[Federal Register Volume 80, Number 248 (Monday, December 28, 2015)]
[Notices]
[Page 80778]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-32551]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[Document Identifier HHS-OS-0945-0002-30D]


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 0945-0002, scheduled 
to expire on December 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 January 27, 
2016.

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 0945-0002 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.

                                        Estimated Annualized Burden Table
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                                                                     Number of    Average burden
             Forms                   Type of         Number of     responses per     hours per     Total burden
                                   respondent       respondents     respondent       response          hours
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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.
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    Total.....................  ................  ..............  ..............  ..............          10,335
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Terry S. Clark,
Asst Information Collection Clearance Officer.
[FR Doc. 2015-32551 Filed 12-24-15; 8:45 am]
 BILLING CODE 4153-01-P