Appendix B 60Day Federal Notice

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Federal Register / Vol. 78, No. 8 / Friday, January 11, 2013 / Notices
Estimated Total Annual Burden
Hours: 8,204.
In compliance with the requirements
of Section 506(c)(2)(A) of the Paperwork
Reduction Act of 1995, the
Administration for Children and
Families is soliciting public comment
on the specific aspects of the
information collection described above.
Copies of the proposed collection of
information can be obtained and
comments may be forwarded by writing
to the Administration for Children and
Families, Office of Planning, Research
and Evaluation, 370 L’Enfant
Promenade SW., Washington, DC 20447,
Attn: ACF Reports Clearance Officer.
Email address:
[email protected]. All requests
should be identified by the title of the
information collection.
The Department specifically requests
comments 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)
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.
Consideration will be given to
comments and suggestions submitted
within 60 days of this publication.
Robert Sargis,
Reports Clearance Officer.
[FR Doc. 2013–00416 Filed 1–10–13; 8:45 am]
BILLING CODE 4184–01–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Agency Information Collection
Activities: Proposed Collection:
Comment Request
ACTION:

Notice.

In compliance with the
requirement for opportunity for public
comment on proposed data collection

SUMMARY:

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, email
[email protected] or call the HRSA
Reports Clearance Officer at (301) 443–
1984.
HRSA especially requests comments
on: (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.
Information Collection Request Title:
Patient Survey-Health Centers (OMB
No. 0915–xxxx) NEW.
The Health Center program supports
Health Centers (HCs), Migrant Health
Centers (MHCs), Health Care for the
Homeless (HCH) programs, and Public
Housing Primary Care (PHPC) programs.
Health Centers (HCs) receive grants from
HRSA to provide primary and
preventive health care services to
medically underserved populations.
The proposed Patient Survey will
collect nationally in-depth information
about HC patients, their health status,
the reasons they seek care at the HCs,
their diagnoses, the services they utilize
at HCs and elsewhere, the quality of
those services, and their satisfaction
with the care they receive, through
personal interviews of a stratified
random sample of HC patients. Prior to
the national study, a cognitive pre-test
will be conducted to refine and test the
survey instrument in different
languages, and to test the survey
sampling methodologies and
procedures. The pre-test will include
cognitive interviews to ensure that the
questions are being understood as was
intended. Interviews conducted in the
pre-test and the national study are

estimated to take approximately 1 hour
and 15 minutes each.
The Patient Survey builds on previous
periodic Patient User-Visit Surveys,
which were conducted to learn about
the process and outcomes of care in HCs
and MHCs, HCHs, and PHPCs. The
original questionnaires were derived
from the National Health Interview
Survey (NHIS) and the National
Ambulatory Medical Care Survey
(NAMCS) conducted by the National
Center for Health Statistics (NCHS).
Conformance with the NHIS and
NAMCS allowed comparisons between
these NCHS surveys and the previous
HC and HCH User-Visit Surveys. The
new Patient Survey was developed
using a questionnaire methodology
similar to that used in the past and will
also potentially allow some longitudinal
comparisons for HCs and HCHs with the
previous User-Visit survey data,
including monitoring of processes and
outcomes over time. In addition, this
survey will be conducted in languages
not used during previous surveys
(which were conducted in English and
Spanish) to include patients from
different racial and ethnic backgrounds,
including Chinese (Mandarin and
Cantonese), Korean, and Vietnamese.
With the exception of Spanish speakers,
other racial and ethnic subgroups were
not able to participate in the previous
surveys.
Burden Statement: Burden in this
context means the time expended by
persons to generate, maintain, retain,
disclose or provide the information
requested. This includes the time
needed to review instructions, to
develop, acquire, install and utilize
technology and systems for the purpose
of collecting, validating and verifying
information, processing and
maintaining information, and disclosing
and providing information, to train
personnel and to be able to respond to
a collection of information, to search
data sources, to complete and review
the collection of information, and to
transmit or otherwise disclose the
information. The total annual burden
hours estimated for this Information
Collection Request are summarized in
the table below.
The annual estimate of burden is as
follows:

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SURVEY PRETEST

Grantee/Site Recruitment ....................................................

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Number of
responses per
respondent

Number of
respondents

Form name

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Average
burden per
response
(in hours)

Total
responses

3

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3.00

Total
burden hours
18.00

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Federal Register / Vol. 78, No. 8 / Friday, January 11, 2013 / Notices
SURVEY PRETEST—Continued
Number of
respondents

Form name

Number of
responses per
respondent

Total
responses

Average
burden per
response
(in hours)

Total
burden hours

Patient Recruitment (At clinic) .............................................
Patient Survey (Administered at clinic) ................................
Patient Recruitment (Through local advertisements/flyers/
word-of-mouth) .................................................................
Patient Survey (Administered following local advertising) ...

21
16

1
1

21
16

.17
1.25

3.57
20.00

71
55

1
1

71
55

.08
1.25

5.68
68.75

Total Pretest .................................................................

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

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

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

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

116.00

Total
responses

Average
burden per
response
(in hours)

NATIONAL STUDY
Number of
respondents

Form name

Total
burden hours

Grantee/Site Recruitment and Training ...............................
Patient Recruitment .............................................................
Patient Survey ......................................................................

165
9,207
6,600

3
1
1

495
9,207
6,600

3.75
.17
1.25

1,856.25
1,565.19
8,250.00

Total National Study .....................................................

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

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

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

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

11,671.44

Addresses: Submit your comments to
[email protected] or mail the HRSA
Reports Clearance Officer, Room 10–29,
Parklawn Building, 5600 Fishers Lane,
Rockville, MD 20857.
Deadline: Comments on this
Information Collection Request must be
received within 60 days of this notice.
Dated: January 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information
Coordination.
[FR Doc. 2013–00364 Filed 1–10–13; 8:45 am]
BILLING CODE 4165–15–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Indian Health Service
Request for Public Comment: 30-Day
Proposed Information Collection:
Indian Health Service Forms To
Implement the Privacy Rule
Indian Health Service, HHS.
Notice.

AGENCY:
ACTION:

In compliance with Section
3507(a)(1)(D) of the Paperwork
Reduction Act of 1995 which requires
30 days for public comment on
proposed information collection
projects, the Indian Health Service (IHS)
is publishing for comment a summary of
a proposed information collection to be
submitted to the Office of Management
and Budget (0MB) for review. This
proposed information collection project
was previously published in the Federal
Register (77 FR 60219) on October 2,

SUMMARY:

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2012, and allowed 60 days for public
comment, as required by 3506(c)(2)(A).
No public comment was received in
response to the notice. The purpose of
this notice is to allow 30 days for public
comment to be submitted directly to
OMB.
Proposed Collection: Title: 0917–
0030, ‘‘IHS Forms to Implement the
Privacy Rule (45 CFR parts 160 & 164).’’
Type of Information Collection Request:
Extension, without revisions, of
currently approved information
collection, 0917–0030, ‘‘IHS Forms to
Implement the Privacy Rule (45 CFR
parts 160 & 164).’’ Form Number(s):
IHS–810, IHS–912–1, IHS–912–2, IHS–
913 and IHS–917. Need and Use of
Information Collection: This collection
of information is made necessary by the
Department of Health and Human
Services Rule entitled ‘‘Standards for
Privacy of Individually Identifiable
Health Information’’ (Privacy Rule) (45
CFR parts 160 and 164). The Privacy
Rule implements the privacy
requirements of the Administrative
Simplification subtitle of the Health
Insurance Portability and
Accountability Act of 1996, creates
national standards to protect
individuals’ personal health
information, and gives patients
increased access to their medical
records. 45 CFR 164.508, 164.522,
164.526 and 164.528 of the Rule require
the collection of information to
implement these protection standards
and access requirements. The IHS will
continue to use the following data
collection instruments to meet the

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information collection requirements
contained in the Rule.
45 CFR 164.508: This provision
requires covered entities to obtain or
receive a valid authorization for its use
or disclosure of protected health
information for other than for treatment,
payment and healthcare operations.
Under the provision individuals may
initiate a written authorization
permitting covered entities to release
their protected health information to
entities of their choosing. The form
IHS–810, ‘‘Authorization for Use or
Disclosure of Protected Health
Information,’’ is used to document an
individual’s authorization to use or
disclose their protected health
information.
45 CFR 164.522: Section 164.522(a)(1)
requires a covered entity to permit
individuals to request that the covered
entity restrict the use and disclosure of
their protected health information. The
covered entity may or may not agree to
the restriction. The form IHS–912–1,
‘‘Request for Restrictions(s),’’ is used to
document an individual’s request for
restriction of their protected health
information, and whether IHS agreed or
disagreed with the restriction. Section
164.522(a)(2) permits a covered entity to
terminate its agreement to a restriction
if the individual agrees to or requests
the termination in writing. The form
IHS–912–2, ‘‘Request for Revocation of
Restriction(s),’’ is used to document the
agency or individual request to
terminate a formerly agreed to
restriction regarding the use and

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