[Federal Register Volume 81, Number 16 (Tuesday, January 26, 2016)]
[Notices]
[Pages 4266-4267]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-01481]


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DEPARTMENT OF DEFENSE

Office of the Secretary

[Docket ID: DoD-2016-OS-0005]


Proposed Collection; Comment Request

AGENCY: Office of the Under Secretary of Defense (Personnel and 
Readiness), DoD.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, the 
Office of the Under Secretary of Defense (Personnel and Readiness) 
announces a proposed public information collection and seeks public 
comment on the provisions thereof. Comments are invited on: (a) Whether 
the proposed collection of information is necessary for the proper 
performance of the functions of the agency, including whether the 
information shall have practical utility; (b) the accuracy of the 
agency's estimate of the burden of the proposed information collection; 
(c) ways to enhance the quality, utility, and clarity of the 
information to be collected; and (d) ways to minimize the burden of the 
information collection on respondents, including through the use of 
automated collection techniques or other forms of information 
technology.

DATES: Consideration will be given to all comments received by March 
28, 2016.

ADDRESSES: You may submit comments, identified by docket number and 
title, by any of the following methods:
     Federal eRulemaking Portal: http://www.regulations.gov. 
Follow the instructions for submitting comments.
     Mail: Department of Defense, Office of the Deputy Chief 
Management Officer, Directorate of Oversight and Compliance, Regulatory 
and Audit Matters Office, 9010 Defense Pentagon, Washington, DC 20301-
9010.
    Instructions: All submissions received must include the agency 
name, docket number and title for this Federal

[[Page 4267]]

Register document. The general policy for comments and other 
submissions from members of the public is to make these submissions 
available for public viewing on the Internet at http://www.regulations.gov as they are received without change, including any 
personal identifiers or contact information.
    Any associated form(s) for this collection may be located within 
this same electronic docket and downloaded for review/testing. Follow 
the instructions at http://www.regulations.gov for submitting comments. 
Please submit comments on any given form identified by docket number, 
form number, and title.

FOR FURTHER INFORMATION CONTACT: To request more information on this 
proposed information collection or to obtain a copy of the proposal and 
associated collection instruments, please write to the Office of the 
Under Secretary of Defense (Personnel and Readiness) (Military 
Community and Family Policy) Office of Family Readiness Policy, Special 
Needs Program, ATTN: Rebecca Lombardi, 4000 Defense Pentagon, 
Washington, DC 20301-4000 or call 571-372-0862.

SUPPLEMENTARY INFORMATION:
    Title; Associated Form; and OMB Number: Family Member Travel 
Screening, DD Form X678-1TEST, Medical and Education Information, DD 
Form X678-2TEST, Dental Health Information, and DD Form X678-3TEST, 
Patient Care Review, OMB Control Number 0704-XXXX.
    Needs and Uses: The DD Forms X678-1 TEST, X678-2 TEST, and X678-3 
TEST are to be used during the Family Member Travel Screening (FMTS) 
process when active duty Service members with Permanent Change of 
Station (PCS) orders to OCONUS or remote installations request Command 
sponsorship for accompanied travel. These forms assist in determining 
the availability of care at a gaining installation by documenting any 
special medical, dental, and/or educational needs of dependents 
accompanying the Service member. Throughout the process, form 
respondents include: (1) Active duty Service members and/or dependents 
over the age of majority who provide demographic information; (2) 
medical and dental providers who provide information about dependent 
medical and dental needs; (3) losing FMTS Office staff who document any 
special medical, dental, and/or educational needs; and (4) gaining FMTS 
Office staff who document the availability of special needs support 
services at a gaining location.
    Affected Public: Individuals or households; medical and dental 
providers.
    Annual Burden Hours: 2,899 hours.
    Number of Respondents: 9,876 respondents.
    Responses per Respondent: 1 per year.
    Annual Responses: 9,876 per year.
    Average Burden per Response: 18 minutes.
    Frequency: As needed.
    The following is a breakdown of the public time burden for specific 
FMTS Pilot forms:
     The DD Form X678-1 TEST Medical and Educational 
Information informs sponsors and FMTS staff about possible special 
medical and/or educational needs of each dependent and guides the 
appropriate record review and the face-to-face interview. This form is 
completed by Service members and/or family members and internal 
physicians.
    [cir] Total annual public time burden for the DD Form X678-1 TEST: 
1,573 hours.
    [cir] Average time per response for the DD Form X678-1 TEST (in 
minutes): 20 minutes.
    [cir] Total annual public cost burden for the DD Form X678-1 TEST: 
$35,714.
     The DD Form X678-2 TEST Dental Health Information 
documents the dental health of dependent(s) in preparation for a move 
to a location where the patient may have limited access to dental care. 
This form is completed by Service members and/or family members and 
internal or civilian dentists.
    [cir] Total annual public time burden for the DD Form X678-2 TEST: 
698 hours.
    [cir] Average time per response for the DD Form X678-2 TEST (in 
minutes): 6 minutes.
    [cir] Total annual public cost burden for the DD Form X678-2 TEST: 
$49,218.
     The DD Form X678-3 TEST Patient Care Review summarizes 
each dependent's medical care received outside the Military Treatment 
Facility (MTF) (completed by non-MTF primary care managers). If 
applicable, this form is completed by Service members and/or family 
members and civilian physicians.
    [cir] Total annual public time burden for the DD Form X678-3 TEST: 
629 hours.
    [cir] Average time per response for the DD Form X678-3 TEST (in 
minutes): 8 minutes.
    [cir] Total annual public cost burden for the DD Form X678-3 TEST: 
$53,081.
    The DD TEST Forms will be piloted to test a standardized FMTS 
process across the military medical departments. The pilot will 
determine how the TEST forms can integrate into Service-specific 
assignment processes. If the forms can successfully integrate into 
these processes, then these TEST forms will be implemented as DD Forms. 
For a period of 90 days, the DD TEST Forms will be used in place of 
existing Service-specific FMTS forms for military families accompanying 
a Service member from a participating losing installation to a 
participating gaining installation. These TEST Forms will be monitored 
until the travel screening processes for all participating families are 
complete. During the pilot, military medical departments at 
participating installations will continue to screen non-pilot families 
using the current military medical department travel screening 
processes and forms.

    Dated: January 21, 2016.
Aaron Siegel,
Alternate OSD Federal Register, Liaison Officer, Department of Defense.
[FR Doc. 2016-01481 Filed 1-25-16; 8:45 am]
BILLING CODE 5001-06-P