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43287

Federal Register / Vol. 77, No. 142 / Tuesday, July 24, 2012 / Notices
characteristics; lifestyle (e.g., smoking);
medicines and/or health conditions, and

three years. The estimated annualized
burden hours are 350.

foods. There are no costs to respondents
other than their time.
ATSDR is requesting approval to
conduct this information collection for

ESTIMATED ANNUALIZED BURDEN HOURS
Form name

Exposure Investigation Participants ........................................

Chemical Exposure Questions

Kimberly S. Lane,
Deputy Director, Office of Science Integrity,
Office of the Associate Director for Science,
Office of the Director, Centers for Disease
Control and Prevention.
[FR Doc. 2012–17961 Filed 7–23–12; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–12–12OG]

Proposed Data Collections Submitted
for Public Comment and
Recommendations

sroberts on DSK5SPTVN1PROD with NOTICES

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 404–639–7570 and
send comments to Kimberly S. Lane,
1600 Clifton Road, MS–D74, Atlanta,
GA 30333 or send an email 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

Number of
responses per
respondent

Number of
respondents

Type of respondent

700

1

Average
burden per
response
(in hours)
30/60

systematically developing a marketing
strategy for The Safer University
Intervention, a comprehensive,
community-based environmental
prevention program with proven
efficacy in reducing intoxication and
alcohol-impaired driving among college
students.
The CDC proposes an on-line
information collection, that will take
place during the spring semester of the
2012–2013 academic year, and will
constitute a follow-up to a marketing
effort targeting a national sample of 4year colleges and universities. The
follow-up comprises a survey of key
informants from the sampled
institutions and key leaders of the
surrounding community.
The CDC will use the information
gathered from the on-line survey to: (1)
Develop and revise customized
marketing and program materials
targeting potential campus and
community stakeholders; and (2) inform
strategies for the marketing plan.
The respondents targeted for the online survey include: College
Administrators and staff, campus and
municipal police; as well as selected
community leaders. A total of up to 160
Institutions of Higher Education (IHE)
will be contacted with a maximum of 12
participants per IHE. A maximum of
1,800 respondents will be contacted by
email and asked to forward the email
and participate in the on-line survey.
Questions of a sensitive nature will not
be asked. The amount of time required
for a respondent to take part in the
survey is estimated to be less than 1
hour. We estimate a total maximum of
1,800 burden hours.
There are no costs to respondents
other than their time.

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
Science to Practice: Developing and
Testing a Marketing Strategy for
Preventing Alcohol-related Problems in
College Communities—NEW—National
Center for Injury Prevention and Control
(NCIPC), Centers for Disease Control
and Prevention (CDC).
Background and Brief Description
Each year, 1,700 college students die
and more than 1.4 million are injured as
a result of alcohol-related incidents.
Additionally, about 25% of students
report negative academic consequences
due to alcohol (Engs et al., 1996; Presley
et al., 1996a, 1996b; Wechsler et al.,
2002). Despite the enormous public
health burden of college-age alcohol
misuse, there have been few rigorous
evaluations of environmental strategies
to address alcohol misuse in college
settings. Environmental strategies
typically involve implementing and
enforcing policies that change the
environments that influence alcoholrelated behavior and subsequent harm.
Further, studies show that the typical
lag time between identifying effective
interventions and obtaining widespread
adoption can stretch to well over a
decade. Given the number of students
harmed, there is an urgent need to
develop more efficient and timely
strategies for moving effective science to
widespread practice. This project will
address this exact issue by

ESTIMATED ANNUALIZED BURDEN HOURS
Type of
respondent

Form

College Administrators and staff ..........................
Campus and Municipal Police officers .................

On-line survey ..............
On-line survey ..............

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600

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1
1

600
600

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43288

Federal Register / Vol. 77, No. 142 / Tuesday, July 24, 2012 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS—Continued

Community Leaders .............................................

On-line survey ..............

600

1

1

600

Total Burden Hours .......................................

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

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

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

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

1,800

[FR Doc. 2012–17984 Filed 7–23–12; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Medicare & Medicaid
Services
[Document Identifier: CMS–10389, CMS–
855S and CMS–855(A,B,I,R)]

Agency Information Collection
Activities: Submission for OMB
Review; Comment Request
Centers for Medicare &
Medicaid Services, HHS.
In compliance with the requirement
of section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Centers for Medicare & Medicaid
Services (CMS), Department of Health
and Human Services, is publishing the
following summary of proposed
collections 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 function;
(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.
1. Type of Information Collection
Request: New collection (request for a
new OMB control number). Title of
Information Collection: The Home and
Community-Based Service (HCBS)
Experience Survey. Use: This study is a
one-time pilot field test involving
individuals who receive HCBS from
Medicaid programs. The field test will
be conducted for the following
purposes: (a) To assess survey

AGENCY:

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Number of
respondents

Average
burden per
respondent
(in hours)

Form

Kimberly S. Lane,
Deputy Director, Office of Scientific Integrity,
Office of the Associate Director for Science,
Office of the Director, Centers for Disease
Control and Prevention.

sroberts on DSK5SPTVN1PROD with NOTICES

Number of
responses per
respondent

Type of
respondent

methodology—to determine how well a
face-to-face survey and telephone
survey performs with individuals who
receive HCBS services; (b) Psychometric
Analysis—to provide information for
the revision and shortening of the
survey based on the assessment of the
reliability and construct validity of
survey items and composites; and (c)
Case mix adjustment analysis—to assess
the variables that may be considered as
case mix adjusters. These preliminary
research activities are not required by
regulation, and will not be used by CMS
to regulate or sanction its customers.
They will be entirely voluntary and the
confidentiality of respondents and their
responses will be preserved.
The information collected will be
used to revise and test the survey
instrument described in the Background
section of the PRA package’s Supporting
Statement. Within the PRA package,
Attachment B includes two versions of
the survey (one modified for
accessibility) and Attachment C has the
introductory information. The end
result will be an improvement in
information collection instruments and
in the quality of data collected, a
reduction or minimization of
respondent burden, increased agency
efficiency, and improved
responsiveness to the public. Following
the field test, CMS will seek approval
from the CAHPS consortium for the
HCBS Experience Survey to be a new
addition to the CAHPS® family of
surveys. Form Number: CMS–10389
(OCN 0938–New). Frequency: Once.
Affected Public: Individuals and
Households. Number of Respondents:
18,000. Total Annual Responses:
18,000. Total Annual Hours: 9,000. (For
policy questions regarding this
collection contact Anita Yuskauskas at
410–786–0268. For all other issues call
410–786–1326.)
2. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Medicare
Enrollment Application—Durable
Medical Equipment, Prosthetics,
Orthotics and Supplies (DMEPOS)
Suppliers Use: The primary function of
the CMS 855S Durable Medical

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Equipment, Prosthetics, Orthotics and
Supplies (DMEPOS) supplier
enrollment application is to gather
information from a supplier that tells us
who it is, whether it meets certain
qualifications to be a health care
supplier, where it renders its services or
supplies, the identity of the owners of
the enrolling entity, and information
necessary to establish the correct claims
payment. The goal of evaluating and
revising the CMS 855S DMEPOS
supplier enrollment application is to
simplify and clarify the information
collection without jeopardizing our
need to collect specific information. The
majority of the revisions contained in
this submission are non-substantive in
nature such as spelling and formatting
corrections; however, we also removed
duplicate fields and obsolete questions
and provided clarification and
simplified the instructions for the
completing the application. Form
Number: CMS–855(S) (OCN: 0938–
1056); Frequency: Yearly; Affected
Public: Private Sector; Business or other
for-profit and not-for-profit institutions;
Number of Respondents: 43,350; Total
Annual Responses: 43,350; Total
Annual Hours: 113,550 (For policy
questions regarding this contact Kim
McPhillips at 410–786–5374. For all
other issues call 410–786–1326.)
3. Type of Information Collection
Request: Extension of a currently
approved collection; Title of
Information Collection: Medicare
Enrollment Application Use: The
primary function of the CMS–855
Medicare enrollment application is to
gather information from a provider or
supplier that tells us who it is, whether
it meets certain qualifications to be a
health care provider or supplier, where
it practices or renders its services, the
identity of the owners of the enrolling
entity, and other information necessary
to establish correct claims payments.
Form Number: CMS–855(A, B, I, R)
(OCN: 0938–0685); Frequency: Yearly;
Affected Public: Private Sector; Business
or other for-profit and not-for-profit
institutions; Number of Respondents:
440,450; Total Annual Responses:
440,450; Total Annual Hours: 856,395
(For policy questions regarding this

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