[Federal Register Volume 80, Number 202 (Tuesday, October 20, 2015)]
[Notices]
[Pages 63561-63562]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-26604]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[Document Identifier: HHS-OS-0945-0002-60D]


Agency Information Collection Activities; Proposed Collection; 
Public Comment Request

AGENCY: Office of the Secretary, HHS.

ACTION: Notice.

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SUMMARY: In compliance with section 3506(c)(2)(A) of the Paperwork 
Reduction Act of 1995, the Office of the Secretary (OS), Department of 
Health and Human Services, announces plans to submit an Information 
Collection Request (ICR), described below, to the Office of Management 
and Budget (OMB). The ICR is for extending the use of the approved 
information collection assigned OMB control number 0945-0002, which 
expires on 12/31/2015. Prior to submitting the ICR to OMB, OS seeks 
comments from the public regarding the burden estimate, below, or any 
other aspect of the ICR.

DATES: Comments on the ICR must be received on or before December 21, 
2015.

ADDRESSES: Submit your comments to 
[email protected] or by calling (202) 690-6162.

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 document identifier HHS-OS-0945-0002-
60D for reference.
    Proposed Project: Complaint Forms for Discrimination; Health 
Information Privacy Complaints.
    OMB No. 0945-0002--Extension--Office of Civil Rights.
    Abstract: The Office for Civil Rights is seeking an extension on an 
approval for a 3-year clearance on a previous collection. Individuals 
may file written complaints with the Office for Civil Rights when they 
believe they have been discriminated against by programs or entities 
that receive Federal financial assistance from the Health and Human 
Service or if they believe that their right to the privacy of protected 
health information has been violated. Annual Number of Respondents 
frequency of submission is record keeping and reporting on occasion.

[[Page 63562]]



                                        Estimated Annualized Burden Table
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                                                                     Number of        Average
             Forms                   Type of         Number of     responses per   burden hours    Total burden
                                   respondent       respondents     respondent     per response        hours
----------------------------------------------------------------------------------------------------------------
Civil Rights Complaint Form...  Individuals or              3493               1           45/60            2620
                                 households, Not-
                                 for-profit
                                 institutions.
Health Information Privacy      Individuals or            10,286               1           45/60            7715
 Complaint Form.                 households, Not-
                                 for-profit
                                 institutions.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............          10,335
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    OS specifically 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.

Darius Taylor,
Information Collection Clearance Officer.
[FR Doc. 2015-26604 Filed 10-19-15; 8:45 am]
 BILLING CODE 4153-01-P