[Federal Register Volume 78, Number 90 (Thursday, May 9, 2013)]
[Notices]
[Pages 27241-27242]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2013-11090]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities; Proposed Collection: 
Comment Request

ACTION: Notice.

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SUMMARY: 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, email [email protected] or 
call the HRSA Information Collection Clearance Officer at (301) 443-
1984.
    HRSA especially requests comments on: (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 
other forms of information technology to minimize the information 
collection burden.

Information Collection Request Title: Countermeasures Injury 
Compensation Program (OMB No. 0915-0334)--Revision

    Abstract: This is a revision to the request for OMB approval of the 
information collection requirements for the Countermeasures Injury 
Compensation Program (CICP or Program). The CICP, within the Health 
Resources and Services Administration (HRSA), administers the 
compensation program specified by the Public Readiness and Emergency 
Preparedness Act (PREP Act). The CICP provides compensation to eligible 
individuals (requesters) who suffer serious injuries directly caused by 
a covered countermeasure administered or used pursuant to a PREP Act 
Declaration, or to their estates and/or survivors. A declaration is 
issued by the Secretary of the Department of Health and Humans Services 
(Secretary). The purpose of a declaration is to identify a disease, 
health condition, or a threat to health that is currently, or may in 
the future constitute, a public health emergency. In addition, the 
Secretary, through a declaration, may recommend and encourage the 
development, manufacturing, distribution, dispensing, and 
administration or use of one or more covered countermeasures to treat, 
prevent, or diagnose the disease, condition, or threat specified in the 
declaration.
    To determine whether a requester is eligible for Program benefits 
(compensation) for the injury, the CICP

[[Page 27242]]

must review the Request for Benefits Package, which includes the 
Request for Benefits Form and Authorization for Use or Disclosure of 
Health Information Form(s), as well as the injured countermeasure 
recipient's medical records and supporting documentation.
    A requester who is an injured countermeasure recipient may be 
eligible to receive benefits for unreimbursed medical expenses and/or 
lost employment income. The estate of a deceased countermeasure 
recipient may also be eligible to receive medical benefits and/or 
benefits for lost employment income accrued prior to the injured 
countermeasure recipient's death. If death was the result of the 
administration or use of the countermeasure, certain survivor(s) of 
deceased eligible countermeasure recipients may be eligible to receive 
a death benefit, but not unreimbursed medical expenses or lost 
employment income benefits (42 CFR Sec.  110.33). The death benefit is 
calculated using either the ``standard calculation'' or the 
``alternative calculation.'' The ``standard calculation'' is based on 
the death benefit available under the Public Safety Officers' Benefits 
(PSOB) Program (42 CFR Sec.  110.82(b)). The ``alternative 
calculation'' is based on the deceased countermeasure recipient's 
income and is only available to the recipient's dependent(s) who is 
(are) younger than age 18.
    Approval is requested for the required continued information 
collection via the Request for Benefits Package, which has been updated 
to include all categories of potentially eligible requesters, including 
adult children, so that the CICP may continue to accept and process 
requests for benefits. The Request for Benefits Form and Instructions 
have been revised to remove the request for a social security number, 
update the CICP Web site address, and add a new category of eligible 
requesters, adult children. This new category was added because the 
CICP is generally required to use the same categories of survivors in 
order of priority for benefits as established and defined by the PSOB 
Program (42 CFR Sec.  110.11(b)). This new category of survivors was 
added under the PSOB Program.
    Approval is requested for new mechanisms of medical documentation 
and supporting documentation collection. During the eligibility review, 
the CICP would like to provide requesters with the opportunity to 
supplement their case files with additional medical records and 
supporting documentation before a final Program decision is made. The 
CICP would ask requesters to complete and sign a form indicating 
whether they intend to submit additional documentation prior to the 
final determination of their case.
    Approval is requested for a benefits documentation package the CICP 
plans to send to requesters who may be eligible for compensation, which 
includes certification forms and instructions outlining the 
documentation needed to determine the types and amounts of benefits. 
This documentation is required under 42 CFR Sec.  110.61-110.63 of the 
CICP's implementing regulations to enable the Program to determine the 
types and amounts of benefits the requester may be eligible to receive.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose or provide the 
information requested. This includes the time needed to review 
instructions; to develop, acquire, install and utilize technology and 
systems for the purpose of collecting, validating and verifying 
information, processing and maintaining information, and disclosing and 
providing information; to train personnel and to be able to respond to 
a collection of information; to search data sources; to complete and 
review the collection of information; and to transmit or otherwise 
disclose the information. The total annual burden hours estimated for 
this Information Collection Request are summarized in the table below.
    The annual estimate of burden is as follows:

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                                                                                        Number of                      Average  burden
                             Form name                                 Number of      responses per   Total responses   per  response     Total burden
                                                                      respondents       respondent                        (in hours)          hours
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Request for Benefits Form and Supporting Documentation............              100                1              100           11              1,100
Authorization for Use or Disclosure of Health Information Form....              100                1              100            2                200
Additional Documentation and Certification........................               30                1               30            *.75              22.5
Benefits Package and Supporting Documentation.....................               30                1               30             .125              3.75
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    Total.........................................................              260                4              260           13.875          1,326.25
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*45 min.


ADDRESSES: Submit your comments to [email protected] or mail the HRSA 
Reports Clearance Officer, Room 10-29, Parklawn Building, 5600 Fishers 
Lane, Rockville, MD 20857.
    Deadline: Comments on this Information Collection Request must be 
received within 60 days of this notice.

    Dated: May 3, 2013.
Bahar Niakan,
Director, Division of Policy and Information Coordination.
[FR Doc. 2013-11090 Filed 5-8-13; 8:45 am]
BILLING CODE 4165-15-P