1,375
1,058
184
1,058
1,058
750
529
1,058
2,645
50
1,058
1,058
1,131
529
529
1,058
794
529
368
90
2,250
735
20
500
600
1,058
1,500
735
883
1,300
735
135
735
1,375
1,008
500
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
735
20
500
600
1,058
1,500
735
883
1,300
735
135
735
1,375
1,008
500
1.00
1.00
3.00
0.50
1.00
1.00
1.00
4.00
1.00
1.00
5.00
1.00
1.00
0.25
1.00
735
20
1,500
300
1,058
1,500
735
3,532
1,300
735
675
735
1,375
252
500
Total Hours ....................................................................................................
35,790
........................
35,790
........................
42,530
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.
Amy P. McNulty,
Acting Director, Division of the Executive
Secretariat.
[FR Doc. 2019–06766 Filed 4–5–19; 8:45 am]
BILLING CODE 4165–15–P
jbell on DSK30RV082PROD with NOTICES
Number of
responses per
respondent
Number of
respondents
Form name
VerDate Sep<11>2014
17:45 Apr 05, 2019
Jkt 247001
DEPARTMENT OF HOMELAND
SECURITY
Coast Guard
Comments must reach the Coast
Guard on or before June 7, 2019.
DATES:
[Docket No. USCG–2019–0039]
Information Collection Request to
Office of Management and Budget;
OMB Control Number: 1625–0061
Coast Guard, DHS.
Sixty-day notice requesting
comments.
AGENCY:
ACTION:
In compliance with the
Paperwork Reduction Act of 1995, the
U.S. Coast Guard intends to submit an
Information Collection Request (ICR) to
the Office of Management and Budget
(OMB), Office of Information and
Regulatory Affairs (OIRA), requesting
approval for reinstatement, without
change, of the following collection of
information: 1625–0061, Commercial
Fishing Industry Vessel Safety
Regulations; without change. Our ICR
describes the information we seek to
collect from the public. Before
SUMMARY:
PO 00000
Frm 00077
submitting this ICR to OIRA, the Coast
Guard is inviting comments as
described below.
Fmt 4703
Sfmt 4703
You may submit comments
identified by Coast Guard docket
number [USCG–2019–0039] to the Coast
Guard using the Federal eRulemaking
Portal at https://www.regulations.gov.
See the ‘‘Public participation and
request for comments’’ portion of the
SUPPLEMENTARY INFORMATION section for
further instructions on submitting
comments.
A copy of the ICR is available through
the docket on the internet at https://
www.regulations.gov. Additionally,
copies are available from: Commandant
(CG–612), Attn: Paperwork Reduction
Act Manager, U.S. Coast Guard, 2703
Martin Luther King Jr. Ave. SE, STOP
7710, Washington, DC 20593–7710.
ADDRESSES:
Mr.
Anthony Smith, Office of Information
Management, telephone 202–475–3532,
FOR FURTHER INFORMATION CONTACT:
E:\FR\FM\08APN1.SGM
08APN1
]]>Agencies
[Federal Register Volume 84, Number 67 (Monday, April 8, 2019)]
[Notices]
[Pages 13937-13938]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-06766]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection:
Public Comment Request: Information Collection Request Title: Health
Center Program Forms, OMB No. 0915-0285--Revision
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
-----------------------------------------------------------------------
SUMMARY: In compliance with the requirement for opportunity for public
comment on proposed data collection projects of the Paperwork Reduction
Act of 1995, 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.
DATES: Comments on this ICR should be received no later than June 7,
2019.
ADDRESSES: Submit your comments to [email protected] or mail the HRSA
Information Collection Clearance Officer, Room 14N136B, 5600 Fishers
Lane, Rockville, MD 20857.
FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the data collection plans and
draft instruments, email [email protected] or call Lisa Wright-
Solomon, the HRSA Information Collection Clearance Officer, at (301)
443-1984.
SUPPLEMENTARY INFORMATION: When submitting comments or requesting
information, please include the information request collection title
for reference.
Information Collection Request Title: Health Center Program Forms;
OMB No. 0915-0285--Revision.
Abstract: The Health Center Program, administered by HRSA, is
authorized under section 330 of the Public Health Service (PHS) Act,
most recently amended by section 50901(b) of the Bipartisan Budget Act
of 2018, Public Law 115-123. Health centers are community-based and
patient-directed organizations that deliver affordable, accessible,
quality, and cost-effective primary health care services to patients
regardless of their ability to pay. Nearly 1,400 health centers operate
approximately 12,000 service delivery sites that provide primary health
care to more than 27 million people in every U.S. state, the District
of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific
Basin. HRSA utilizes forms for new and existing health centers and
other entities to apply for various grant and non-grant opportunities,
renew grant and non-grant designations, report progress, and change
their scopes of project.
Need and Proposed Use of the Information: Health Center Program-
specific forms are necessary for Health Center Program award processes
and oversight. These forms provide HRSA staff and objective review
committee panels with information essential for application evaluation,
funding recommendation and approval, designation, and monitoring. These
forms also provide HRSA staff with information essential for evaluating
compliance with Health Center Program legislative and regulatory
requirements.
HRSA intends to make the following changes to its forms:
Modify the following forms to streamline and clarify data
currently being collected: 1A, 1C, 2, 3, 3A, 4, 5A, 5C, 6A, 8, 12,
Health Center Controlled Networks (HCCN) Progress Report, Program
Specific Forms Instructions, Project Narrative Update (Budget Period
Progress Report [BPR]), Project Work Plan, and the Summary Page.
Rename Substance Abuse Progress Report to Health Center
Program Progress Report.
Add the following forms necessary for funding applications
and program monitoring: Capital Semi-Annual Progress Report, HCCN
Participating Health Center List, Loan Guarantee Application, Patient
Target Question Verification, Project Plan, and Substance Use Disorder
and Mental Health Services (SUD-MH) Supplemental Funding Progress
Report.
Remove the following forms to further streamline
information collected by HRSA and reduce burden: Alterations and
Renovations Project Cover Page, Form 9: Need for Assistance, Form 10:
Annual Emergency Preparedness Report, HCCN Work Plan, Outreach and
Enrollment Supplemental, and Zika Progress Report.
Likely Respondents: Health Center Program award recipients (those
funded under section 330 of the PHS Act) and Health Center Program
look-alikes, state and national technical assistance organizations, and
other organizations seeking funding.
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 ICR are summarized in the table below.
Total Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Average
Number of Number of Total burden per Total burden
Form name respondents responses per responses response (in hours
respondent hours)
----------------------------------------------------------------------------------------------------------------
Capital Semi-Annual Progress 996 1 996 1.00 996
Report (New)...................
Checklist for Adding a New 450 1 450 1.00 450
Service........................
Checklist for Adding a New 1,480 1 1,480 1.50 2,220
Service Delivery Site..........
Checklist for Adding a New 100 1 100 0.50 50
Target Population..............
Checklist for Deleting an 500 1 500 1.00 500
Existing Service...............
[[Page 13938]]
Checklist for Deleting an 500 1 500 1.00 500
Existing Service Delivery Site.
Clinical Performance Measures... 1,058 1 1,058 3.50 3,703
Equipment List.................. 1,375 1 1,375 1.00 1,375
Expanded Services Project 1,058 1 1,058 1.00 1,058
Narrative).....................
Federal Object Class Categories. 735 1 735 0.25 184
Financial Performance Measures.. 1,058 1 1,058 1.00 1,058
Form 1A: General Information 1,058 1 1,058 1.00 1,058
Worksheet......................
Form 1B: BPHC Funding Request 1,000 1 1,000 0.75 750
Summary........................
Form 1C: Documents on File...... 1,058 1 1,058 0.50 529
Form 2: Staffing Profile........ 1,058 1 1,058 1.00 1,058
Form 3: Income Analysis......... 1,058 1 1,058 2.50 2,645
Form 3A: Look-Alike Budget 50 1 50 1.00 50
Information....................
Form 4: Community 1,058 1 1,058 1.00 1,058
Characteristics................
Form 5A: Services Provided...... 1,058 1 1,058 1.00 1,058
Form 5B: Service Sites.......... 1,508 1 1,508 0.75 1,131
Form 5C: Other Activities/ 1,058 1 1,058 0.50 529
Locations......................
Form 6A: Current Board Member 1,058 1 1,058 0.50 529
Characteristics................
Form 6B: Request for Waiver of 1,058 1 1,058 1.00 1,058
Governance Requirements........
Form 8: Health Center Agreements 1,058 1 1,058 0.75 794
Form 12: Organization Contacts.. 1,058 1 1,058 0.50 529
Funding Sources................. 735 1 735 0.50 368
HCCN Participating Health Center 90 1 90 1.00 90
List (NEW).....................
HCCN Progress Report............ 90 1 90 25.00 2,250
Health Center Program Progress 735 1 735 1.00 735
Report (previously Substance
Abuse Progress Report).........
Loan Guarantee Application (NEW) 20 1 20 1.00 20
Operational Plan Instructions... 500 1 500 3.00 1,500
Other Requirements for Sites.... 600 1 600 0.50 300
Patient Target Question 1,058 1 1,058 1.00 1,058
Verification (NEW).............
Program Specific Form 1,500 1 1,500 1.00 1,500
Instructions...................
Project Cover Page.............. 735 1 735 1.00 735
Project Narrative Update (BPR).. 883 1 883 4.00 3,532
Project Plan (NEW).............. 1,300 1 1,300 1.00 1,300
Project Qualification Criteria.. 735 1 735 1.00 735
Project Work Plan............... 135 1 135 5.00 675
Proposal Cover Page............. 735 1 735 1.00 735
SUD-MH Supplemental Funding 1,375 1 1,375 1.00 1,375
Progress Report (NEW)..........
Summary Page.................... 1,008 1 1,008 0.25 252
Supplemental Information........ 500 1 500 1.00 500
-------------------------------------------------------------------------------
Total Hours................. 35,790 .............. 35,790 .............. 42,530
----------------------------------------------------------------------------------------------------------------
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.
Amy P. McNulty,
Acting Director, Division of the Executive Secretariat.
[FR Doc. 2019-06766 Filed 4-5-19; 8:45 am]
BILLING CODE 4165-15-P
