81 FR 43215 - Agency Information Collection Activities: Proposed Collection: Comment Request
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration Federal Register Volume 81, Issue 127 (July 1, 2016)
Health Resources and Services Administration
Federal Register Volume 81, Issue 127 (July 1, 2016)
| Page Range | 43215-43216 | |
| FR Document | 2016-15710 |
[Federal Register Volume 81, Number 127 (Friday, July 1, 2016)] [Notices] [Pages 43215-43216] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2016-15710] ----------------------------------------------------------------------- DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Agency Information Collection Activities: Proposed Collection: Comment Request AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice. ----------------------------------------------------------------------- SUMMARY: 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, email [email protected] or call the HRSA Information Collection Clearance Officer at (301) 443- 1984. DATES: Comments on this ICR should be received no later than August 30, 2016. ADDRESSES: Submit your comments to [email protected] or by mail to the HRSA Reports Clearance Officer, 14N39, 5600 Fishers Lane, Rockville, MD 20857. FOR FURTHER INFORMATION CONTACT: 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 Information Collection Clearance Officer at (301) 443-1984. SUPPLEMENTARY INFORMATION: When submitting comments or requesting information, please include the information request collection title for reference. Information Collection Request Title: Countermeasures Injury Compensation Program. OMB No. 0915-0334--Extension. Abstract: This is an extension request for OMB approval of the information collection requirements for the Countermeasures Injury Compensation Program (CICP or Program). CICP, within the Division of Injury Compensation Programs (DICP), Healthcare Systems Bureau, HRSA, administers the compensation program specified by the Public Readiness and Emergency Preparedness Act of 2005 (PREP Act). CICP provides compensation to eligible individuals who suffer serious injuries directly caused by a covered countermeasure administered or used pursuant to a PREP Act Declaration, or to their estates and/or to certain survivors. A declaration is issued by the Secretary of the Department of Health and Humans Services (Secretary). The purpose of a declaration is to identify a disease, health condition, or a threat to health that is currently, or may in the future constitute, a public health emergency. In addition, the Secretary, through a declaration, may recommend and encourage the development, manufacturing, distribution, dispensing, and administration or use of one or more covered countermeasures to treat, prevent, or diagnose the disease, condition, or threat specified in the declaration. To determine whether a requester is eligible for Program benefits (compensation) for the injury, CICP must review the Request for Benefits Package, which includes the Request for Benefits Form and Authorization for [[Page 43216]] Use or Disclosure of Health Information Form(s), as well as the injured countermeasure recipient's medical records and supporting documentation. A requester who is an injured countermeasure recipient may be eligible to receive benefits for unreimbursed medical expenses and/or lost employment income. The estate of a deceased countermeasure recipient may also be eligible to receive medical benefits and/or benefits for lost employment income accrued prior to the injured countermeasure recipient's death. If death was the result of the administration or use of the countermeasure, certain survivor(s) of deceased eligible countermeasure recipients may be eligible to receive a death benefit, but not unreimbursed medical expenses or lost employment income benefits. 42 CFR 110.33. The death benefit is calculated using either the ``standard calculation'' or the ``alternative calculation.'' The ``standard calculation'' is based on the death benefit available under the Public Safety Officers' Benefits (PSOB) Program. 42 CFR 110.82(b). The ``alternative calculation'' is based on the deceased countermeasure recipient's income and is only available to the recipient's dependent(s) younger than age 18 at the time of the countermeasure recipient's death. Continued approval is requested for the required information collection via the Request for Benefits Package (RFB) and for continued use of CICP's mechanisms of medical documentation and supporting documentation collection. During the eligibility review, CICP provides requesters with the opportunity to supplement their Requests for Benefits with additional medical records and supporting documentation before a final Program decision is made. CICP asks requesters to complete and sign a form indicating whether they intend to submit additional documentation prior to the final determination of their case. In addition, approval is requested for the continued use of a benefits documentation package that CICP sends to requesters who may be eligible for compensation, which includes certification forms and instructions outlining the documentation needed to determine the types and amounts of benefits. This documentation is required under 42 CFR 110.61-110.63 of CICP's implementing regulation to enable the Program to determine the types and amounts of benefits the requester may be eligible to receive. Likely Respondents: Members of the public who believe they have sustained serious physical injuries or deaths as the direct result of the administration or use of a covered countermeasure for a disease, condition, or threat that the Secretary determines either constitutes a current public health emergency, or there is a credible risk that the disease, condition, or threat may in the future constitute such an emergency. Persons who may be eligible to receive benefits from the CICP are: (1) Injured countermeasure recipients, as described in Sec. 110.3(n). (2) Survivors, as described in Sec. Sec. 110.3(cc) and 110.11. (3) Estates of deceased injured countermeasure recipients, as described in Sec. 110.10(a)(3). 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: ---------------------------------------------------------------------------------------------------------------- Average Number of Number of Total burden per Total burden Form name respondents responses per responses response (in hours respondent hours) ---------------------------------------------------------------------------------------------------------------- Request for Benefits Form and 100 1 100 11 1,100 Supporting Documentation....... Authorization for Use or 100 1 100 2 200 Disclosure of Health Information Form............... Additional Documentation and 30 1 30 .75 22.5 Certification.................. Benefits Package and Supporting 30 1 30 .125 3.75 Documentation.................. ------------------------------------------------------------------------------- Total....................... 100 .............. 100 .............. 1,326.25 ---------------------------------------------------------------------------------------------------------------- * The number 100 represents an estimate of individuals applying for Program benefits. The 4 documents are required of the same 100 individuals or subset of the 100 individuals. 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. Jason E. Bennett, Director, Division of the Executive Secretariat. [FR Doc. 2016-15710 Filed 6-30-16; 8:45 am] BILLING CODE 4165-15-P
![Federal Register / Vol. 81, No. 127 / Friday, July 1, 2016 / Notices 43215
No. 126/Wednesday, July 1, 2015/ may have been designated by letter to obtain a copy of the data collection
Notices 37637). The lists also include since that date. The appropriate plans and draft instruments, email
automatic facility HPSAs, designated as agencies and individuals have been or paperwork@hrsa.gov or call the HRSA
a result of the Health Care Safety Net will be notified of these actions by Information Collection Clearance Officer
Amendments of 2002 (Pub. L. 107–251), letter. These newly designated HPSAs at (301) 443–1984.
not subject to update requirements. will be included in the next publication DATES: Comments on this ICR should be
Each list of designated HPSAs (primary of the HPSA list and are currently received no later than August 30, 2016.
medical care, mental health, and dental) included in the daily updates posted on ADDRESSES: Submit your comments to
is arranged by state. Within each state, the HRSA Web site at http:// paperwork@hrsa.gov or by mail to the
the list is presented by county. If only www.hrsa.gov/shortage/find.html. HRSA Reports Clearance Officer, 14N39,
a portion (or portions) of a county is Any designated HPSA listed on the 5600 Fishers Lane, Rockville, MD
(are) designated, or if the county is part HRSA Web site is subject to withdrawal 20857.
of a larger designated service area, or if from designation if new information
FOR FURTHER INFORMATION CONTACT: To
a population group residing in the received and confirmed by HRSA
county or a facility located in the county request more information on the
indicates that the relevant data for the
has been designated, the name of the proposed project or to obtain a copy of
area involved have significantly
service area, population group, or the data collection plans and draft
changed since its designation. The
facility involved is listed under the instruments, email paperwork@hrsa.gov
effective date of such a withdrawal will
county name. Counties that have a or call the HRSA Information Collection
be the next publication of a notice
whole county geographic HPSA are Clearance Officer at (301) 443–1984.
regarding this list in the Federal
indicated by the ‘‘Entire county HPSA’’ SUPPLEMENTARY INFORMATION: When
Register.
notation following the county name. All requests for new designations, submitting comments or requesting
Further details on the snapshot of updates, or withdrawals should be information, please include the
HPSAs listed can be found on the HRSA based on the relevant criteria in information request collection title for
Web site: http://www.hrsa.gov/ regulations published at 42 CFR part 5. reference.
shortage/. Information Collection Request Title:
In addition to the specific listings Electronic Access Address Countermeasures Injury Compensation
included in this notice, all Indian Tribes The complete list of HPSAs Program.
that meet the definition of such Tribes designated as of May 13, 2016, are OMB No. 0915–0334—Extension.
in the Indian Health Care Improvement available on the HRSA Web site at Abstract: This is an extension request
Act of 1976, 25 U.S.C. 1603(d), are http://www.hrsa.gov/shortage/. for OMB approval of the information
automatically designated as population Frequently updated information on collection requirements for the
groups with primary medical care and HPSAs is also available at http:// Countermeasures Injury Compensation
dental health professional shortages. datawarehouse.hrsa.gov. Program (CICP or Program). CICP,
The Health Care Safety Net within the Division of Injury
Dated: June 24, 2016. Compensation Programs (DICP),
Amendments of 2002 also made the
James Macrae, Healthcare Systems Bureau, HRSA,
following entities eligible for automatic
facility HPSA designations: All federally Acting Administrator. administers the compensation program
qualified health centers (FQHCs) and [FR Doc. 2016–15678 Filed 6–30–16; 8:45 am] specified by the Public Readiness and
rural health clinics that offer services BILLING CODE 4165–15–P Emergency Preparedness Act of 2005
regardless of ability to pay. These (PREP Act). CICP provides
entities include: FQHCs funded under compensation to eligible individuals
section 330 of the PHS Act, FQHC Look- DEPARTMENT OF HEALTH AND who suffer serious injuries directly
Alikes, and Tribal and urban Indian HUMAN SERVICES caused by a covered countermeasure
clinics operating under the Indian Self- administered or used pursuant to a
Determination and Education Act of Health Resources and Services PREP Act Declaration, or to their estates
1975 (25 U.S.C. 450) or the Indian Administration and/or to certain survivors. A
Health Care Improvement Act. Many, declaration is issued by the Secretary of
Agency Information Collection the Department of Health and Humans
but not all, of these entities are included Activities: Proposed Collection:
on this listing. Exclusion from this list Services (Secretary). The purpose of a
Comment Request declaration is to identify a disease,
does not exclude them from HPSA
designation; any facilities eligible for AGENCY: Health Resources and Services health condition, or a threat to health
automatic designation will be included Administration, HHS. that is currently, or may in the future
in the HRSA Data Warehouse list of ACTION: Notice. constitute, a public health emergency.
HPSAs as they are identified. In addition, the Secretary, through a
SUMMARY: In compliance with the declaration, may recommend and
Future Updates of Lists of Designated requirement for opportunity for public encourage the development,
HPSAs comment on proposed data collection manufacturing, distribution, dispensing,
The lists of HPSAs at http:// projects (Section 3506(c)(2)(A) of Title and administration or use of one or
www.hrsa.gov/shortage/ consist of all 44, United States Code, as amended by more covered countermeasures to treat,
those that were designated as of May 13, the Paperwork Reduction Act of 1995, prevent, or diagnose the disease,
asabaliauskas on DSK3SPTVN1PROD with NOTICES
2016. It should be noted that HPSAs are Pub. L. 104–13), the Health Resources condition, or threat specified in the
currently updated on an ongoing basis and Services Administration (HRSA) declaration.
based on the identification of new areas, publishes periodic summaries of To determine whether a requester is
population groups, facilities, and sites proposed projects being developed for eligible for Program benefits
that meet the eligibility criteria or that submission to the Office of Management (compensation) for the injury, CICP
no longer meet eligibility criteria and/or and Budget (OMB) under the Paperwork must review the Request for Benefits
are being replaced by another type of Reduction Act of 1995. To request more Package, which includes the Request for
designation. As such, additional HPSAs information on the proposed project or Benefits Form and Authorization for
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![43216 Federal Register / Vol. 81, No. 127 / Friday, July 1, 2016 / Notices
Use or Disclosure of Health Information via the Request for Benefits Package public health emergency, or there is a
Form(s), as well as the injured (RFB) and for continued use of CICP’s credible risk that the disease, condition,
countermeasure recipient’s medical mechanisms of medical documentation or threat may in the future constitute
records and supporting documentation. and supporting documentation such an emergency. Persons who may
A requester who is an injured collection. During the eligibility review, be eligible to receive benefits from the
countermeasure recipient may be CICP provides requesters with the CICP are:
eligible to receive benefits for opportunity to supplement their (1) Injured countermeasure recipients,
unreimbursed medical expenses and/or Requests for Benefits with additional as described in § 110.3(n).
lost employment income. The estate of medical records and supporting (2) Survivors, as described in
a deceased countermeasure recipient documentation before a final Program §§ 110.3(cc) and 110.11.
may also be eligible to receive medical decision is made. CICP asks requesters (3) Estates of deceased injured
benefits and/or benefits for lost to complete and sign a form indicating countermeasure recipients, as described
employment income accrued prior to whether they intend to submit in § 110.10(a)(3).
the injured countermeasure recipient’s additional documentation prior to the Burden Statement: Burden in this
death. If death was the result of the final determination of their case. In context means the time expended by
administration or use of the addition, approval is requested for the persons to generate, maintain, retain,
countermeasure, certain survivor(s) of continued use of a benefits disclose or provide the information
deceased eligible countermeasure documentation package that CICP sends requested. This includes the time
recipients may be eligible to receive a to requesters who may be eligible for needed to review instructions; to
death benefit, but not unreimbursed compensation, which includes develop, acquire, install and utilize
medical expenses or lost employment certification forms and instructions technology and systems for the purpose
income benefits. 42 CFR 110.33. The outlining the documentation needed to of collecting, validating and verifying
death benefit is calculated using either determine the types and amounts of information, processing and
the ‘‘standard calculation’’ or the benefits. This documentation is required maintaining information, and disclosing
‘‘alternative calculation.’’ The ‘‘standard under 42 CFR 110.61–110.63 of CICP’s and providing information; to train
calculation’’ is based on the death implementing regulation to enable the personnel and to be able to respond to
benefit available under the Public Safety Program to determine the types and a collection of information; to search
Officers’ Benefits (PSOB) Program. 42 amounts of benefits the requester may data sources; to complete and review
CFR 110.82(b). The ‘‘alternative be eligible to receive. Likely the collection of information; and to
calculation’’ is based on the deceased Respondents: Members of the public transmit or otherwise disclose the
countermeasure recipient’s income and who believe they have sustained serious information. The total annual burden
is only available to the recipient’s physical injuries or deaths as the direct hours estimated for this Information
dependent(s) younger than age 18 at the result of the administration or use of a Collection Request are summarized in
time of the countermeasure recipient’s covered countermeasure for a disease, the table below.
death. Continued approval is requested condition, or threat that the Secretary The annual estimate of burden is as
for the required information collection determines either constitutes a current follows:
Average
Number of
Number of Total burden per Total burden
Form name responses per
respondents responses response hours
respondent (in hours)
Request for Benefits Form and Supporting Documentation 100 1 100 11 1,100
Authorization for Use or Disclosure of Health Information
Form ................................................................................. 100 1 100 2 200
Additional Documentation and Certification ......................... 30 1 30 .75 22.5
Benefits Package and Supporting Documentation .............. 30 1 30 .125 3.75
Total .............................................................................. 100 ........................ 100 ........................ 1,326.25
* The number 100 represents an estimate of individuals applying for Program benefits. The 4 documents are required of the same 100 individ-
uals or subset of the 100 individuals.
HRSA especially requests comments DEPARTMENT OF HEALTH AND the public interest in connection with
on: (1) The necessity and utility of the HUMAN SERVICES the performance of duties imposed on
proposed information collection for the the National Institutes of Health by law,
proper performance of the agency’s National Institutes of Health and that these duties can best be
functions, (2) the accuracy of the performed through the advice and
estimated burden, (3) ways to enhance Office of the Director; Notice of Charter
counsel of this group.
the quality, utility, and clarity of the Renewal
Inquiries may be directed to Jennifer
information to be collected, and (4) the
In accordance with Title 41 of the Spaeth, Director, Office of Federal
asabaliauskas on DSK3SPTVN1PROD with NOTICES
use of automated collection techniques
or other forms of information U.S. Code of Federal Regulations, Advisory Committee Policy, Office of
technology to minimize the information Section 102–3.65(a), notice is hereby the Director, National Institutes of
collection burden. given that the Charter for the Office of Health, 6701 Democracy Boulevard,
AIDS Research Advisory Council was Suite 1000, Bethesda, Maryland 20892
Jason E. Bennett, renewed for an additional two-year (Mail code 4875), Telephone (301) 496–
Director, Division of the Executive Secretariat. period on June 27, 2016. 2123, or spaethj@od.nih.gov.
[FR Doc. 2016–15710 Filed 6–30–16; 8:45 am] It is determined that the Office of
BILLING CODE 4165–15–P AIDS Research Advisory Council is in
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Document Created: 2016-07-14 11:37:53
Document Modified: 2016-07-14 11:37:53
| 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 | Comments on this ICR should be received no later than August 30, 2016. | |
| Contact | 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 Information Collection Clearance Officer at (301) 443-1984. | |
| FR Citation | 81 FR 43215 |
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