[Federal Register Volume 77, Number 81 (Thursday, April 26, 2012)]
[Notices]
[Pages 24963-24964]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2012-10031]


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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, email 
[email protected] or call the HRSA Reports Clearance Office on (301) 
443-1984.
    The following request has been submitted to the Office of 
Management and Budget for review under the Paperwork Reduction Act of 
1995:

Proposed Project: Uncompensated Services Assurance Report (OMB No. 
0915-0077)--[Revision]

    Under the Hill-Burton Act, the Government provides grants and loans 
for construction or renovation of health care facilities. As a 
condition of receiving this construction assistance, facilities are 
required to provide services to persons unable to pay. A condition of 
receiving this assistance requires facilities to provide assurances 
periodically that the required level of uncompensated care is being 
provided, and that certain notification and record keeping procedures 
are being followed. These standard requirements are referred to as the 
uncompensated services assurance.
    The annual estimate of burden is as follows:

                                    Estimate of Information Collection Burden
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                                     Number of     Responses per       Total         Hours per     Total burden
           Instrument               respondents     respondent       responses       response          hours
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                                           Disclosure Burden (42 CFR)
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Published Notices (124.504(c))..              63               1              63            0.75           47.25
Individual Notices (124.504(c)).              63               1              63           43.60        2,746.80
Determinations of Eligibility                 63              99           6,237            0.75        4,677.75
 (124.507)......................
                                 -------------------------------------------------------------------------------
    Subtotal Disclosure Burden..  ..............  ..............  ..............  ..............        7,471.80
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                                                    Reporting
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Uncompensated Services Report--               10               1              10           11.00          110.00
 HRSA-710 Form (124.509(a)).....
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                                     Application for Compliance Alternatives
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Public Facilities (124.513).....               4               1               4            6.00           24.00
Small Obligation Facilities                    0  ..............  ..............  ..............  ..............
 (124.514(c))...................
Charitable Facilities                          0  ..............  ..............  ..............  ..............
 (124.516(c))...................
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                                Annual Certification for Compliance Alternatives
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Public Facilities (124.509(b))..              32               1              32            0.50           16.00
Charitable Facilities                         13               1              13            0.50            6.50
 (124.509(b))...................
Small Obligation Facilities                    0  ..............               0  ..............  ..............
 (124.509(c))...................
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                                       Complaint Information (124.511(a))
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Individuals.....................              10               1              10            0.25            2.50
Facilities......................              10               1              10            0.50            5.00
                                 -------------------------------------------------------------------------------
    Subtotal Reporting Burden...  ..............  ..............  ..............  ..............          164.00
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[[Page 24964]]


 
                                                          Number of record                        Total burden
                     Recordkeeping                            keepers         Hours per year         hours
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                                                  Recordkeeping
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Non-alternative Facilities (124.510(a))................                 33                 50           1,650.00
Unrestricted Availability (124.510(b)).................                 30                 50           1,500.00
                                                        --------------------------------------------------------
    Subtotal Recordkeeping Burden......................  .................  .................           3,150.00
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    Email comments to [email protected] or mail the HRSA Reports 
Clearance Officer, Room 10-29, Parklawn Building, 5600 Fishers Lane, 
Rockville, MD 20857. Written comments should be received within 60 days 
of this notice.

    Dated: April 20, 2012.
Reva Harris,
Acting Director, Division of Policy and Information Coordination.
[FR Doc. 2012-10031 Filed 4-25-12; 8:45 am]
BILLING CODE 4165-15-P