[Federal Register Volume 76, Number 162 (Monday, August 22, 2011)]
[Notices]
[Page 52335]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-21428]



[[Page 52335]]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


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

    Periodically, the Health Resources and Services Administration 
(HRSA) publishes abstracts of information collection requests under 
review by the Office of Management and Budget (OMB), in compliance with 
the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). To request 
a copy of the clearance requests submitted to OMB for review, e-mail 
[email protected] or call the HRSA Reports Clearance Office on (301) 
443-1129.
    The following request has been submitted to the Office of 
Management and Budget for review under the Paperwork Reduction Act of 
1995:

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 email 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:

----------------------------------------------------------------------------------------------------------------
                                     Number of     Responses per       Total         Hours per     Total burden
           Instrument               respondents     respondent       responses       response          hours
----------------------------------------------------------------------------------------------------------------
Free Clinics FTCA Program                    200               1             200              14            2800
 Application....................
                                 -------------------------------------------------------------------------------
    Total.......................             200  ..............             200  ..............            2800
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    Written comments and recommendations concerning the proposed 
information collection should be sent within 30 days of the date of 
this notice to the desk officer for HRSA, either by e-mail to [email protected] or by fax to 202-395-6974. Please direct all 
correspondence to the ``attention of the desk officer for HRSA.''

    Dated: August 16, 2011.
Reva Harris,
Acting Director, Division of Policy and Information Coordination.
[FR Doc. 2011-21428 Filed 8-19-11; 8:45 am]
BILLING CODE 4165-15-P