81 FR 3393 - Proposed Collection; Comment Request
DEPARTMENT OF DEFENSE
Department of the Army Federal Register Volume 81, Issue 13 (January 21, 2016)
Department of the Army
Federal Register Volume 81, Issue 13 (January 21, 2016)
| Page Range | 3393-3393 | |
| FR Document | 2016-01075 |
[Federal Register Volume 81, Number 13 (Thursday, January 21, 2016)] [Notices] [Page 3393] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-01075] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF DEFENSE Department of the Army [Docket ID: USA-2016-HQ-0001] Proposed Collection; Comment Request AGENCY: U.S. Army Medical Command, Family Advocacy Program Office, DoD. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the Army Family Advocacy Program Office, US Army announces a proposed public information collection and seeks public comment on the provisions thereof. 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 information collection; (c) ways to enhance the quality, utility, and clarity of the information to be collected; and (d) ways to minimize the burden of the information collection on respondents, including through the use of automated collection techniques or other forms of information technology. DATES: Consideration will be given to all comments received by March 21, 2016. ADDRESSES: You may submit comments, identified by docket number and title, by any of the following methods:Federal eRulemaking Portal: http://www.regulations.gov. Follow the instructions for submitting comments. Mail: Department of Defense, Office of the Deputy Chief Management Officer, Directorate of Oversight and Compliance, Regulatory and Audit Matters Office, 9010 Defense Pentagon, Washington, DC 20301- 9010. Instructions: All submissions received must include the agency name, docket number and title for this Federal Register document. The general policy for comments and other submissions from members of the public is to make these submissions available for public viewing on the Internet at http://www.regulations.gov as they are received without change, including any personal identifiers or contact information. Any associated form(s) for this collection may be located within this same electronic docket and downloaded for review/testing. Follow the instructions at http://www.regulations.gov for submitting comments. Please submit comments on any given form identified by docket number, form number, and title. FOR FURTHER INFORMATION CONTACT: To request more information on this proposed information collection or to obtain a copy of the proposal and associated collection instruments, please write to the U.S. Army Medical Command, Health Policy & Services, Behavioral Health Service Line, Family Advocacy Program (ATTN: MCHO-CL-H/Ms. Kathleen Foreman), 2748 Worth Road, JBSA Fort Sam Houston, TX 78234; or call the Point of Contact for U.S. Army Medical Command, Family Advocacy Program Office at 210-295-7370 or email at [email protected]. SUPPLEMENTARY INFORMATION: Title; Associated Form; and OMB Number: Family Advocacy Program; MEDCOM Form 811-Pilot (Behavioral Health Intake-Psychosocial History and Assessment); OMB Control Number 0702- XXXX. Needs and Uses: The information collection requirement is necessary to obtain and record the behavioral/mental health, psychological and social history of military health eligible and non-eligible beneficiaries in need of domestic violence and child abuse emergency and non-emergency support. The form is used by family advocacy workers to assess the clinical and non-clinical needs of individuals and families to ensure victim safety; reduce the risk of adverse behavioral health events like suicide, homicide, accidental death, and physical, emotional, and sexual abuse and neglect; refer victims and alleged offenders to appropriate treatment and case management resources; to gather case information for presentation and incident determination by a family advocacy review board; and to gather information for data analysis and reporting purposes for overall program improvement. Affected Public: Individuals or households. Annual Burden Hours: 3,950. Number of Respondents: 7,900. Responses per Respondent: 1. Annual Responses: 7,900. Average Burden per Response: 30 minutes. Frequency: On occasion. Respondents are U.S. citizens (military, civilian, and military- affiliated civilians; spouses, intimate partners; child care providers; teachers) or foreign nationals seeking emergency and non-emergency support from military health care facilities, child care facilities, and DoD school systems who are seeking domestic violence or child abuse support for themselves or their children. MEDCOM Form 811-Pilot records the information needed to conduct a thorough and responsible risk assessment, behavioral health assessment, treatment plan, and case monitoring or management plan. The completed form is included in the Family Advocacy Case file and in Family Advocacy System of Records (information system). The form is used by family advocacy workers to assess the clinical and non-clinical needs of individuals and families to ensure victim safety; reduce the risk of adverse behavioral health events like suicide, homicide, accidental death, and physical, emotional sexual abuse and neglect; refer victims and alleged offenders to appropriate treatment and case management resources; to gather case information for presentation and incident determination by a family advocacy review board; and to gather information for data analysis and reporting purposes for overall program improvement. If the form is not included in the Family Advocacy file, the records will reflect inconsistent risk assessment, behavioral health assessment, treatment and management planning. This form is essential to data collection to inform treatment and management planning. The form bolsters efforts to maintain and document family advocacy worker's compliance with standards in the assessment of victims and alleged offenders of abuse. In addition, the information gathered supports program improvement and risk mitigation. Dated: January 14, 2016. Aaron Siegel, Alternate OSD Federal RegisterLiaison Officer, Department of Defense. [FR Doc. 2016-01075 Filed 1-20-16; 8:45 am] BILLING CODE 5001-06-P
![Federal Register / Vol. 81, No. 13 / Thursday, January 21, 2016 / Notices 3393
Authority: 42 U.S.C. 4342, 4344. Any associated form(s) for this affiliated civilians; spouses, intimate
Dated: January 15, 2016. collection may be located within this partners; child care providers; teachers)
Christine J. Harada, same electronic docket and downloaded or foreign nationals seeking emergency
Federal Chief Sustainability Officer.
for review/testing. Follow the and non-emergency support from
instructions at http:// military health care facilities, child care
[FR Doc. 2016–01132 Filed 1–20–16; 8:45 am]
www.regulations.gov for submitting facilities, and DoD school systems who
BILLING CODE 3225–F6–P
comments. Please submit comments on are seeking domestic violence or child
any given form identified by docket abuse support for themselves or their
number, form number, and title. children. MEDCOM Form 811-Pilot
DEPARTMENT OF DEFENSE FOR FURTHER INFORMATION CONTACT: To records the information needed to
request more information on this conduct a thorough and responsible risk
Department of the Army proposed information collection or to assessment, behavioral health
obtain a copy of the proposal and assessment, treatment plan, and case
[Docket ID: USA–2016–HQ–0001] monitoring or management plan. The
associated collection instruments,
Proposed Collection; Comment please write to the U.S. Army Medical completed form is included in the
Request Command, Health Policy & Services, Family Advocacy Case file and in
Behavioral Health Service Line, Family Family Advocacy System of Records
AGENCY: U.S. Army Medical Command, Advocacy Program (ATTN: MCHO–CL– (information system). The form is used
Family Advocacy Program Office, DoD. H/Ms. Kathleen Foreman), 2748 Worth by family advocacy workers to assess
ACTION: Notice. Road, JBSA Fort Sam Houston, TX the clinical and non-clinical needs of
78234; or call the Point of Contact for individuals and families to ensure
SUMMARY: In compliance with the U.S. Army Medical Command, Family victim safety; reduce the risk of adverse
Paperwork Reduction Act of 1995, the Advocacy Program Office at 210–295– behavioral health events like suicide,
Army Family Advocacy Program Office, 7370 or email at homicide, accidental death, and
US Army announces a proposed public kathleen.p.foreman.civ@mail.mil. physical, emotional sexual abuse and
information collection and seeks public neglect; refer victims and alleged
SUPPLEMENTARY INFORMATION: Title;
comment on the provisions thereof. offenders to appropriate treatment and
Comments are invited on: (a) Whether Associated Form; and OMB Number: case management resources; to gather
the proposed collection of information Family Advocacy Program; MEDCOM case information for presentation and
is necessary for the proper performance Form 811-Pilot (Behavioral Health incident determination by a family
of the functions of the agency, including Intake-Psychosocial History and advocacy review board; and to gather
whether the information shall have Assessment); OMB Control Number information for data analysis and
practical utility; (b) the accuracy of the 0702–XXXX. reporting purposes for overall program
Needs and Uses: The information improvement. If the form is not
agency’s estimate of the burden of the
collection requirement is necessary to included in the Family Advocacy file,
proposed information collection; (c)
obtain and record the behavioral/mental the records will reflect inconsistent risk
ways to enhance the quality, utility, and
health, psychological and social history assessment, behavioral health
clarity of the information to be
of military health eligible and non- assessment, treatment and management
collected; and (d) ways to minimize the
eligible beneficiaries in need of planning. This form is essential to data
burden of the information collection on
domestic violence and child abuse collection to inform treatment and
respondents, including through the use
emergency and non-emergency support. management planning. The form
of automated collection techniques or
The form is used by family advocacy bolsters efforts to maintain and
other forms of information technology.
workers to assess the clinical and non- document family advocacy worker’s
DATES: Consideration will be given to all clinical needs of individuals and
comments received by March 21, 2016. compliance with standards in the
families to ensure victim safety; reduce assessment of victims and alleged
ADDRESSES: You may submit comments, the risk of adverse behavioral health offenders of abuse. In addition, the
identified by docket number and title, events like suicide, homicide, information gathered supports program
by any of the following methods: accidental death, and physical, improvement and risk mitigation.
• Federal eRulemaking Portal: http:// emotional, and sexual abuse and
www.regulations.gov. Follow the neglect; refer victims and alleged Dated: January 14, 2016.
instructions for submitting comments. offenders to appropriate treatment and Aaron Siegel,
• Mail: Department of Defense, Office case management resources; to gather Alternate OSD Federal RegisterLiaison
of the Deputy Chief Management case information for presentation and Officer, Department of Defense.
Officer, Directorate of Oversight and incident determination by a family [FR Doc. 2016–01075 Filed 1–20–16; 8:45 am]
Compliance, Regulatory and Audit advocacy review board; and to gather BILLING CODE 5001–06–P
Matters Office, 9010 Defense Pentagon, information for data analysis and
Washington, DC 20301–9010. reporting purposes for overall program
Instructions: All submissions received improvement. DEPARTMENT OF DEFENSE
must include the agency name, docket Affected Public: Individuals or
number and title for this Federal Office of the Secretary
households.
Register document. The general policy Annual Burden Hours: 3,950. [Docket ID: DoD–2016–OS–0002]
asabaliauskas on DSK9F6TC42PROD with NOTICES
for comments and other submissions Number of Respondents: 7,900.
from members of the public is to make Responses per Respondent: 1. Privacy Act of 1974; System of
these submissions available for public Annual Responses: 7,900. Records
viewing on the Internet at http:// Average Burden per Response: 30 AGENCY: Office of the Secretary of
www.regulations.gov as they are minutes. Defense, DoD.
received without change, including any Frequency: On occasion.
ACTION: Notice to add a new System of
personal identifiers or contact Respondents are U.S. citizens
Records.
information. (military, civilian, and military-
VerDate Sep<11>2014 18:26 Jan 20, 2016 Jkt 238001 PO 00000 Frm 00017 Fmt 4703 Sfmt 4703 E:\FR\FM\21JAN1.SGM 21JAN1](https://thefederalregister.org/doc/81_FR_3406/page/1.svg)
Document Created: 2018-02-02 12:33:36
Document Modified: 2018-02-02 12:33:36
| Category | Regulatory Information | |
| Collection | Federal Register | |
| sudoc Class | AE 2.7: GS 4.107: AE 2.106: | |
| Publisher | Office of the Federal Register, National Archives and Records Administration | |
| Section | Notices | |
| Action | Notice. | |
| Dates | Consideration will be given to all comments received by March 21, 2016. | |
| Contact | To request more information on this proposed information collection or to obtain a copy of the proposal and associated collection instruments, please write to the U.S. Army Medical Command, Health Policy & Services, Behavioral Health Service Line, Family Advocacy Program (ATTN: MCHO-CL-H/Ms. Kathleen Foreman), 2748 Worth Road, JBSA Fort Sam Houston, TX 78234; or call the Point of Contact for U.S. Army Medical Command, Family Advocacy Program Office at 210-295-7370 or email at [email protected] | |
| FR Citation | 81 FR 3393 |
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