Proposed Data Collection Submitted for Public Comment and Recommendations, 8254-8256 [2022-03081]
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8254
Federal Register / Vol. 87, No. 30 / Monday, February 14, 2022 / Notices
prescription opioids, with rates of
deaths involving prescription opioids
more than quadrupling from 1999 to
2019. In response, a range of clinical
practice guidelines, policies, and
regulations have been released in recent
years to address the opioid overdose
epidemic, with the goals of supporting
safer opioid prescribing, improving
diagnosis and treatment of OUD, and
reducing overdose deaths in the United
States.
To design this evaluation, we
previously conducted and completed a
‘‘Feasibility Assessment of Health
Systems’’ via surveys to determine the
range of policies and guidelines being
implemented by health systems,
followed by an ‘‘evaluability
assessment’’ by means of interviews
with leaders of nine health systems. For
the purposes of this evaluation,
‘‘Chronic pain management policies/
guidelines’’ refers to policies/guidelines
that may include prescribing of opioid
medications, nonpharmacologic
therapies, and/or non-opioid
medications for chronic pain, as well as
OUD assessment and treatment.
In early 2020, CDC requested OMB
approval for a Feasibility Assessment of
Health Systems (‘‘Feedback on the use
of the CDC Guideline for Prescribing
Opioids for Chronic Pain’’) through the
‘‘Generic Clearance for the Collection of
Routine Customer Feedback’’ (OMB
Control No. 0920–1050). This brief
eligibility assessment consisting of
surveys was sent to approximately 250
health systems to understand the
landscape of health systems and the
types of guidelines or policies
implemented, and what strategies were
used to do so. Of 250 health systems
contacted, 46 responded and were
considered for the following
preliminary phase, the evaluability
assessment. Among the 46 health
systems who completed the feasibility
assessment surveys, nine were selected
for a more in-depth ‘‘evaluability
assessment’’ based on several factors
identified in the initial feasibility
(survey) assessment, as well as other
expert knowledge of potential systems.
The purpose of this data collection
effort is to: (1) Obtain an enhanced
understanding of facilitators and
barriers to guideline-concordant
management of chronic pain and opioid
prescribing (including access to MOUD)
at the health system level, in order to
improve patient outcomes while
maximizing patient safety and to
facilitate uptake by clinicians and
health systems, (2) describe unintended
benefits and consequences to guideline/
policy implementation, and (3) identify
racial and ethnic disparities in
guideline/policy implementation.
This mixed-methods, pre-post
evaluation of health systems’
implementation of chronic pain
management and opioid prescribing
policies/guidelines and the resultant
outcomes requires both primary data
collection (such as surveys, key
informant interviews, focus groups, etc.)
and secondary data collection (such as
administrative, EHR, pharmacy
dispensing, prescribing data, etc.) efforts
to adequately answer the research
questions. While secondary data (QI
measures) from health system EHRs will
provide longitudinal pre-post measures,
primary data is needed to understand
the characteristics and mechanisms of
practice and patient change that can be
attributed to the policies and guidelines.
CDC requests OMB approval for an
estimated 577 annual burden hours.
There are no direct costs to respondents
other than their time to participate in
the study.
ESTIMATED ANNUALIZED BURDEN HOURS
Form name
Patient ............................................................................................................
Treatment facility staff (Including primary care clinicians, health system
leaders, and other system staff and representatives).
Patient Survey ...................................
Clinician Survey ................................
Invitation/Follow up Email .................
System Leaders Interview Guide ......
Case Study .......................................
Member Checking Sessions .............
Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Scientific Integrity, Office of Science,
Centers for Disease Control and Prevention.
[FR Doc. 2022–03076 Filed 2–11–22; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60–Day–22–1283; Docket No. CDC–2022–
0019]
jspears on DSK121TN23PROD with NOTICES1
Number of
respondents
Type of respondent
Proposed Data Collection Submitted
for Public Comment and
Recommendations
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
AGENCY:
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ACTION:
Notice with comment period.
The Centers for Disease
Control and Prevention (CDC), as part of
its continuing effort to reduce public
burden and maximize the utility of
government information, invites the
general public and other federal
agencies the opportunity to comment on
a proposed and/or continuing
information collection, as required by
the Paperwork Reduction Act of 1995.
This notice invites comment on a
proposed information collection project
titled Monitoring and Reporting for the
Overdose Data to Action Co-Operative
Agreement. Information collected will
provide crucial data for program
performance monitoring, budget
tracking, and where applicable, program
success for programs funded under
Overdose Data to Action (CDC–RFA–
CE19–1904).
SUMMARY:
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667
1,313
1,980
17
30
17
Number of
responses per
respondent
1
1
2
1
1
1
Average
burden per
response
(in hours)
10/60
10/60
3/60
1
30/60
1
CDC must receive written
comments on or before April 15, 2022.
DATES:
You may submit comments,
identified by Docket No. CDC–2022–
0019 by either of the following methods:
• Federal eRulemaking Portal:
Regulations.gov. Follow the instructions
for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. CDC will post, without
change, all relevant comments to
Regulations.gov.
Please note: Submit all comments
through the Federal eRulemaking portal
(regulations.gov) or by U.S. mail to the
address listed above.
ADDRESSES:
E:\FR\FM\14FEN1.SGM
14FEN1
8255
Federal Register / Vol. 87, No. 30 / Monday, February 14, 2022 / Notices
To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS
H21–8, Atlanta, Georgia 30329; phone:
404–639–7570; Email: omb@cdc.gov.
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. In addition, the PRA also
requires federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
FOR FURTHER INFORMATION CONTACT:
and a prevention component, with 10
strategies in the funding opportunity
across both components. The intent is to
ensure that funded jurisdictions are well
equipped to do rigorous work under
both components, and to ensure that
these components are linked and
implemented as part of a system.
This ICR will focus on three tools that
funded jurisdictions will be required to
use to assess performance as well as
measure effectiveness: The Activity
Progress Report, the Evaluation and
Performance Measuring Plan, and the
Organizational Capacity Assessment
Tool. These tools support the overall
OD2A NOFO (all strategies above).
There is an overall reduction in burden
of 880 burden hours from the previously
approved request.
A total of 79 jurisdictions were
eligible to receive awards under this
funding opportunity, and 67
jurisdictions submitted applications, of
which 66 were funded. Each funded
jurisdiction will be required to report
the four elements of this ICR. Reporting
is based on both web-based tools and
Word templates. This information is
being collected to provide crucial data
to CDC for program monitoring and
budget tracking, to improve timely CDCrecipient communications, and to
inform technical assistance and
guidance documents produced by CDC
to support program implementation
among funded jurisdictions. The
information feedback loop created by
these information collection tools is
designed to help jurisdictions decrease
fatal and nonfatal overdoses. It will also
provide CDC with the capacity to
respond in a timely manner to requests
for information about the program from
the Department of Health and Human
Services (HHS), the White House,
Congress, and other sources.
CDC requests approval for an
estimated 462 annual burden hours.
There is no cost to respondents other
than their time.
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.
Proposed Project
Monitoring and Reporting for the
Overdose Data to Action Co-Operative
Agreement—Revision—National Center
for Injury Prevention and Control
(NCIPC), Centers for Disease Control
and Prevention (CDC).
Background and Brief Description
The Centers for Disease Control and
Prevention (CDC), National Center for
Injury Prevention and Control (NCIPC)
seeks OMB approval for a Revision of a
previously approved Information
Collection Request (ICR) (OMB Control
No. 0920–1283, Expiration 01/31/2023)
for a one-year period, to continue
collecting information from
jurisdictions (which include states,
Washington DC, U.S. Territories, cities
and counties) funded under the
Overdose Data to Action (CDC–RFA–
CE19–1904) funding opportunity.
Drug overdose deaths in the United
States increased by 18% per year from
2014 to 2016. Opioid overdose deaths
have increased fivefold from 1999 to
2016, and in 2017, there were more than
47,000 deaths attributed to opioids.
While the opioid overdose epidemic
worsens in scope and magnitude, it is
also becoming more complex. The
complex and changing nature of the
opioid overdose epidemic highlights the
need for an interdisciplinary,
comprehensive, and cohesive public
health approach.
The purpose of the Overdose Data to
Action (CDC–RFA–CE19–1904) notice
of funding opportunity (OD2A NOFO),
is to support funded jurisdictions in
obtaining high quality, complete, and
timely data on opioid prescribing and
overdoses, and to use those data to
inform prevention and response efforts.
There are two required components of
this award—a surveillance component
jspears on DSK121TN23PROD with NOTICES1
ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents
Number of
responses per
respondent
Average
burden per
response
(in hours)
Total burden
(in hours)
Type of respondents
Form name
Overdose Data to Action funded jurisdictions (State, territories, counties and cities) and their Designated Delegates.
Evaluation and Performance Measuring Plan Template —Annual reporting.
Organizational Capacity Assessment—Annual Reporting.
Activity Progress Report Tool—Annual Reporting.
66
1
4
264
66
1
1
66
66
1
2
132
...........................................................
........................
........................
........................
462
Total ...........................................
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8256
Federal Register / Vol. 87, No. 30 / Monday, February 14, 2022 / Notices
Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Scientific Integrity, Office of Science,
Centers for Disease Control and Prevention.
[FR Doc. 2022–03081 Filed 2–11–22; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
Solicitation of Nominations for
Appointment to the Board of Scientific
Counselors, National Institute for
Occupational Safety and Health (BSC,
NIOSH)
ACTION:
Notice.
The Centers for Disease
Control and Prevention (CDC) is seeking
nominations for membership on the
BSC, NIOSH. The BSC NIOSH consists
of 15 experts in fields associated with
occupational safety and health, such as
occupational medicine, occupational
nursing, industrial hygiene,
occupational safety, engineering,
toxicology, chemistry, safety and health
education, ergonomics, epidemiology,
biostatistics, psychology, wellness,
research translation, and evaluation.
DATES: Nominations for membership on
the BSC, NIOSH must be received no
later than April 15, 2022. Packages
received after this time will not be
considered for the current membership
cycle.
ADDRESSES: All nominations should be
mailed to NIOSH Docket 278, c/o
Pauline Benjamin, Committee
Management Specialist, National
Institute for Occupational Safety and
Health, Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS
V–24–4, Atlanta, Georgia 30329–4027,
or emailed (recommended) to
nioshdocket@cdc.gov.
FOR FURTHER INFORMATION CONTACT:
Emily J.K. Novicki, M.A., M.P.H.,
NIOSH, CDC, 1600 Clifton Road NE, MS
V24–4, Atlanta, GA, 30329–4027,
Telephone: (404) 498–2581, or email at
ENovicki@cdc.gov.
SUPPLEMENTARY INFORMATION:
Nominations are being sought for
indviduals who have the expertise and
qualifications necessary to contribute to
the accomplishments of the Board’s
objectives. Nominees will be selected
based on expertise in the fields
associated with occupational safety and
health, such as occupational medicine,
occupational nursing, industrial
hygiene, occupational safety,
engineering, toxicology, chemistry,
jspears on DSK121TN23PROD with NOTICES1
SUMMARY:
VerDate Sep<11>2014
17:54 Feb 11, 2022
Jkt 256001
safety and health education,
ergonomics, epidemiology, biostatistics,
psychology, wellness, research
translation, and evaluation. Federal
employees will not be considered for
membership. Members may be invited
to serve for up to four-year terms.
Selection of members is based on
candidates’ qualifications to contribute
to the accomplishment of NIOSH BSC
objectives https://www.cdc.gov/niosh/
bsc/default.html.
The U.S. Department of Health and
Human Services policy stipulates that
committee membership be balanced in
terms of points of view represented, and
the committee’s function. Appointments
shall be made without discrimination
on the basis of age, race, ethnicity,
gender, sexual orientation, gender
identity, HIV status, disability, and
cultural, religious, or socioeconomic
status. Nominees must be U.S. citizens,
and cannot be full-time employees of
the U.S. Government. Current
participation on federal workgroups or
prior experience serving on a federal
advisory committee does not disqualify
a candidate; however, HHS policy is to
avoid excessive individual service on
advisory committees and multiple
committee memberships. Committee
members are Special Government
Employees (SGEs), requiring the filing
of financial disclosure reports at the
beginning and annually during their
terms. CDC reviews potential candidates
for BSC, NIOSH membership each year
and provides a slate of nominees for
consideration to the Secretary of HHS
for final selection. HHS notifies selected
candidates of their appointment near
the start of the term in January 2023, or
as soon as the HHS selection process is
completed. Note that the need for
different expertise varies from year to
year and a candidate who is not selected
in one year may be reconsidered in a
subsequent year. SGE nominees must be
U.S. citizens, and cannot be full-time
employees of the U.S. Government.
Candidates should submit the
following items:
D Current curriculum vitae, including
complete contact information
(telephone numbers, mailing address,
email address)
D At least one letter of
recommendation from person(s) not
employed by the U.S. Department of
Health and Human Services.
(Candidates may submit letter(s) from
current HHS employees if they wish,
but at least one letter must be submitted
by a person not employed by an HHS
agency (e.g., CDC, NIH, FDA, etc.).
Nominations may be submitted by the
candidate him- or herself, or by the
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person/organization recommending the
candidate.
The Director, Strategic Business
Initiatives Unit, Office of the Chief
Operating Officer, Centers for Disease
Control and Prevention, has been
delegated the authority to sign Federal
Register notices pertaining to
announcements of meetings and other
committee management activities, for
both the Centers for Disease Control and
Prevention and the Agency for Toxic
Substances and Disease Registry.
Kalwant Smagh,
Director, Strategic Business Initiatives Unit,
Office of the Chief Operating Officer, Centers
for Disease Control and Prevention.
[FR Doc. 2022–03037 Filed 2–11–22; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
Healthcare Infection Control Practices
Advisory Committee (HICPAC)
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice of meeting.
AGENCY:
In accordance with the
Federal Advisory Committee Act, the
CDC announces the following meeting
for the Healthcare Infection Control
Practices Advisory Committee
(HICPAC). This virtual meeting is open
to the public, limited only by audio and
web conference lines (300 audio and
web conference lines are available).
Registration is required. To register for
this web conference, please go to:
www.cdc.gov/hicpac. All registered
participants will receive the meeting
link and instructions shortly before the
meeting.
DATES: The meeting will be held on
March 24, 2022, from 12:00 p.m. to 2:30
p.m., EDT.
ADDRESSES: Please click the link below
to join the webinar: https://
cdc.zoomgov.com/j/1609325835?
pwd=M2Nqa0VMSExYS1RCUj
RKeTVvTzFnZz09.
Meeting ID: 160 932 5835.
Passcode: b#B0i6q.
Dial-in Lines:
+1–669–254–5252 (San Jose)
+1–646–828–7666 (New York)
Meeting ID: 160 932 5835.
Phone Passcode: 45841052.
FOR FURTHER INFORMATION CONTACT:
Sydnee Byrd, M.P.A., HICPAC, Division
of Healthcare Quality Promotion,
SUMMARY:
E:\FR\FM\14FEN1.SGM
14FEN1
]]>Agencies
[Federal Register Volume 87, Number 30 (Monday, February 14, 2022)]
[Notices]
[Pages 8254-8256]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-03081]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[60-Day-22-1283; Docket No. CDC-2022-0019]
Proposed Data Collection Submitted for Public Comment and
Recommendations
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice with comment period.
-----------------------------------------------------------------------
SUMMARY: The Centers for Disease Control and Prevention (CDC), as part
of its continuing effort to reduce public burden and maximize the
utility of government information, invites the general public and other
federal agencies the opportunity to comment on a proposed and/or
continuing information collection, as required by the Paperwork
Reduction Act of 1995. This notice invites comment on a proposed
information collection project titled Monitoring and Reporting for the
Overdose Data to Action Co-Operative Agreement. Information collected
will provide crucial data for program performance monitoring, budget
tracking, and where applicable, program success for programs funded
under Overdose Data to Action (CDC-RFA-CE19-1904).
DATES: CDC must receive written comments on or before April 15, 2022.
ADDRESSES: You may submit comments, identified by Docket No. CDC-2022-
0019 by either of the following methods:
Federal eRulemaking Portal: Regulations.gov. Follow the
instructions for submitting comments.
Mail: Jeffrey M. Zirger, Information Collection Review
Office, Centers for Disease Control and Prevention, 1600 Clifton Road
NE, MS H21-8, Atlanta, Georgia 30329.
Instructions: All submissions received must include the agency name
and Docket Number. CDC will post, without change, all relevant comments
to Regulations.gov.
Please note: Submit all comments through the Federal eRulemaking
portal (regulations.gov) or by U.S. mail to the address listed above.
[[Page 8255]]
FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the information collection plan
and instruments, contact Jeffrey M. Zirger, Information Collection
Review Office, Centers for Disease Control and Prevention, 1600 Clifton
Road NE, MS H21-8, Atlanta, Georgia 30329; phone: 404-639-7570; Email:
[email protected].
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. In addition, the PRA also requires
federal agencies to provide a 60-day notice in the Federal Register
concerning each proposed collection of information, including each new
proposed collection, each proposed extension of existing collection of
information, and each reinstatement of previously approved information
collection before submitting the collection to the OMB for approval. To
comply with this requirement, we are publishing this notice of a
proposed data collection as described below.
The OMB is particularly interested in comments that will help:
1. Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
2. Evaluate the accuracy of the agency's estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and clarity of the information to
be collected;
4. Minimize the burden of the collection of information on those
who are to respond, including through the use of appropriate automated,
electronic, mechanical, or other technological collection techniques or
other forms of information technology, e.g., permitting electronic
submissions of responses; and
5. Assess information collection costs.
Proposed Project
Monitoring and Reporting for the Overdose Data to Action Co-
Operative Agreement--Revision--National Center for Injury Prevention
and Control (NCIPC), Centers for Disease Control and Prevention (CDC).
Background and Brief Description
The Centers for Disease Control and Prevention (CDC), National
Center for Injury Prevention and Control (NCIPC) seeks OMB approval for
a Revision of a previously approved Information Collection Request
(ICR) (OMB Control No. 0920-1283, Expiration 01/31/2023) for a one-year
period, to continue collecting information from jurisdictions (which
include states, Washington DC, U.S. Territories, cities and counties)
funded under the Overdose Data to Action (CDC-RFA-CE19-1904) funding
opportunity.
Drug overdose deaths in the United States increased by 18% per year
from 2014 to 2016. Opioid overdose deaths have increased fivefold from
1999 to 2016, and in 2017, there were more than 47,000 deaths
attributed to opioids. While the opioid overdose epidemic worsens in
scope and magnitude, it is also becoming more complex. The complex and
changing nature of the opioid overdose epidemic highlights the need for
an interdisciplinary, comprehensive, and cohesive public health
approach.
The purpose of the Overdose Data to Action (CDC-RFA-CE19-1904)
notice of funding opportunity (OD2A NOFO), is to support funded
jurisdictions in obtaining high quality, complete, and timely data on
opioid prescribing and overdoses, and to use those data to inform
prevention and response efforts. There are two required components of
this award--a surveillance component and a prevention component, with
10 strategies in the funding opportunity across both components. The
intent is to ensure that funded jurisdictions are well equipped to do
rigorous work under both components, and to ensure that these
components are linked and implemented as part of a system.
This ICR will focus on three tools that funded jurisdictions will
be required to use to assess performance as well as measure
effectiveness: The Activity Progress Report, the Evaluation and
Performance Measuring Plan, and the Organizational Capacity Assessment
Tool. These tools support the overall OD2A NOFO (all strategies above).
There is an overall reduction in burden of 880 burden hours from the
previously approved request.
A total of 79 jurisdictions were eligible to receive awards under
this funding opportunity, and 67 jurisdictions submitted applications,
of which 66 were funded. Each funded jurisdiction will be required to
report the four elements of this ICR. Reporting is based on both web-
based tools and Word templates. This information is being collected to
provide crucial data to CDC for program monitoring and budget tracking,
to improve timely CDC-recipient communications, and to inform technical
assistance and guidance documents produced by CDC to support program
implementation among funded jurisdictions. The information feedback
loop created by these information collection tools is designed to help
jurisdictions decrease fatal and nonfatal overdoses. It will also
provide CDC with the capacity to respond in a timely manner to requests
for information about the program from the Department of Health and
Human Services (HHS), the White House, Congress, and other sources.
CDC requests approval for an estimated 462 annual burden hours.
There is no cost to respondents other than their time.
Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Average
Number of Number of burden per Total burden
Type of respondents Form name respondents responses per response (in (in hours)
respondent hours)
----------------------------------------------------------------------------------------------------------------
Overdose Data to Action funded Evaluation and 66 1 4 264
jurisdictions (State, Performance .............. .............. .............. ..............
territories, counties and Measuring Plan .............. .............. .............. ..............
cities) and their Designated Template -- 66 1 1 66
Delegates. Annual
reporting.
Organizational
Capacity
Assessment--Ann
ual Reporting.
Activity 66 1 2 132
Progress Report
Tool--Annual
Reporting.
---------------------------------------------------------------------------------
Total..................... ................ .............. .............. .............. 462
----------------------------------------------------------------------------------------------------------------
[[Page 8256]]
Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific
Integrity, Office of Science, Centers for Disease Control and
Prevention.
[FR Doc. 2022-03081 Filed 2-11-22; 8:45 am]
BILLING CODE 4163-18-P
