Attachment D -- 30 Day FR Notice

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Federal Register / Vol. 74, No. 91 / Wednesday, May 13, 2009 / Notices

of Health and Human Services, is
publishing the following summary of a
proposed information collection request
for public comment. Interested persons
are invited to send comments regarding
this 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.
To obtain copies of the supporting
statement and any related forms for the
proposed paperwork collections

within the Department of Health and
Human Services (HHS), will collect and
analyze data on race, sex, national
origin, and disability from applicants for
employment. Information will be
collected by each of the personnel
offices in the Department. The form will
be used routinely by the OPDIVs when
recruiting for all positions, including
senior level positions and for selected
job series where workforce analysis has
shown evidence of low representation of
minorities, women, or persons with
disabilities. The results of the collection
will assist the Department to determine
if present recruitment sources yield
qualified minority and female
applicants and applicants with
disabilities as required by EEOC MD
715.

referenced above, e-mail your request,
including your address, phone number,
OMB number, and OS document
identifier, to
[email protected], or call
the Reports Clearance Office on (202)
690–6162. Written comments and
recommendations for the proposed
information collections must be directed
to the OS Paperwork Clearance Officer
at the above email address within 60days.
Proposed Project: Request for
Applicant Background Survey—OMB
No. Extension–0990–0208 Assistant
Secretary for Administration and
Management.
Abstract:
The Applicant Background Survey
form will be used for the next three
years by the Operating Divisions
(OPDIVs). The major sub-organizations

ESTIMATED ANNUALIZED BURDEN TABLE
Type of respondent

Number of
respondents

Number of
responses per
respondent

Average
burden hours
per response
(minutes)

Total burden
hours

Individuals ........................................................................................................

30,000

1

2

1,000

Terry Nicolosi,
Office of the Secretary, Paperwork Reduction
Act Reports Clearance Officer.
[FR Doc. E9–11078 Filed 5–12–09; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities: Proposed Collection;
Comment Request
AGENCY: Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
SUMMARY: This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and
Budget (OMB) approve the proposed
information collection project:
‘‘Coordinating Care across Primary Care
and Specialty Care Practices.’’ In
accordance with the Paperwork
Reduction Act of 1995, 44 U.S.C.
3506(c)(2)(A), AHRQ invites the public
to comment on this proposed
information collection.
This proposed information collection
was previously published in the Federal
Register on March 5th, 2009 and

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allowed 60 days for public comment.
One comment was received. The
purpose of this notice is to allow an
additional 30 days for public comment.
This notice differs from the 60 day
notice in that the Patient Satisfaction
Survey has been eliminated.
DATES: Comments on this notice must be
received by June 12, 2009.
ADDRESSES: Written comments should
be submitted to: AHRQ’s OMB Desk
Officer by fax at (202) 395–6974
(attention: AHRQ’s desk officer) or by email at [email protected]
(attention: AHRQ’s desk officer).
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at [email protected].
SUPPLEMENTARY INFORMATION:
Proposed Project
‘‘Coordinating Care across Primary
Care and Specialty Care Practices.’’
AHRQ proposes an evaluation of the
redesign of the transitions of care
between primary care and specialty care
services. The purpose of the redesign is
to remedy inefficiencies in the current
referral processes that threaten care
quality and safety, and system

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efficiency. This redesign is being
implemented at the Boston Medical
Center (BMC), and two affiliated health
centers. The evaluation will be
conducted for AHRQ by its contractor,
the Boston University School of Public
Health (BUSPH).
Care coordination has been identified
by the Institute of Medicine (IOM) as a
key strategy with potential to improve
the effectiveness, safety and efficiency
of the health care system. At the same
time, care coordination, particularly in
transitions among sites of care, is often
lacking. Research shows that problems
in coordination of care and common
failures in patients’ transitioning
between and among systems typically
create serious quality concerns in many
settings. Individuals moving across
systems of care and between care
providers are vulnerable to fragmented
and disjointed care (Coleman et al.,
2004). Uncoordinated and fragmented
transitions can lead to a wide range of
costly problems and threats to patient
safety including greater use of hospital
and emergency services (Coleman et al.,
2004), ordering and completion of
redundant tests (Coleman & Berenson,
2004), prescription and medication
errors and use of poly-pharmacy by
multiple providers (Coleman &
Berenson, 2004). The end result is often
confusion about conflicting care plans
and lack of follow-up care. The aim of

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Federal Register / Vol. 74, No. 91 / Wednesday, May 13, 2009 / Notices
this evaluation is to address this
confusion and fragmentation by
expanding knowledge of how to
improve the experience and outcomes
for patients in transitions of care
between primary care and specialty
practices. The initial focus is on
referrals between primary care and two
specialties: gastroenterology (GI) and
obstetrics (OB). The redesigned referral
system will be tested by implementing
it in three participating primary care
sites and two specialty clinics. We
expect that the lessons learned from this
evaluation will provide a model and
tools that can later easily be tested and
applied to other sites and specialties in
the BMC system and provide lessons
learned to other systems seeking to
sustainably improve their referral
systems.
This project is being conducted
pursuant to AHRQ’s statutory authority
to conduct research and evaluations on
health care and systems for the delivery
of such care, including activities with
respect to: The quality, effectiveness,
efficiency, appropriateness and value of
health care services; clinical practice,
including primary care and practiceoriented research; and health care costs,
productivity, organization, and market

forces. See 42 U.S.C. 299a(a)(1), (4) and
(6).
The overall aims of the evaluation are
to provide a rigorous assessment of the
success of the redesigned referral system
in meeting its improvement goals and to
gain an understanding of the
implementation of the redesigned
system.
Method of Collection
This evaluation will include the
following data collections:
• Medical record data will be used to
analyze aspects of the referral process,
such as percentage of items on referral
forms filled in, proportion of specialty
appointments made, time between
referral and initial specialty
appointment. Patients’ personal health
data will not be analyzed. The medical
record data will be used to measure both
the fidelity of the redesigned system
within the practices and success in
meeting redesign improvement goal
(outcome) indicators. The medical
record data will be extracted by project
staff and will not impose a burden on
the participating health care sites.
• Focus groups with providers,
clinical staff and administrative staff
will be conducted in each primary care
site and in each specialty practice. The

group sessions will pursue three topics:
The extent to which the new system is
being used as intended; the perceived
effectiveness of the new system as
implemented; and the organization and
culture of the clinical setting. Themes
from the focus groups will be used to
assess fidelity of implementation,
performance outcomes and factors
affecting fidelity and outcomes.
• Implementation logs and meeting
notes kept by the project team
throughout the redesign implementation
will document the implementation
process, including factors affecting the
process, challenges encountered, and
strategies for dealing with the
challenges. This component of the
evaluation will not impose a burden on
the participating health care sites.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours for the
respondents’ time to participate in this
two year evaluation. Focus groups will
be conducted with about 21 clinical
staff at each of the 3 primary care sites
and 2 specialty care sites (Exhibit 1
shows 2.5 sites per year). Each focus
group session will last about 45
minutes. The total annualized burden is
estimated to be 39 hours.

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

Form name

Number of
responses
per
respondent

Hours per
response

Total burden
hours

Focus groups ...................................................................................................

2.5

21

45/60

39

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

2.5

na

na

39

Exhibit 2 shows the estimated
annualized cost burden associated with
the respondents’ time to participate in

this project. The total annualized cost
burden is estimated to be $1,463.

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents

Form name

Total burden
hours

Average
hourly wage
rate*

Total cost
burden

Focus groups ...................................................................................................

2.5

39

$37.50

$1,463

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

2.5

39

na

1,463

* The hourly wage is based upon the weighted mean of the average wages for physicians ($58.76, n=45), clinical administrative staff ($17.64,
n=30) and other clinical staff ($25.48, n=30). National Compensation Survey: Occupational Wages in the United States, U.S. Department of
Labor, Bureau of Labor Statistics. June 2007, Summary 0703, http://www.bls.gov/ncs/ocs/sp/ncblo9 1 0.pdf. Accessed December 10, 2008.

Estimated Annual Costs to the Federal
Government
Exhibit 3 shows the estimated total
and annualized cost for this two-year

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evaluation. The total cost is $155,110
and includes $23,267 for project
development, $32,573 for data
collection activities, $31,022 for data

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processing and analysis, $15,511 for the
publication of results, $12,408 for
project management and $40,329 for
overhead.

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Federal Register / Vol. 74, No. 91 / Wednesday, May 13, 2009 / Notices
EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
Cost component

Total cost

Annualized
cost

Project Development ...............................................................................................................................................
Data Collection Activities .........................................................................................................................................
Data Processing and Analysis .................................................................................................................................
Publication of Results ..............................................................................................................................................
Project Management ................................................................................................................................................
Overhead .................................................................................................................................................................

$23,267
32,573
31,022
15,511
12,408
40,329

$11,633
16,287
15,511
7,756
6,204
20,164

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

155,110

77,555

Request for Comments
In accordance with the above-cited
Paperwork Reduction Act legislation,
comments on AHRQ’s information
collection are requested with regard to
any of the following: (a) Whether the
proposed collection of information is
necessary for the proper performance of
AHRQ health care research, quality
improvement and information
dissemination functions, including
whether the information will have
practical utility; (b) the accuracy of
AHRQ’s estimate of burden (including
hours and costs) of the proposed
collection(s) 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 upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to
this notice will be summarized and
included in the Agency’s subsequent
request for OMB approval of the
proposed information collection. All
comments will become a matter of
public record.
Dated: May 4, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E9–11009 Filed 5–12–09; 8:45 am]
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Agency Information Collection
Activities: Proposed Collection:
Comment Request
In compliance with the requirement
for opportunity for public comment on
proposed data collection projects
(section 3506(c)(2)(A) of Title 44, United
States Code, as amended by the
Paperwork Reduction Act of 1995, Pub.
L. 104–13), the Health Resources and
Services Administration (HRSA)
publishes periodic summaries of
proposed projects being developed for
submission to the Office of Management
and Budget (OMB) under the Paperwork
Reduction Act of 1995. To request more
information on the proposed project or
to obtain a copy of the data collection
plans and draft instruments, e-mail
[email protected] or call the HRSA
Reports Clearance Officer on (301) 443–
1129.
Comments are invited on: (a) The
proposed collection of information for
the proper performance of the functions
of the agency; (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.
Proposed Project Title: Interim
Evaluation of the Bright Futures for
Women’s Health and Wellness
(BFWHW) Initiative, Emotional
Wellness Consumer Tools—NEW.

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Purpose: The purpose of this project
is to design and implement a three-year
interim evaluation to address initial
outcomes for the BFWHW emotional
wellness tools targeted at consumers.
The project is funded by the Health
Resources and Services Administrations
(HRSA), Office of Women’s Health
(OWH). The evaluation will seek to
determine (1) the acceptability of the
tools by the target audiences, (2)
strategies for ensuring their ongoing use,
and (3) the outcomes associated with
the use of these tools in three to four
selected primary care sites.
The evaluation team will work with
HRSA OWH and an Expert Committee
to identify the questions of interest for
the evaluation plan and methodology.
There will be two major components—
a descriptive/process component
focusing on the design and
implementation of the program’s
intervention and an impact component
focusing on the preliminary outcomes of
the intervention on the target audiences
and their behavioral intentions.
Respondents:
Female consumers (adolescents
between the ages of 13 and 17 and
adults 18 and older) who receive
services from primary care sites or
community service organizations will
receive a written survey on site at the
time of service.
Distributors of the Consumer Tools
(e.g., healthcare providers, program
staff, and community stakeholders/
organizations) from the three to four
selected HRSA-funded program sites
will respond to a web-based written
survey.
Female consumers (adolescents
between the ages of 13 and 17 and
adults 18 and older) who receive
services from primary care sites or
community service organizations will be
invited to participate in a focus group.

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