[Federal Register Volume 80, Number 177 (Monday, September 14, 2015)]
[Notices]
[Pages 55138-55139]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-23024]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[Document Identifier: HHS-OS-0937-0166-30D]


Agency Information Collection Activities; Submission to OMB for 
Review and Approval; Public Comment Request

AGENCY: Office of the Secretary, HHS.

ACTION: Notice.

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SUMMARY: In compliance with section 3507(a)(1)(D) of the Paperwork 
Reduction Act of 1995, the Office of the Secretary (OS), Department of 
Health and Human Services, has submitted an Information Collection 
Request (ICR), described below, to the Office of Management and Budget 
(OMB) for review and approval. The ICR is for renewal of the approved 
information collection assigned OMB control number 0937-0166, scheduled 
to expire on October 31, 2015. Comments submitted during the first 
public review of this ICR will be provided to OMB. OMB will accept 
further comments from the public on this ICR during the review and 
approval period.

DATES: Comments on the ICR must be received on or before October 14, 
2015.

ADDRESSES: Submit your comments to [email protected] or via 
facsimile to (202) 395-5806.

FOR FURTHER INFORMATION CONTACT: Information Collection Clearance 
staff, [email protected] or (202) 690-6162.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the OMB control number 0937-0166 and 
document identifier.
    Information Collection Request Title: HHS 42 CFR part 50, subpart 
B; Sterilization of Persons in Federally Assisted Family Planning 
Projects--OMB No. 0937-0166-Extension-OASH, Office of Population 
Affairs--Office of Family Planning.
    Abstract: This is a request for extension of a currently approved 
collection for the disclosure and record-keeping requirements codified 
at 42 CFR part 50, subpart B (``Sterilization of Persons in Federally 
Assisted Family Planning Projects''). The consent form solicits 
information to assure voluntary and informed consent to persons 
undergoing sterilization in programs of health services which are 
supported by federal financial assistance administered by the Public 
Health Service (PHS). Consent forms are signed by individuals 
undergoing a federally funded sterilization procedure and certified by 
necessary medical authorities. Forms are incorporated into the 
patient's medical records and the agency's records. Through periodic 
site audits and visits, PHS staff review completed consent forms to 
determine compliance with the regulation. Thus, the purpose of the 
consent form is twofold. First, it serves as a mechanism to ensure that 
a person receives information about sterilization and voluntarily 
consents to the procedure. Second, it facilitates compliance 
monitoring. The Sterilization Consent Form has been revised to reflect 
a new expiration date on the Required Consent Form. There are no other 
revisions to the form.
    Likely Respondents: Interested persons who desire to send comments 
regarding this burden estimate or any other aspect of this collection 
of information that OS specifically requests comments.

[[Page 55139]]



                                    Total Estimated Annualized Burden--Hours
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                                                                     Number of
      Type of respondent           Information       Number of     responses per  Average burden    Total hours
                                   collection       respondents     respondent     per  response
----------------------------------------------------------------------------------------------------------------
Citizens Seeking Sterilization  Information              100,000               1               1         100,000
                                 Disclosure for
                                 Sterilization
                                 Consent Form.
Citizens Seeking Sterilization  Record-keeping           100,000               1           15/60          25,000
                                 for
                                 Sterilization
                                 Consent Form.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............         125,000
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Darius Taylor,
Information Collection Clearance Officer.
[FR Doc. 2015-23024 Filed 9-11-15; 8:45 am]
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