Submission for Office of Management and Budget Review; Medical Assessment Form and Dental Assessment Form (Office of Management and Budget 0970-0466), 52166-52167 [2023-16822]
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52166
Federal Register / Vol. 88, No. 150 / Monday, August 7, 2023 / Notices
information technology to minimize the
information collection burden.
DATES: Comments must be received by
October 6, 2023.
ADDRESSES: When commenting, please
reference the document identifier or
OMB control number. To be assured
consideration, comments and
recommendations must be submitted in
any one of the following ways:
1. Electronically. You may send your
comments electronically to https://
www.regulations.gov. Follow the
instructions for ‘‘Comment or
Submission’’ or ‘‘More Search Options’’
to find the information collection
document(s) that are accepting
comments.
2. By regular mail. You may mail
written comments to the following
address: CMS, Office of Strategic
Operations and Regulatory Affairs,
Division of Regulations Development,
Attention: Document Identifier/OMB
Control Number: ll, Room C4–26–05,
7500 Security Boulevard, Baltimore,
Maryland 21244–1850.
To obtain copies of a supporting
statement and any related forms for the
proposed collection(s) summarized in
this notice, please access the CMS PRA
website by copying and pasting the
following web address into your web
browser: https://www.cms.gov/
Regulations-and-Guidance/Legislation/
PaperworkReductionActof1995/PRAListing.
FOR FURTHER INFORMATION CONTACT:
William N. Parham at (410) 786–4669.
SUPPLEMENTARY INFORMATION:
ddrumheller on DSK120RN23PROD with NOTICES1
Contents
This notice sets out a summary of the
use and burden associated with the
following information collections. More
detailed information can be found in
each collection’s supporting statement
and associated materials (see
ADDRESSES).
CMS–10393 Beneficiary and Family
Centered Data Collection
Under the 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
requires Federal agencies to publish a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each proposed
VerDate Sep<11>2014
18:58 Aug 04, 2023
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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.
1. Type of Information Collection
Request: Revision of a previously
approved collection; Title of
Information Collection: Beneficiary and
Family Centered Data Collection; Use:
To ensure the QIOs are effectively
meeting their goals, CMS collects
information about beneficiary
experience receiving support from the
QIOs. This is a request to revise the
information collection. The revisions to
this information collection include the
deletion of the previously approved
Direct Feedback Survey and associated
instructions and the General Feedback
Web Survey and associated instructions.
The information collection uses both
qualitative and quantitative strategies to
ensure CMS and the QIOs understand
beneficiary experiences through all
interactions with the QIO including
initial contact, interim interactions, and
case closure. Information collection
instruments are tailored to reflect the
steps in each type of process, as well as
the average time it takes to complete
each process. The information
collection will:
• Allow beneficiaries to directly
provide feedback about the services they
receive under the QIO program;
• Provide quality improvement data
for QIOs to improve the quality of
service delivered to Medicare
beneficiaries; and
• Provide evaluation metrics for CMS
to use in assessing performance of QIO
contractors.
To achieve the above goals,
information collection will include:
Experience Survey: The Experience
Survey will be administered via
telephone and mail to beneficiaries/
representatives after the Quality of Care
(Medical Record Review) complaint/
Immediate Advocacy/appeal case has
been closed. The goal of the Experience
Survey is to assess beneficiary overall
and specific experiences with the BFCC
QIOs. Form Number: CMS–10393 (OMB
control number: 0938–1177); Frequency:
Once; Affected Public: Individuals or
households; Number of Respondents:
9,000; Number of Responses: 9,000;
Total Annual Hours: 2,250. (For policy
questions regarding this collection,
contact Renee Graves-Dorsey at 410–
786–7142.)
Frm 00059
Fmt 4703
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[FR Doc. 2023–16793 Filed 8–4–23; 8:45 am]
BILLING CODE 4120–01–P
Information Collection
PO 00000
Dated: August 2, 2023.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for Office of Management
and Budget Review; Medical
Assessment Form and Dental
Assessment Form (Office of
Management and Budget 0970–0466)
Office of Refugee Resettlement,
Administration for Children and
Families, U.S. Department of Health and
Human Services.
ACTION: Request for public comments.
AGENCY:
The Administration for
Children and Families (ACF) is
requesting a 3-year extension of the
forms Medical Assessment Form
(formerly, the Initial Medical Exam
(IME) Form and Supplemental
Tuberculosis (TB) Screening Form) and
Dental Assessment Form (formerly, the
Dental Exam Form) (Office of
Management and Budget (OMB) #0970–
0466, expiration December 31, 2023).
Changes are proposed to the currently
approved forms.
DATES: Comments due within 30 days of
publication. OMB must make a decision
about 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.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review-Open
for Public Comments’’ or by using the
search function. You can also obtain
copies of the proposed collection of
information by emailing infocollection@
acf.hhs.gov. Identify all emailed
requests by the title of the information
collection.
SUPPLEMENTARY INFORMATION: The ACF
ORR places unaccompanied children in
their custody in care provider programs
until unification with a qualified
sponsor. Care provider programs are
SUMMARY:
E:\FR\FM\07AUN1.SGM
07AUN1
52167
Federal Register / Vol. 88, No. 150 / Monday, August 7, 2023 / Notices
required to provide children with a
range of services including medical,
dental, and mental health care. Each
child must receive an initial medical
exam (IME) within 2 business days of
admission to an ORR care provider
program or temporary influx care
facility. The IME satisfies Flores
requirements which require a ‘‘complete
medical examination, including a
screening for infectious disease’’. The
purposes of the IME are to assess
general health, administer vaccinations
in keeping with U.S. standards (also
required by Flores), identify health
conditions that require further attention,
and detect contagious diseases of public
health importance, such as influenza or
TB. The IME is performed by a licensed
health care provider and comprised of a
complete medical history and physical
exam, risk, and age-based laboratory
screenings, TB screenings and
immunizations. In addition, children
may be referred to a specialist by their
healthcare provider for acute or chronic
conditions that require additional
evaluation. If a child is in ORR custody
60 to 90 days after admission, they must
receive an initial dental exam, or sooner
if directed by state licensing
requirements. Children who are in ORR
care for an extended length of time may
require urgent or routine medical and
dental well-child evaluations.
The forms are used as worksheets for
generalist healthcare providers and
pediatric and other medical specialty
healthcare providers to compile
information that would otherwise have
been collected during the health
evaluation. Once completed, the forms
are given to care provider program staff
for entry into ORR’s secure, electronic
data record system. Data is used to
monitor the health of unaccompanied
children while in ORR care, for case
management of any identified illnesses/
conditions and to ensure care provider
program compliance with ORR
requirements.
ORR has merged the former IME Form
and Supplemental TB Screening Form
into one form, the Medical Assessment
Form which will be used during all
medical evaluations with a mid-level or
higher medical professional. ORR has
incorporated other changes to the forms
to streamline the flow of data collection,
clarify the intent of certain fields,
improve data quality, and ensure
alignment with ORR requirements. In
addition, ORR has written instructional
letters for the Medical Assessment Form
and Dental Assessment Form to explain
the purpose of the forms and provide
general guidance on completion to
healthcare providers.
Respondents: Healthcare providers
(pediatricians, medical specialists, and
dentists), Care Provider Program Staff.
Annual Burden Estimates
ESTIMATED OPPORTUNITY TIME FOR RESPONDENTS
Annual
number of
respondents
Instrument
Respondent
Medical Assessment Form ...............
Pediatricians, General ......................
Medical specialist, General ..............
Dentists ............................................
Dental Assessment Form .................
Total number
of responses
per
respondent
300
750
250
840
22
64
Average
burden hours
per response
0.22
0.22
0.12
Annual burden
hours
55,440
3,630
1,920
Estimated Total Annual Burden
Hours: 60,990.
ddrumheller on DSK120RN23PROD with NOTICES1
ESTIMATED RECORDKEEPING TIME
Annual
number of
respondents
Instrument
Respondent
Medical Assessment Form completed by a medical professional.
Medical Assessment Form not completed by a medical professional
(information obtained via health
records).
Dental Assessment Form .................
Care Provider Program Staff ...........
Estimated Total Annual Burden
Hours: 99,825.
Authority: 6 U.S.C. 279: 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])
Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2023–16822 Filed 8–4–23; 8:45 am]
BILLING CODE 4184–45–P
VerDate Sep<11>2014
18:58 Aug 04, 2023
Jkt 259001
0.33
0.17
88,605
8,500
500
32
0.17
2,720
Proposed Information Collection
Activity; Release of Unaccompanied
Children From Office of Refugee
Resettlement Custody (Office of
Management and Budget #0970–0552)
Office of Refugee Resettlement,
Administration for Children and
Frm 00060
Fmt 4703
Sfmt 4703
Annual burden
hours
537
100
Administration for Children and
Families
PO 00000
Average
burden hours
per response
500
500
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
AGENCY:
Total number
of responses
per
respondent
Families, Department of Health and
Human Services.
ACTION:
Request for public comments.
The Office of Refugee
Resettlement (ORR), Administration for
Children and Families (ACF), U.S.
Department of Health and Human
Services, is inviting public comments
on revisions to an approved information
collection. The request consists of
several forms that allow the
Unaccompanied Children (UC) Program
to process release of unaccompanied
SUMMARY:
E:\FR\FM\07AUN1.SGM
07AUN1
]]>Agencies
[Federal Register Volume 88, Number 150 (Monday, August 7, 2023)]
[Notices]
[Pages 52166-52167]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-16822]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Submission for Office of Management and Budget Review; Medical
Assessment Form and Dental Assessment Form (Office of Management and
Budget 0970-0466)
AGENCY: Office of Refugee Resettlement, Administration for Children and
Families, U.S. Department of Health and Human Services.
ACTION: Request for public comments.
-----------------------------------------------------------------------
SUMMARY: The Administration for Children and Families (ACF) is
requesting a 3-year extension of the forms Medical Assessment Form
(formerly, the Initial Medical Exam (IME) Form and Supplemental
Tuberculosis (TB) Screening Form) and Dental Assessment Form (formerly,
the Dental Exam Form) (Office of Management and Budget (OMB) #0970-
0466, expiration December 31, 2023). Changes are proposed to the
currently approved forms.
DATES: Comments due within 30 days of publication. OMB must make a
decision about 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.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular
information collection by selecting ``Currently under 30-day Review-
Open for Public Comments'' or by using the search function. You can
also obtain copies of the proposed collection of information by
emailing [email protected]. Identify all emailed requests by
the title of the information collection.
SUPPLEMENTARY INFORMATION: The ACF ORR places unaccompanied children in
their custody in care provider programs until unification with a
qualified sponsor. Care provider programs are
[[Page 52167]]
required to provide children with a range of services including
medical, dental, and mental health care. Each child must receive an
initial medical exam (IME) within 2 business days of admission to an
ORR care provider program or temporary influx care facility. The IME
satisfies Flores requirements which require a ``complete medical
examination, including a screening for infectious disease''. The
purposes of the IME are to assess general health, administer
vaccinations in keeping with U.S. standards (also required by Flores),
identify health conditions that require further attention, and detect
contagious diseases of public health importance, such as influenza or
TB. The IME is performed by a licensed health care provider and
comprised of a complete medical history and physical exam, risk, and
age-based laboratory screenings, TB screenings and immunizations. In
addition, children may be referred to a specialist by their healthcare
provider for acute or chronic conditions that require additional
evaluation. If a child is in ORR custody 60 to 90 days after admission,
they must receive an initial dental exam, or sooner if directed by
state licensing requirements. Children who are in ORR care for an
extended length of time may require urgent or routine medical and
dental well-child evaluations.
The forms are used as worksheets for generalist healthcare
providers and pediatric and other medical specialty healthcare
providers to compile information that would otherwise have been
collected during the health evaluation. Once completed, the forms are
given to care provider program staff for entry into ORR's secure,
electronic data record system. Data is used to monitor the health of
unaccompanied children while in ORR care, for case management of any
identified illnesses/conditions and to ensure care provider program
compliance with ORR requirements.
ORR has merged the former IME Form and Supplemental TB Screening
Form into one form, the Medical Assessment Form which will be used
during all medical evaluations with a mid-level or higher medical
professional. ORR has incorporated other changes to the forms to
streamline the flow of data collection, clarify the intent of certain
fields, improve data quality, and ensure alignment with ORR
requirements. In addition, ORR has written instructional letters for
the Medical Assessment Form and Dental Assessment Form to explain the
purpose of the forms and provide general guidance on completion to
healthcare providers.
Respondents: Healthcare providers (pediatricians, medical
specialists, and dentists), Care Provider Program Staff.
Annual Burden Estimates
Estimated Opportunity Time for Respondents
----------------------------------------------------------------------------------------------------------------
Total number Average burden
Instrument Respondent Annual number of responses hours per Annual burden
of respondents per respondent response hours
----------------------------------------------------------------------------------------------------------------
Medical Assessment Form....... Pediatricians, 300 840 0.22 55,440
General. 750 22 0.22 3,630
Medical
specialist,
General.
Dental Assessment Form........ Dentists........ 250 64 0.12 1,920
----------------------------------------------------------------------------------------------------------------
Estimated Total Annual Burden Hours: 60,990.
Estimated Recordkeeping Time
----------------------------------------------------------------------------------------------------------------
Total number Average burden
Instrument Respondent Annual number of responses hours per Annual burden
of respondents per respondent response hours
----------------------------------------------------------------------------------------------------------------
Medical Assessment Form Care Provider 500 537 0.33 88,605
completed by a medical Program Staff. 500 100 0.17 8,500
professional. ................
Medical Assessment Form not
completed by a medical
professional (information
obtained via health records).
Dental Assessment Form........ 500 32 0.17 2,720
----------------------------------------------------------------------------------------------------------------
Estimated Total Annual Burden Hours: 99,825.
Authority: 6 U.S.C. 279: 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])
Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2023-16822 Filed 8-4-23; 8:45 am]
BILLING CODE 4184-45-P
