82 FR 14209 - Proposed Collection; Comment Request
DEPARTMENT OF DEFENSE
Department of the Army Federal Register Volume 82, Issue 51 (March 17, 2017)
Department of the Army
Federal Register Volume 82, Issue 51 (March 17, 2017)
| Page Range | 14209-14209 | |
| FR Document | 2017-05365 |
[Federal Register Volume 82, Number 51 (Friday, March 17, 2017)] [Notices] [Page 14209] From the Federal Register Online [www.thefederalregister.org] [FR Doc No: 2017-05365] ======================================================================= ----------------------------------------------------------------------- DEPARTMENT OF DEFENSE Department of the Army [Docket ID: USA-2016-HQ-0001] Proposed Collection; Comment Request AGENCY: US 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: 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; the accuracy of the agency's estimate of the burden of the proposed information collection; ways to enhance the quality, utility, and clarity of the information to be collected; and 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 May 16, 2017. 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 for Oversight and Compliance, Regulatory and Advisory Committee Division, 4800 Mark Center Drive, Mailbox #24, Suite 08D09B, Alexandria, VA 22350-1700. 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: March 14, 2017. Aaron Siegel, Alternate OSD Federal Register, Liaison Officer, Department of Defense. [FR Doc. 2017-05365 Filed 3-16-17; 8:45 am] BILLING CODE 5001-06-P
![Federal Register / Vol. 82, No. 51 / Friday, March 17, 2017 / Notices 14209
Agency Number: None. Instructions: All submissions received reporting purposes for overall program
Affected Public: Organizations must include the agency name, docket improvement.
applying for funding by the Social number and title for this Federal Affected Public: Individuals or
Innovation Fund. Register document. The general policy households.
Total Respondents: 50. for comments and other submissions Annual Burden Hours: 3,950.
Frequency: Annual. from members of the public is to make Number of Respondents: 7,900.
Average Time per Response: Averages these submissions available for public Responses per Respondent: 1.
24 hours. viewing on the Internet at http://
Estimated Total Burden Hours: 1,200. Annual Responses: 7,900.
www.regulations.gov as they are
Total Burden Cost (capital/startup): Average Burden per Response: 30
received without change, including any
None. minutes.
personal identifiers or contact
Total Burden Cost (operating/ Frequency: On occasion.
information.
maintenance): None. Respondents are U.S. citizens
Any associated form(s) for this (military, civilian, and military-
Dated: March 10, 2017. collection may be located within this affiliated civilians; spouses, intimate
Lois Nembhard, same electronic docket and downloaded partners; child care providers; teachers)
Director (Acting), Social Innovation Fund. for review/testing. Follow the or foreign nationals seeking emergency
[FR Doc. 2017–05312 Filed 3–16–17; 8:45 am] instructions at http:// and non-emergency support from
BILLING CODE 6050–28–P www.regulations.gov for submitting military health care facilities, child care
comments. Please submit comments on facilities, and DoD school systems who
any given form identified by docket are seeking domestic violence or child
DEPARTMENT OF DEFENSE number, form number, and title. abuse support for themselves or their
FOR FURTHER INFORMATION CONTACT: To children. MEDCOM Form 811–Pilot
Department of the Army request more information on this records the information needed to
[Docket ID: USA–2016–HQ–0001] proposed information collection or to conduct a thorough and responsible risk
obtain a copy of the proposal and assessment, behavioral health
Proposed Collection; Comment associated collection instruments, assessment, treatment plan, and case
Request please write to the U.S. Army Medical monitoring or management plan. The
Command, Health Policy & Services, completed form is included in the
AGENCY: US Army Medical Command, Behavioral Health Service Line, Family Family Advocacy Case file and in
Family Advocacy Program Office, DoD. Advocacy Program (ATTN: MCHO–CL– Family Advocacy System of Records
ACTION: Notice. H/Ms. Kathleen Foreman), 2748 Worth (information system). The form is used
SUMMARY: In compliance with the Road, JBSA Fort Sam Houston, TX by family advocacy workers to assess
Paperwork Reduction Act of 1995, the 78234; or call the Point of Contact for the clinical and non-clinical needs of
Army Family Advocacy Program Office, U.S. Army Medical Command, Family individuals and families to ensure
US Army announces a proposed public Advocacy Program Office at 210–295– victim safety; reduce the risk of adverse
information collection and seeks public 7370 or email at behavioral health events like suicide,
comment on the provisions thereof. kathleen.p.foreman.civ@mail.mil. homicide, accidental death, and
Comments are invited on: Whether the SUPPLEMENTARY INFORMATION: physical, emotional sexual abuse and
proposed collection of information is Title; Associated Form; and OMB neglect; refer victims and alleged
necessary for the proper performance of Number: Family Advocacy Program; offenders to appropriate treatment and
the functions of the agency, including MEDCOM Form 811–Pilot (Behavioral case management resources; to gather
whether the information shall have Health Intake–Psychosocial History and case information for presentation and
practical utility; the accuracy of the Assessment); OMB Control Number incident determination by a family
agency’s estimate of the burden of the 0702–XXXX. advocacy review board; and to gather
proposed information collection; ways information for data analysis and
Needs and Uses: The information reporting purposes for overall program
to enhance the quality, utility, and collection requirement is necessary to
clarity of the information to be improvement. If the form is not
obtain and record the behavioral/mental included in the Family Advocacy file,
collected; and ways to minimize the health, psychological and social history
burden of the information collection on the records will reflect inconsistent risk
of military health eligible and non- assessment, behavioral health
respondents, including through the use eligible beneficiaries in need of
of automated collection techniques or assessment, treatment and management
domestic violence and child abuse planning. This form is essential to data
other forms of information technology. emergency and non-emergency support. collection to inform treatment and
DATES: Consideration will be given to all The form is used by family advocacy management planning. The form
comments received by May 16, 2017. workers to assess the clinical and non- bolsters efforts to maintain and
ADDRESSES: You may submit comments, clinical needs of individuals and document family advocacy worker’s
identified by docket number and title, families to ensure victim safety; reduce compliance with standards in the
by any of the following methods: the risk of adverse behavioral health assessment of victims and alleged
• Federal eRulemaking Portal: http:// events like suicide, homicide, offenders of abuse. In addition, the
www.regulations.gov. Follow the accidental death, and physical,
asabaliauskas on DSK3SPTVN1PROD with NOTICES
information gathered supports program
instructions for submitting comments. emotional, and sexual abuse and improvement and risk mitigation.
• Mail: Department of Defense, Office neglect; refer victims and alleged
of the Deputy Chief Management offenders to appropriate treatment and Dated: March 14, 2017.
Officer, Directorate for Oversight and case management resources; to gather Aaron Siegel,
Compliance, Regulatory and Advisory case information for presentation and Alternate OSD Federal Register, Liaison
Committee Division, 4800 Mark Center incident determination by a family Officer, Department of Defense.
Drive, Mailbox #24, Suite 08D09B, advocacy review board; and to gather [FR Doc. 2017–05365 Filed 3–16–17; 8:45 am]
Alexandria, VA 22350–1700. information for data analysis and BILLING CODE 5001–06–P
VerDate Sep<11>2014 20:02 Mar 16, 2017 Jkt 241001 PO 00000 Frm 00012 Fmt 4703 Sfmt 9990 E:\FR\FM\17MRN1.SGM 17MRN1](https://thefederalregister.org/doc/82_FR_14260/page/1.svg)
Document Created: 2017-03-17 02:49:13
Document Modified: 2017-03-17 02:49:13
| 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 May 16, 2017. | |
| 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 | 82 FR 14209 |
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