[Federal Register Volume 65, Number 108 (Monday, June 5, 2000)]
[Notices]
[Pages 35653-35654]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-13983]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-R-0211]


Agency Information Collection Activities: Submission for OMB 
Review; Comment Request

AGENCY: Health Care Financing Administration.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, is 
publishing the following summary of proposed collections for public 
comment. Interested persons are invited to send comments regarding this 
burden estimate or any other aspect of this collection of information, 
including any of the following subjects: (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

[[Page 35654]]

other forms of information technology to minimize the information 
collection burden.
    Type of Information Collection Request: Extension of a currently 
approved collection; Title of Information Collection: Model Application 
Template for State Child Health Plan Under Title XXI of the Social 
Security Act, State Children's Health Insurance Program, and Model 
Application Template and Instructions; Form No.: HCFA-R-211 (OMB #0938-
0707); Use: States are required to submit Title XXI plans and 
amendments for approval by the Secretary pursuant to section 2102 of 
the Social Security Act in order to receive funds for initiating and 
expanding health insurance coverage for uninsured children. The model 
application Template is used to assist States in submitting a State 
Child Health Plan and amendments to that plan; Affected Public: State, 
Local or Tribal Government; Number of Respondents: 37; Total Annual 
Responses: 37; Total Annual Hours: 2,960.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access HCFA's 
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail 
your request, including your address, phone number, OMB number, and 
HCFA document identifier, to [email protected], or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 30 days of this notice directly to the OMB desk officer: OMB 
Human Resources and Housing Branch, Attention: Allison Eydt, New 
Executive Office Building, Room 10235, Washington, DC 20503.

    Dated: May 25, 2000.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 00-13983 Filed 6-2-00; 8:45 am]
BILLING CODE 4120-03-P