82 FR 10623 - Agency Information Collection Activities: Proposed Request and Comment Request
SOCIAL SECURITY ADMINISTRATION Federal Register Volume 82, Issue 29 (February 14, 2017)
Federal Register Volume 82, Issue 29 (February 14, 2017)
| Page Range | 10623-10627 | |
| FR Document | 2017-02941 |
[Federal Register Volume 82, Number 29 (Tuesday, February 14, 2017)] [Notices] [Pages 10623-10627] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-02941] ======================================================================= ----------------------------------------------------------------------- SOCIAL SECURITY ADMINISTRATION [Docket No: SSA-2017-0003] Agency Information Collection Activities: Proposed Request and Comment Request The Social Security Administration (SSA) publishes a list of information collection packages requiring clearance by the Office of Management and Budget (OMB) in compliance with Public Law 104-13, the Paperwork Reduction Act of 1995, effective October 1, 1995. This notice includes a new information collection and revisions of OMB-approved information collections. SSA is soliciting comments on the accuracy of the agency's burden estimate; the need for the information; its practical utility; ways to enhance its quality, utility, and clarity; and ways to minimize burden on respondents, including the use of automated collection techniques or other forms of information technology. Mail, email, or fax your comments and recommendations on the information collection(s) to the OMB Desk Officer and SSA Reports Clearance Officer at the following addresses or fax numbers. (OMB) Office of Management and Budget, Attn: Desk Officer for SSA, Fax: 202-395-6974, Email address: [email protected] (SSA) Social Security Administration, OLCA, Attn: Reports Clearance Director, 3100 West High Rise, 6401 Security Blvd., Baltimore, MD 21235, Fax: 410-966-2830, Email address: [email protected] Or you may submit your comments online through www.regulations.gov, [[Page 10624]] referencing Docket ID Number [SSA-2017-0003]. I. The information collections below are pending at SSA. SSA will submit them to OMB within 60 days from the date of this notice. To be sure we consider your comments, we must receive them no later than April 17, 2017. Individuals can obtain copies of the collection instruments by writing to the above email address. 1. Supported Employment Demonstration (SED) Project--0960-NEW. Sponsored by SSA, the SED project builds on the success of the intervention designed for the Mental Health Treatment Study (MHTS) previously funded by SSA. The MHTS provides integrated mental health and vocational services to disability beneficiaries with mental illness. The SED will offer these same services to individuals with mental illness for whom SSA denied Social Security disability benefits. SSA seeks to determine whether offering this evidence-based package of integrated vocational and mental health services to denied disability applicants fosters employment that leads to self-sufficiency; improved mental health and quality of life; and reduced demand for disability benefits. The SED will use a randomized controlled trial to compare the outcomes of two treatment groups and a control group. Study participation spans 36 months beginning on the day following the date of randomization to one of the three study groups. The SED study population consists of individuals aged 18 to 50 who apply for disability benefits alleging a mental illness, and the initial decision is a denial of benefits in the past 60 days. The SED will enroll up to 1,000 participants in each of the three study arms for a total of 3,000 participants: 40 participants in each of three study arms for the 20 urban sites equaling an n of 2,400 urban site participants, and 20 participants in each of three arms for the 10 rural sites equaling an n of 600 rural site participants. We randomly select and assign each enrolled participant to one of three study arms:Full-Service Treatment (n = 1,000). The multi-component service model from the MHTS comprises the Full-Service Treatment. At its core, it includes an Individual Placement and Support (IPS) supported employment specialist and behavioral health specialist providing IPS supported employment services integrated with behavioral health care. Participants in the full-service treatment group will also receive the services of a Nurse Care Coordinator who coordinates Systematic Medication Management services, as well assistance with: Out-of-pocket expenses associated with prescription behavioral health medications; work-related expenses; and services and treatment not covered by the participant's health insurance. Basic-Service Treatment (n = 1,000). The Basic-Service Treatment model leaves intact IPS supported employment integrated with behavioral health services as the centerpiece of the intervention arm. The Basic-Service Treatment is essentially the Full-Service model without the services of the Nurse Care Coordinator; Systematic Medication Management; and the funds associated with out-of-pocket expenses for prescription behavioral health medications. Usual Services (n = 1,000). This study arm represents a control group against which we can compare the two treatment groups. Participants assigned to this group seek services as they normally would (or would not) in their community. However, at the time of randomization, each Usual Service participant will receive a comprehensive manual describing mental health and vocational services in their locale, along with state and national resources. This study will test the two treatment conditions against each other and against the control group on multiple outcomes of policy interest to SSA. The key outcomes of interest include: (1) Employment; (2) earnings; (3) income; (4) mental status; (5) quality of life; (6) health services utilization; and (7) SSA disability benefit receipt and amount. SSA is also interested in the study take up rate (participation); knowing who enrolls (and who does not); and fidelity to evidence-based treatments; among other aspects of implementation. Data collection for the evaluation of the SED will consist of the following activities: Baseline in-person participant interviews; quarterly participant telephone interviews; receipt of SSA administrative record data; and collection of site-level program data. Evaluation team members will also conduct site visits involving: (1) Pre-visit environmental scans to understand the local context in which we embed SED services; (2) independent fidelity assessments in conjunction with those carried out by state Mental Health or Vocational Rehabilitation staff; (3) key informant interviews with the IPS specialist, the nurse care coordinator, the case manager, and facility director; (4) focus groups with participants in the Full-Service and Basic-Service Treatment groups; and (5) ethnographic data collection consisting of observations in the natural environment, and person- centered interviews with participants and non-participants. The respondents are study participants and non-participants; family members; IPS specialists; nurse care coordinators; case managers; and facility directors. Type of Request: Request for a new information collection. ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- Competency and CIDI Screener.................... 3,000 1 40 2,000 Baseline Interview.............................. 3,000 1 45 2,250 Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 3,000 9 20 9,000 9, 10, and 11)................................. Annual Interview (Quarters 4, 8, and 11)........ 3,000 3 30 4,500 Fidelity Assessment Participant Interview....... 180 4 60 720 Fidelity Assessment Family Member Interview..... 90 4 60 360 Key Informant Interview......................... 120 4 60 480 Participant Focus Groups........................ 600 2 60 1,200 Person-Centered Interview....................... 180 4 60 720 --------------------------------------------------------------- Totals...................................... 13,170 .............. .............. 21,230 ---------------------------------------------------------------------------------------------------------------- [[Page 10625]] 2. Student Reporting Form--20 CFR 404.352(b)(2); 404.367; 404.368; 404.415; 404.434; 422.135--0960-0088. To qualify for Social Security Title II student benefits, student beneficiaries must be in full-time attendance status at an educational institution. In addition, SSA requires these beneficiaries to report events that may cause a reduction, termination, or suspension of their benefits. SSA collects this information on Forms SSA-1383 and SSA-1383-FC to determine if the changes or events the student beneficiaries report will affect their continuing entitlement to SSA benefits. SSA also uses the SSA-1383 and SSA-1383-FC to calculate the correct benefit amounts for student beneficiaries. The respondents are Social Security Title II student beneficiaries. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Modality of completion respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-1383........................................ 74,887 1 6 7,489 SSA-1383-FC..................................... 1,247 1 6 125 --------------------------------------------------------------- Totals...................................... 76,134 .............. .............. 7,614 ---------------------------------------------------------------------------------------------------------------- 3. Advanced Notice of Termination of Child's Benefits & Student's Statement Regarding School Attendance--20 CFR 404.350-404.352, 404.367- 404.368--0960-0105. SSA collects information on Forms SSA-1372-BK and SSA-1372-BK-FC to determine whether children of an insured worker meet the eligibility requirements for student benefits. The data we collect allows SSA to determine student entitlement and thether to terminate benefits. The respondents are student claimants for Social Security benefits; their respective schools; and in some cases; their representative payees. Type of Request: Revision of an OMB-approved information collection. SSA-1372-BK ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Type of respondent respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- Individuals/Households.......................... 99,850 1 8 13,313 State/Local/Tribal Government................... 99,850 1 3 4,993 --------------------------------------------------------------- Totals...................................... 199,700 .............. .............. 18,306 ---------------------------------------------------------------------------------------------------------------- SSA-1372-BK-FC ---------------------------------------------------------------------------------------------------------------- Average Estimated Number of Frequency of burden per total annual Type of respondent respondents response response burden (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- Individuals/Households.......................... 1,198 1 8 160 State/Local/Tribal Government................... 1,198 1 3 60 --------------------------------------------------------------- Totals...................................... 2,396 .............. .............. 220 --------------------------------------------------------------- Grand Total................................. 200,096 .............. .............. 18,526 ---------------------------------------------------------------------------------------------------------------- 4. Request for Review of Hearing Decision/Order--20 CFR 404.967- 404.981, 416.1467-416.1481--0960-0277. Claimants have a statutory right under the Social Security Act and current regulations to request review of an administrative law judge's (ALJ) hearing decision or dismissal of a hearing request on Title II and Title XVI claims. Claimants may request Appeals Council review by filing a written request using Form HA-520. SSA uses the information to establish the claimant filed the request for review within the prescribed time and to ensure the claimant completed the requisite steps permitting the Appeals Council review. The Appeals Council uses the information to: (1) Document the claimant's reason(s) for disagreeing with the ALJ's decision or dismissal; (2) determine whether the claimant has additional evidence to submit; and (3) determine whether the claimant has a representative or wants to appoint one. The respondents are claimants requesting review of an ALJ's decision or dismissal of hearing. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated Modality of completion Number of Frequency of per response total annual respondents response (minutes) burden (hours) ---------------------------------------------------------------------------------------------------------------- HA-520...................................... 175,000 1 10 29,167 ---------------------------------------------------------------------------------------------------------------- [[Page 10626]] 5. Disability Update Report--20 CFR 404.1589-404.1595 and 416.988- 416.996--0960-0511. As part of our statutory requirements, SSA periodically uses Form SSA-455, the Disability Update Report, to evaluate current Title II disability beneficiaries' and Title XVI disability payment recipients' continued eligibility for Social Security disability payments. Specifically, SSA uses the form to determine if: (1) There is enough evidence to warrant referring the respondent for a full medical Continuing Disability Review (CDR); (2) the respondent's impairments are still present and indicative of no medical improvement, precluding the need for a CDR; or (3) the respondent has unresolved work-related issues. SSA mails Form SSA-455 to specific disability recipients, whom we select as possibly qualifying for the CDR process. SSA pre-fills the form with data specific to the disability recipient, except for the sections we ask the recipients to complete. When SSA receives the completed form, we scan it into SSA's system. This allows us to gather the information electronically, and enables SSA to process the returned forms through automated decision logic to decide the proper course of action to take. The respondents are recipients of Title II and Title XVI Social Security disability payments. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-455..................................... 1,500,000 1 15 375,000 ---------------------------------------------------------------------------------------------------------------- II. SSA submitted the information collections below to OMB for clearance. Your comments regarding the information collections would be most useful if OMB and SSA receive them 30 days from the date of this publication. To be sure we consider your comments, we must receive them no later than March 16, 2017. Individuals can obtain copies of the OMB clearance package by writing to [email protected]. 1. Agreement to Sell Property--20 CFR 416.1240-1245--0960-0127. Individuals or couples who are otherwise eligible for Supplemental Security Income (SSI) payments, but whose resources exceed the allowable limit may receive conditional payments if they agree to dispose of the excess non-liquid resources and make repayments. SSA uses Form SSA-8060-U3 to document this agreement, and to ensure the individuals understand their obligations. Respondents are applicants for and recipients of SSI payments who will be disposing of excess non- liquid resources. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-8060-U3................................. 20,000 1 10 3,333 ---------------------------------------------------------------------------------------------------------------- 2. Development of Participation in a Vocational Rehabilitation or Similar Program--20 CFR 404.316(c), 404.337(c), 404.352(d), 404.1586(g), 404.1596, 404.1597(a), 404.327, 404.328, 416.1321(d), 416.1331(a)-(b), and 416.1338, 416.1402--0960-0282. State Disability Determination Services (DDS) must determine if Social Security disability payment recipients whose disability ceased and who participate in vocational rehabilitation programs may continue to receive disability payments. To do this, DDSs need information about the recipients; the types of program participation; and the services they receive under the rehabilitation program. SSA uses Form SSA-4290 to collect this information. The respondents are State employment networks; vocational rehabilitation agencies; or other providers of educational or job training services. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-4290.................................... 3,000 1 15 750 ---------------------------------------------------------------------------------------------------------------- 3. Appointment of Representative--20 CFR 404.1707, 404.1720, 408.1101, 416.1507, and 416.1520--0960-0527. Individuals claiming rights or benefits under the Social Security Act (Act) must notify SSA in writing when they appoint an individual to represent them in dealing with SSA. SSA collects the information on Form SSA-1696-U4 to verify the appointment of these representatives. The SSA-1696-U4 allows SSA to inform representatives of items that affect the recipient's claim, and allows claimants to give permission to their appointed representatives to designate a person to receive their claims files. Respondents are applicants for, or recipients of, Social Security disability benefits (SSDI) or SSI payments who are notifying SSA they have appointed a person to represent them in their dealings with SSA. Type of Request: Revision of an OMB-approved information collection. [[Page 10627]] ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-1696-U4................................. 800,000 1 10 133,333 ---------------------------------------------------------------------------------------------------------------- 4. Work Activity Report (Self-Employment)--20 CFR 404.1520(b), 20 CFR 404.1571-404.1576, 20 CFR 404.1584-404.1593, and 20 CFR 416.971- 416.976--0960-0598. SSA uses Form SSA-820-U4 to determine initial or continuing eligibility for (1) Title II SSDI, or (2) Title XVI SSI payments. Under Titles II and XVI of the Act, recipients receive disability benefits and SSI payments based on their inability to engage in substantial gainful activity (SGA) due to a physical or mental condition. Therefore, when the recipients resume work, they must report their work so SSA can evaluate and determine by law whether they continue to meet the disability requirements. SSA uses Form SSA-820-U4 to obtain information on self-employment activities of Social Security Title II and XVI disability applicants and recipients. We use the data we obtain to evaluate disability claims, and to help us determine if the claimant meets current disability provisions under Titles II and XVI. Since applicants for disability benefits or payments must prove an inability to perform any kind of SGA generally available in the national economy for which we expect them to qualify based on age, education, and work experience, any work an applicant performed until, or subsequent to, the date the disability allegedly began, affects our disability determination. The respondents are applicants and claimants for SSI payments or SSDI benefits. Type of Request: Revision of an OMB-approved information collection. ---------------------------------------------------------------------------------------------------------------- Average burden Estimated total Modality of completion Number of Frequency of per response annual burden respondents response (minutes) (hours) ---------------------------------------------------------------------------------------------------------------- SSA-820-BK.................................. 100,000 1 30 50,000 ---------------------------------------------------------------------------------------------------------------- Dated: February 9, 2017. Naomi R. Sipple, Reports Clearance Officer, Social Security Administration. [FR Doc. 2017-02941 Filed 2-13-17; 8:45 am] BILLING CODE 4191-02-P
![Federal Register / Vol. 82, No. 29 / Tuesday, February 14, 2017 / Notices 10623
For the Commission, by the Division of Percent Percent
Trading and Markets, pursuant to delegated
authority.27 Non-Profit Organizations With- For Physical Damage:
Eduardo A. Aleman, out Credit Available Else- Non-Profit Organizations with
Assistant Secretary. where ..................................... 2.500 Credit Available Elsewhere ... 2.500
[FR Doc. 2017–02910 Filed 2–13–17; 8:45 am]
Non-Profit Organizations with-
The number assigned to this disaster out Credit Available Else-
BILLING CODE 8011–01–P
for physical damage is 15041C and for where ..................................... 2.500
economic injury is 15042C. For Economic Injury:
Non-Profit Organizations with-
SMALL BUSINESS ADMINISTRATION (Catalog of Federal Domestic Assistance out Credit Available Else-
Number 59008) where ..................................... 2.500
[Disaster Declaration #15041 and #15042]
James E. Rivera,
Associate Administrator for Disaster
The number assigned to this disaster
Mississippi Disaster #MS–00098 for physical damage is 15043C and for
Assistance.
AGENCY: U.S. Small Business [FR Doc. 2017–02908 Filed 2–13–17; 8:45 am]
economic injury is 15044C.
Administration. BILLING CODE 8025–01–P (Catalog of Federal Domestic Assistance
ACTION: Notice. Number 59008)
James E. Rivera,
SUMMARY: This is a Notice of the SMALL BUSINESS ADMINISTRATION Associate Administrator for Disaster
Presidential declaration of a major
[Disaster Declaration #15043 and #15044] Assistance.
disaster for Public Assistance Only for
[FR Doc. 2017–02907 Filed 2–13–17; 8:45 am]
the State of Mississippi (FEMA–4295– Georgia Disaster #GA–00092 BILLING CODE 8025–01–P
DR), dated 02/06/2017.
Incident: Severe Storms, Tornadoes, AGENCY: U.S. Small Business
Straight-line Winds, and Flooding. Administration.
Incident Period: 01/20/2017 through ACTION: Notice. SOCIAL SECURITY ADMINISTRATION
01/21/2017. [Docket No: SSA–2017–0003]
Effective Date: 02/06/2017. SUMMARY: This is a Notice of the
Physical Loan Application Deadline Presidential declaration of a major Agency Information Collection
Date: 04/07/2017. disaster for Public Assistance Only for Activities: Proposed Request and
Economic Injury (EIDL) Loan the State of Georgia (FEMA–4297–DR), Comment Request
Application Deadline Date: 11/06/2017. dated 02/07/2017.
Incident: Severe Storms, Tornadoes, The Social Security Administration
ADDRESSES: Submit completed loan
Straight-line Winds, and Flooding. (SSA) publishes a list of information
applications to: U.S. Small Business Incident Period: 01/21/2017 through collection packages requiring clearance
Administration, Processing and 01/22/2017. by the Office of Management and
Disbursement Center, 14925 Kingsport Effective Date: 02/07/2017. Budget (OMB) in compliance with
Road, Fort Worth, TX 76155. Physical Loan Application Deadline Public Law 104–13, the Paperwork
FOR FURTHER INFORMATION CONTACT: A. Date: 04/10/2017. Reduction Act of 1995, effective October
Escobar, Office of Disaster Assistance, Economic Injury (EIDL) Loan 1, 1995. This notice includes a new
U.S. Small Business Administration, Application Deadline Date: 11/07/2017. information collection and revisions of
409 3rd Street SW., Suite 6050, ADDRESSES: Submit completed loan OMB-approved information collections.
Washington, DC 20416. applications to: U.S. Small Business SSA is soliciting comments on the
SUPPLEMENTARY INFORMATION: Notice is Administration, Processing and accuracy of the agency’s burden
hereby given that as a result of the Disbursement Center, 14925 Kingsport estimate; the need for the information;
President’s major disaster declaration on Road, Fort Worth, TX 76155. its practical utility; ways to enhance its
02/06/2017, Private Non-Profit FOR FURTHER INFORMATION CONTACT: quality, utility, and clarity; and ways to
organizations that provide essential A. Escobar, Office of Disaster minimize burden on respondents,
services of governmental nature may file Assistance, U.S. Small Business including the use of automated
disaster loan applications at the address Administration, 409 3rd Street SW., collection techniques or other forms of
listed above or other locally announced Suite 6050, Washington, DC 20416. information technology. Mail, email, or
locations. SUPPLEMENTARY INFORMATION: Notice is fax your comments and
The following areas have been hereby given that as a result of the recommendations on the information
determined to be adversely affected by President’s major disaster declaration on collection(s) to the OMB Desk Officer
the disaster: 02/07/2017, Private Non-Profit and SSA Reports Clearance Officer at
Primary Counties: Forrest, Lamar, Perry. organizations that provide essential the following addresses or fax numbers.
The Interest Rates are: services of governmental nature may file (OMB) Office of Management and
disaster loan applications at the address Budget, Attn: Desk Officer for SSA,
Percent listed above or other locally announced Fax: 202–395–6974, Email address:
locations. OIRA_Submission@omb.eop.gov
For Physical Damage: The following areas have been (SSA) Social Security Administration,
sradovich on DSK3GMQ082PROD with NOTICES
Non-Profit Organizations With determined to be adversely affected by OLCA, Attn: Reports Clearance
Credit Available Elsewhere ... 2.500 the disaster: Director, 3100 West High Rise, 6401
Non-Profit Organizations With-
Primary Counties: Baker, Brooks, Security Blvd., Baltimore, MD 21235,
out Credit Available Else-
where ..................................... 2.500 Calhoun, Clay, Cook, Crisp, Fax: 410–966–2830, Email address:
For Economic Injury: Dougherty, Thomas, Turner, OR.Reports.Clearance@ssa.gov
Wilcox, Worth. Or you may submit your comments
27 17 CFR 200.30–3(a)(12). The Interest Rates are: online through www.regulations.gov,
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referencing Docket ID Number [SSA– site participants, and 20 participants in mental health and vocational services in
2017–0003]. each of three arms for the 10 rural sites their locale, along with state and
I. The information collections below equaling an n of 600 rural site national resources.
are pending at SSA. SSA will submit participants. This study will test the two treatment
them to OMB within 60 days from the We randomly select and assign each conditions against each other and
date of this notice. To be sure we enrolled participant to one of three against the control group on multiple
consider your comments, we must study arms: outcomes of policy interest to SSA. The
receive them no later than April 17, • Full-Service Treatment (n = 1,000). key outcomes of interest include: (1)
2017. Individuals can obtain copies of The multi-component service model Employment; (2) earnings; (3) income;
the collection instruments by writing to from the MHTS comprises the Full- (4) mental status; (5) quality of life; (6)
the above email address. Service Treatment. At its core, it health services utilization; and (7) SSA
includes an Individual Placement and disability benefit receipt and amount.
1. Supported Employment Support (IPS) supported employment
Demonstration (SED) Project—0960– SSA is also interested in the study take
specialist and behavioral health up rate (participation); knowing who
NEW. Sponsored by SSA, the SED specialist providing IPS supported
project builds on the success of the enrolls (and who does not); and fidelity
employment services integrated with
intervention designed for the Mental to evidence-based treatments; among
behavioral health care. Participants in
Health Treatment Study (MHTS) other aspects of implementation. Data
the full-service treatment group will
previously funded by SSA. The MHTS collection for the evaluation of the SED
also receive the services of a Nurse Care
provides integrated mental health and will consist of the following activities:
Coordinator who coordinates Systematic
vocational services to disability Baseline in-person participant
Medication Management services, as
beneficiaries with mental illness. The interviews; quarterly participant
well assistance with: Out-of-pocket
SED will offer these same services to telephone interviews; receipt of SSA
expenses associated with prescription
individuals with mental illness for administrative record data; and
behavioral health medications; work-
whom SSA denied Social Security collection of site-level program data.
related expenses; and services and
disability benefits. SSA seeks to treatment not covered by the Evaluation team members will also
determine whether offering this participant’s health insurance. conduct site visits involving: (1) Pre-
evidence-based package of integrated • Basic-Service Treatment (n = visit environmental scans to understand
vocational and mental health services to 1,000). The Basic-Service Treatment the local context in which we embed
denied disability applicants fosters model leaves intact IPS supported SED services; (2) independent fidelity
employment that leads to self- employment integrated with behavioral assessments in conjunction with those
sufficiency; improved mental health and health services as the centerpiece of the carried out by state Mental Health or
quality of life; and reduced demand for intervention arm. The Basic-Service Vocational Rehabilitation staff; (3) key
disability benefits. The SED will use a Treatment is essentially the Full-Service informant interviews with the IPS
randomized controlled trial to compare model without the services of the Nurse specialist, the nurse care coordinator,
the outcomes of two treatment groups Care Coordinator; Systematic the case manager, and facility director;
and a control group. Study participation Medication Management; and the funds (4) focus groups with participants in the
spans 36 months beginning on the day associated with out-of-pocket expenses Full-Service and Basic-Service
following the date of randomization to for prescription behavioral health Treatment groups; and (5) ethnographic
one of the three study groups. The SED medications. data collection consisting of
study population consists of individuals • Usual Services (n = 1,000). This observations in the natural
aged 18 to 50 who apply for disability study arm represents a control group environment, and person-centered
benefits alleging a mental illness, and against which we can compare the two interviews with participants and non-
the initial decision is a denial of treatment groups. Participants assigned participants. The respondents are study
benefits in the past 60 days. The SED to this group seek services as they participants and non-participants;
will enroll up to 1,000 participants in normally would (or would not) in their family members; IPS specialists; nurse
each of the three study arms for a total community. However, at the time of care coordinators; case managers; and
of 3,000 participants: 40 participants in randomization, each Usual Service facility directors.
each of three study arms for the 20 participant will receive a Type of Request: Request for a new
urban sites equaling an n of 2,400 urban comprehensive manual describing information collection.
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
Competency and CIDI Screener ...................................................................... 3,000 1 40 2,000
Baseline Interview ............................................................................................ 3,000 1 45 2,250
Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 9, 10, and 11) ......................... 3,000 9 20 9,000
Annual Interview (Quarters 4, 8, and 11) ........................................................ 3,000 3 30 4,500
Fidelity Assessment Participant Interview ....................................................... 180 4 60 720
Fidelity Assessment Family Member Interview ............................................... 90 4 60 360
Key Informant Interview ................................................................................... 120 4 60 480
sradovich on DSK3GMQ082PROD with NOTICES
Participant Focus Groups ................................................................................ 600 2 60 1,200
Person-Centered Interview .............................................................................. 180 4 60 720
Totals ........................................................................................................ 13,170 ........................ ........................ 21,230
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Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
SSA–1696–U4 ................................................................................................. 800,000 1 10 133,333
4. Work Activity Report (Self- recipients resume work, they must payments must prove an inability to
Employment)—20 CFR 404.1520(b), 20 report their work so SSA can evaluate perform any kind of SGA generally
CFR 404.1571–404.1576, 20 CFR and determine by law whether they available in the national economy for
404.1584–404.1593, and 20 CFR continue to meet the disability which we expect them to qualify based
416.971–416.976—0960–0598. SSA uses requirements. SSA uses Form SSA–820– on age, education, and work experience,
Form SSA–820–U4 to determine initial U4 to obtain information on self- any work an applicant performed until,
or continuing eligibility for (1) Title II employment activities of Social Security or subsequent to, the date the disability
SSDI, or (2) Title XVI SSI payments. Title II and XVI disability applicants allegedly began, affects our disability
Under Titles II and XVI of the Act, and recipients. We use the data we determination. The respondents are
recipients receive disability benefits and obtain to evaluate disability claims, and applicants and claimants for SSI
SSI payments based on their inability to to help us determine if the claimant
payments or SSDI benefits.
engage in substantial gainful activity meets current disability provisions
(SGA) due to a physical or mental under Titles II and XVI. Since Type of Request: Revision of an OMB-
condition. Therefore, when the applicants for disability benefits or approved information collection.
Average Estimated
Number of Frequency burden per total annual
Modality of completion respondents of response response burden
(minutes) (hours)
SSA–820–BK ................................................................................................... 100,000 1 30 50,000
Dated: February 9, 2017. barred unless the claim is filed on or safety and operation of SR 29. The
Naomi R. Sipple, before July 14, 2017. If the Federal law actions by the Federal agencies, and the
Reports Clearance Officer, Social Security that authorizes judicial review of a laws under which such actions were
Administration. claim provides a time period of less taken, are described in the
[FR Doc. 2017–02941 Filed 2–13–17; 8:45 am] than 150 days for filing such claim, then Environmental Assessment (EA) for the
BILLING CODE 4191–02–P that shorter time period still applies. project, approved on November 23,
FOR FURTHER INFORMATION CONTACT: For 2016, in the FHWA Finding of No
Caltrans: Chris Quiney, Branch Chief R– Significant Impact (FONSI) issued on
DEPARTMENT OF TRANSPORTATION 1, Caltrans Environmental Planning November 23, 2016, and in other
Office—District 2, 1657 Riverside Drive, documents in the FHWA project
Federal Highway Administration Redding, CA 96001, regular office hours records. The EA, FONSI, and other
7:30 a.m.–4:15 p.m. Monday–Friday, project records are available by
Notice of Final Federal Agency Actions telephone: (530) 225–3174, email: contacting Caltrans at the addresses
on Proposed Highway in California chris.quiney@dot.ca.gov. provided above. The Caltrans EA and
AGENCY: Federal Highway SUPPLEMENTARY INFORMATION: Effective FONSI can be viewed and downloaded
Administration (FHWA), DOT. July 1, 2007, the Federal Highway from the project Web site at http://
Administration (FHWA) assigned, and www.dot.ca.gov/dist1/d1projects/
ACTION: Notice of limitation on claims
the California Department of lake29/.
for Judicial Review of Actions by the
Transportation (Caltrans) assumed, This notice applies to all Federal
California Department of Transportation
environmental responsibilities for this agency decisions as of the issuance date
(Caltrans), pursuant to 23 U.S.C. 327,
project pursuant to 23 U.S.C. 327. of this notice and all laws under which
and other federal agencies.
Notice is hereby given that the Caltrans such actions were taken, including but
SUMMARY: The FHWA, on behalf of has taken final agency actions subject to not limited to:
Caltrans, is issuing this notice to 23 U.S.C. 139(l)(1) by issuing licenses, 1. General: National Environmental
announce actions taken by Caltrans, that permits, and approvals for the following Policy Act (NEPA) [42 U.S.C. 4321–
are final within the meaning of 23 highway project in the State of 4351]; Federal Aid Highway Act [23
U.S.C. 139(l)(1). The actions relate to a California: Widening and improvement U.S.C. 109 and 23 U.S.C. 128]
proposed highway project, on State of an eight-mile segment of State Route 2. Air: Clean Air Act [42 U.S.C. 7401–
Route 29, in the County of Lake, State (SR) 29, beginning 0.2 miles east of 7671(q)]
of California. Those actions grant Diener Drive and ending 0.6 miles west 3. Land: Section 4(f) of the Department
licenses, permits, and approvals for the of the SR 175 intersection, in Lake of Transportation Act of 1966 [49
sradovich on DSK3GMQ082PROD with NOTICES
project. County. The project will widen and U.S.C. 303]
DATES: By this notice, the FHWA, on improve the existing two-lane highway 4. Wildlife: Endangered Species Act [16
behalf of Caltrans, is advising the public to a four-lane divided expressway with U.S.C. 1531–1544 and Section
of final agency actions subject to 23 access control to provide a modern 1536]; Migratory Bird Treaty Act
U.S.C. 139(l)(1). A claim seeking transportation facility that will provide [16 U.S.C. 703–712]
judicial review of the Federal agency adequate capacity to accommodate 5. Historic and Cultural Resources:
actions on the highway project will be anticipated traffic growth and improve Section 106 of the National Historic
VerDate Sep<11>2014 16:48 Feb 13, 2017 Jkt 241001 PO 00000 Frm 00066 Fmt 4703 Sfmt 4703 E:\FR\FM\14FEN1.SGM 14FEN1](https://thefederalregister.org/doc/82_FR_10652/page/5.svg)
Document Created: 2017-02-13 23:40:05
Document Modified: 2017-02-13 23:40:05
| 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 | |
| FR Citation | 82 FR 10623 |
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