[Federal Register Volume 76, Number 96 (Wednesday, May 18, 2011)]
[Notices]
[Pages 28792-28793]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-12248]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Comment Request

    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, e-mail [email protected] or 
call the HRSA Reports Clearance Officer at (301) 443-1129.
    Comments are invited on: (a) The proposed collection of information 
for the proper performance of the functions of the agency; (b) the 
accuracy of the agency's estimate of the burden of the proposed 
collection of information; (c) ways to enhance the quality, utility, 
and clarity of the information to be collected; and (d) ways to 
minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques or other 
forms of information technology.

Proposed Project: Free Clinics FTCA Program Application (OMB No. 0915-
0293)--Revision

    Under 42 U.S.C. 233(o) and HRSA BPHC Policy Information Notice 
2011-02, ``Free Clinics Federal Tort Claims Act (FTCA) Program Policy 
Guide,'' the FTCA Free Clinic Program requires free clinics to submit 
annual, renewal, and supplemental applications for the process of 
deeming qualified health care professionals, board members, officers, 
and contractors for FTCA malpractice insurance coverage. It is proposed 
that the application forms be modified to comply with the Patient 
Protection and Affordable Care Act section 10608, amending 42 U.S.C. 
233(o)(1), as well as upgrade the application to provide for an 
electronic submission. The modifications include: (1) Inclusion of 
board members, officers, employees, and contractors into one 
comprehensive application, and (2) a fully electronic application that 
can be submitted electronically via e-mail or the internet. It is 
anticipated that these modifications will decrease the time and effort 
required by the current OMB approved FTCA application forms.
    The annual estimate of burden is as follows:

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                                                                    Number of       Responses per                         Hours per       Total burden
                          Instrument                               respondents       respondent      Total responses      response            hours
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Free Clinics FTCA Program Application.........................               200                 1               200                14              2800
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    Total.....................................................               200  ................               200  ................              2800
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    E-mail comments to [email protected] or mail the HRSA Reports 
Clearance Officer, Room 10-33, Parklawn Building, 5600 Fishers Lane, 
Rockville, MD 20857. Written comments

[[Page 28793]]

should be received within 60 days of this notice.

    Dated: May 12 2011.
Reva Harris,
Acting Director, Division of Policy and Information Coordination.
[FR Doc. 2011-12248 Filed 5-17-11; 8:45 am]
BILLING CODE 4165-15-P