Attachment C - 60 day FRN

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Federal Register / Vol. 73, No. 5 / Tuesday, January 8, 2008 / Notices

which is headed by a Regional
Administrator (RA).
The Regional Support Centers serve as
the focal point for the development,
coordination and administration of
OAA programs within the designated
HHS region. Represent the Assistant
Secretary for Aging within the region,
providing information for, and
contributing to the development of,
national policy dealing with the elderly.
Based on national policy and priorities,
establish field program goals and
objectives. Serve as the effective and
visible advocates for the elderly to
Federal agencies in their geographic
jurisdiction to ensure the rights of the
elderly; advise, consult and cooperate
with each Federal agency proposing or
administering programs or services
related to the aging; coordinate and
assist in the planning and development
by public (including Federal, State,
Tribal and local agencies) and private
organizations of comprehensive and
coordinated services and opportunities
for older individuals in each community
of the nation; and conduct active public
education of officials and citizens and
the aged to ensure broad understanding
of the needs and capabilities of the aged.
Monitor, assist and evaluate State
Agencies on Aging administering
programs supported under Titles II, III
and VII of the OAA, and Indian Tribal
Organizations administering projects
under Title VI. Review OAA State Plans
on Aging and recommend approval or
disapproval to the Assistant Secretary
for Aging, as appropriate. Review
applications and recommend approval
or disapproval of Title VI applications
to the Assistant Secretary.
Advise the Assistant Secretary of
problems and progress of programs
through the Deputy Assistant Secretary,
CPO; recommend to the Assistant
Secretary changes that would improve
OAA operations; evaluate the
effectiveness of OAA and related
programs in the Regions and
recommend to the Assistant Secretary or
take positive action to gain
improvement; and guide agencies and
grantees in applications of policy to
specific operational issues requiring
resolution. Facilitate interagency
cooperation at the Federal, Regional
Support Center, State and Tribal levels
to enhance resources and assistance
available to the elderly. Disseminate and
provide technical assistance regarding
program guidelines and developments
to State and Area Agencies, Indian
Tribal Organizations and local
community service providers.
II. Delegations of Authority: All
delegations and redelegations of
authority made to officials and

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employees of affected organizational
components will continue in them or
their successors pending further
redelegations.
III. Funds, Personnel and Equipment:
Transfer of organizations and functions
affected by this reorganization shall be
accompanied in each instance by direct
and support funds, positions, personnel,
records, equipment, supplies and other
resources.
Dated: December 26, 2007.
Michael O. Leavitt,
Secretary.
[FR Doc. E8–39 Filed 1–7–08; 8:45 am]
BILLING CODE 4154–01–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–08–0212]

Proposed Data Collections Submitted
for Public Comment and
Recommendations
In compliance with the requirement
of Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995 for
opportunity for public comment on
proposed data collection projects, the
Centers for Disease Control and
Prevention (CDC) will publish periodic
summaries of proposed projects. To
request more information on the
proposed projects or to obtain a copy of
the data collection plans and
instruments, call 404–639–5960 and
send comments to Maryam I. Daneshvar,
CDC Acting Reports Clearance Officer,
1600 Clifton Road, MS–D74, Atlanta,
GA 30333 or send an e-mail to
[email protected].
Comments are invited on: (a) Whether
the proposed collection of information
is necessary for the proper performance
of the functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection of information; (c)
ways to enhance the quality, utility, and
clarity of the information to be
collected; and (d) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques
or other forms of information
technology. Written comments should
be received within 60 days of this
notice.
Proposed Project
National Hospital Discharge Survey—
Revision—The National Hospital

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Discharge Survey (NHDS) (OMB# 0920–
0212), National Center for Health
Statistics (NCHS), Centers for Disease
Control and Prevention (CDC).
Background and Brief Description
Section 306 of the Public Health
Service (PHS) Act (42 U.S.C. 242k), as
amended, authorizes that the Secretary
of Health and Human Services (DHHS),
acting through NCHS, shall collect
statistics on the extent and nature of
illness and disability of the population
of the United States. This three-year
clearance request includes the data
collection in 2008 and 2009 using the
current NHDS design; a pretest of a new
design; and data collection for 2010 and
2011 of the survey using the new
design.
Current NHDS
The National Hospital Discharge
Survey (NHDS) has been conducted
continuously by the National Center for
Health Statistics, CDC, since 1965. It is
the principal source of data on inpatient
utilization of short-stay, non-Federal
hospitals and is the principal annual
source of nationally representative
estimates on the characteristics of
discharges, the lengths of stay,
diagnoses, surgical and non-surgical
procedures, and the patterns of use of
care in hospitals in various regions of
the country. It is the benchmark against
which special programmatic data
sources are measured. The data items
collected are the basic core of the
variables contained in the Uniform
Hospital Discharge Data Set (UHDDS) in
addition to several variables (admission
source and type, admitting diagnosis
and present on admission indicators)
which are identical to those needed for
billing of inpatient services for Medicare
patients. In the current survey, data are
obtained in one of three ways:
Abstracted by hospital staff; abstracted
by Bureau of the Census Staff under an
interagency agreement; and provided in
electronic format. Due to budgetary
constraints, the number of hospitals and
the number of discharges for the 2008
and 2009 NHDS data collections will
decrease by approximately 50% from
previous years.
Redesigned NHDS
Although the current NHDS is still
fulfilling its intended functions, it is
based on concepts from the health care
delivery system, as well as the hospital
and patient universes, of previous
decades. It has become clear that a
redesign of the NHDS that provides
greater depth of information is
necessary.

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In 2008, a sample of 40 hospitals will
be selected for a pretest. These hospitals
will not be a probability sample, but
instead will be intentionally selected to
include hospitals of differing size,
location and other characteristics
related to their service and patient
clientele.
In 2010, a redesigned NHDS will be
implemented and will consist of a
completely new sample of
approximately 240 hospitals. The
redesigned NHDS will use a modified
two stage design. The first stage
sampling will be hospitals. The second
stage of sampling will be discharges. A
stratified, random sample of 120
discharges is targeted within each
hospital. In the redesigned survey all
data will be abstracted by trained health
care staff under contract. All data will
be obtained from hospital records and
charts and computer systems.

The current data items will be
collected with significant additional
details. Patient level data items to be
collected include personal identifiers
such as Social Security number, name
and medical record number; clinical
laboratory results such as hematocrit
and white blood cell count; and
financial billing and record data. The
survey includes detailed questions for
three modules: Acute myocardial
infarction; infectious disease; and end of
life issues. Facility level data items
include demographic information,
clinical capabilities, and financial
information.
Users of NHDS data include, but are
not limited to the CDC; the
Congressional Research Office; the
Office of the Assistant Secretary for
Planning and Evaluation (ASPE);
American Health Care Association,
Centers for Medicare and Medicaid

Services (CMS), and Bureau of the
Census. Data collected through the
NHDS are essential for evaluating health
status of the population, for the
planning of programs and policy to
elevate the health status of the Nation,
for studying morbidity trends, and for
research activities in the health field.
NHDS data have been used extensively
in the development and monitoring of
goals for the Year 2000 and 2010
Healthy People Objectives. In addition,
NHDS data provide annual updates for
numerous tables in the Congressionallymandated NCHS report, Health, United
States. Other users of these data include
universities, contract research
organizations, many in the private
sector, foundations, and a variety of
users in the print media. There is no
cost to respondents other than their time
to participate.

ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

Hospitals

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Current NHDS:
Primary Procedure abstracting .................................................................
Alternate (Census) Procedure (pulling & refiling records) .......................
In-House Tape or Printout Hospital (programming) .................................
Induction ...................................................................................................

Number of
responses per
respondent

Hours per
response

Response
burden
(hours)

13
41
29
10

250
250
12
1

6/60
1/60
13/60
2

325
171
75
20

Sub-total ............................................................................................
Redesign HDS Pre-test:
Survey presentation to hospital ................................................................
Facility questionnaire ................................................................................
Sample discharges and obtain data .........................................................
Debrief hospital staff .................................................................................
Quality control ...........................................................................................

........................

........................

........................

591

13
13
13
13
2

1
1
10
1
25

1
4.1
14/60
1
14/60

13
53
30
13
12

Sub-total ............................................................................................
Redesign Survey 2010 & 2011:
Survey presentation to hospital ................................................................
Facility questionnaire ................................................................................
Sample discharges and obtain data .........................................................
Pre-testing of new data elements .............................................................
Quality control ...........................................................................................
Non-response study .................................................................................

........................

........................

........................

121

160
80
160
13
3
27

1
1
120
120
25
1

1
4.1
14/60
5/60
14/60
2

160
328
4,480
130
18
54

Sub-total ............................................................................................

........................

........................

........................

5,170

Total ...........................................................................................

........................

........................

........................

5,882

Dated: December 27, 2007.
Maryam I. Daneshvar,
Acting Reports Clearance Officer, Centers for
Disease Control and Prevention.
[FR Doc. E8–51 Filed 1–7–08; 8:45 am]

DEPARTMENT OF HEALTH AND
HUMAN SERVICES

BILLING CODE 4163–18–P

Notice of hearing: Reconsideration of
Disapproval of California’s State Plan
Amendment (SPA) 06–019B

Centers for Medicare & Medicaid
Services

Centers for Medicare &
Medicaid Services (CMS), HHS.

AGENCY:
ACTION:

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Notice of hearing.

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SUMMARY: This notice announces an
administrative hearing to be held on
February 15, 2008, at the CMS San
Francisco Regional Office, 90 7th Street,
5th Floor, Room 5A, San Francisco,
California 94103, to reconsider CMS’
decision to disapprove California’s SPA
06–019B.
Closing Date: Requests to participate
in the hearing as a party must be
received by the presiding officer by
January 23, 2008.

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