[Federal Register Volume 84, Number 119 (Thursday, June 20, 2019)]
[Notices]
[Pages 28820-28822]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-13054]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-19-1108]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Centers 
for Disease Control and Prevention (CDC) has submitted the information 
collection request titled Paul Coverdell National Acute Stroke Program 
(PCNASP) to the Office of Management and Budget (OMB) for review and 
approval. CDC previously published a ``Proposed Data Collection 
Submitted for Public Comment and Recommendations'' notice on February 
7, 2019 to obtain comments from the public and affected agencies. CDC 
did not receive comments related to the previous notice. This notice 
serves to allow an additional 30 days for public and affected agency 
comments.
    CDC will accept all comments for this proposed information 
collection project.

[[Page 28821]]

The Office of Management and Budget is particularly interested in 
comments that:
    (a) Evaluate whether the proposed collection of information is 
necessary for the proper performance of the functions of the agency, 
including whether the information will have practical utility;
    (b) Evaluate the accuracy of the agencies estimate of the burden of 
the proposed collection of information, including the validity of the 
methodology and assumptions used;
    (c) Enhance the quality, utility, and clarity of the information to 
be collected;
    (d) Minimize the burden of the collection of information on those 
who are to respond, including, through the use of appropriate 
automated, electronic, mechanical, or other technological collection 
techniques or other forms of information technology, e.g., permitting 
electronic submission of responses; and
    (e) Assess information collection costs.
    To request additional information on the proposed project or to 
obtain a copy of the information collection plan and instruments, call 
(404) 639-7570 or send an email to [email protected]. Direct written comments 
and/or suggestions regarding the items contained in this notice to the 
Attention: CDC Desk Officer, Office of Management and Budget, 725 17th 
Street NW, Washington, DC 20503 or by fax to (202) 395-5806. Provide 
written comments within 30 days of notice publication.

Proposed Project

    Paul Coverdell National Acute Stroke Program (PCNASP) (OMB No. 
0920-1108, exp. 03/31/2019)--Reinstatement with Change--National Center 
for Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers 
for Disease Control and Prevention (CDC).

Background and Brief Description

    Stroke is the fifth leading cause of death in the United States and 
results in approximately 145,000 deaths per year. Additionally, 
approximately 800,000 stroke events are reported each year, including 
approximately 185,000 recurrent strokes. However, many strokes are 
preventable, and patient outcomes can be improved through coordinated 
care that begins at stroke onset and is delivered in a timely manner.
    Stroke outcomes depend upon the rapid recognition of signs and 
symptoms of stroke, prompt transport to a treatment facility, and early 
rehabilitation. Improving outcomes requires a coordinated systems 
approach involving pre-hospital care, emergency department and hospital 
care, prevention of complications, post-stroke rehabilitation, and 
ongoing secondary prevention. Through the Paul Coverdell National Acute 
Stroke Program (PCNASP), CDC has been continuously working to measure 
and improve acute stroke care using well-known quality improvement 
strategies coupled with frequent evaluation of results. PCNASP awardees 
are state health departments who work with participating hospitals, 
Emergency Medical Services (EMS) agencies, and other healthcare 
partners (e.g., post-stroke recovery facilities) in their jurisdictions 
to improve quality of care and transitions of care for stroke patients. 
During initial cooperative agreement cycles, PCNASP awardees focused on 
improving in-hospital quality of care (QoC) with technical assistance 
provided by CDC. Through lessons learned during this process and other 
supporting evidence in the field, it has become evident that it is also 
important to examine pre- and post-hospital transitions of care to link 
the entire continuum of stroke care when improving QoC for stroke 
patients.
    The PCNASP's current five-year cooperative agreement started on 
July 1, 2015 and includes nine awardees and their selected partners 
(hospitals, EMS agencies, other healthcare facilities). This current 
funding reflects additional emphasis on pre-hospital quality of care as 
well as the post-hospital transition of care setting from hospital to 
home or other healthcare facility. With technical assistance provided 
by CDC, awardees have worked on identifying and using data systems to 
systematically collect and report data on all three phases of the 
stroke care continuum and on hospital capacity.
    PCNASP had OMB approval for the collection of pre-hospital (EMS), 
in-hospital, and post-hospital patient care data, as well as hospital 
inventory data (OMB No. 0920-1108). This approval expired on 3/31/2019, 
and awardees have discontinued data submission. The lapsed information 
collection will resume after OMB approval of a reinstatement package.
    When possible, in-hospital patient care data continues to align 
with standards set by The Joint Commission (TJC) and the American Heart 
Association's Get With The Guidelines (GWTG) program. There are no 
changes to the estimated burden for the collection of in-hospital data. 
The average burden per response remains 30 minutes for awardees, for a 
total of 18 hours annually.
    Data collection methods for pre- and post-hospital care data are 
revised to allow for information collection through existing data 
systems, including GWTG and the National Emergency Medical Services 
Information System (NEMSIS). CDC has worked with awardees, the American 
Heart Association and NEMSIS to identify areas of alignment and new 
collaboration to reduce the burden of pre-hospital data collection. The 
average burden per response will vary from 30 minutes to two hours. 
Thus, the burden for pre-hospital data is being reduced from 96 to 60 
burden hours annually. Similarly, the burden for post-hospital data is 
reduced from 38 to 22 burden hours annually, because data collection 
will occur using GWTG or another similar mechanism, and data will be 
transmitted automatically to awardees. The average burden per response 
will vary from 30 minutes to two hours per quarter for post-hospital 
data collection.
    Primary data collection of hospital inventory data is collected to 
understand the capacity and infrastructure of the hospitals that admit 
and treat stroke patients. The average burden per response remains 30 
minutes for hospitals, and eight hours for each PCNASP awardee to 
prepare an aggregate hospital inventory file. The number of respondents 
is increasing from 315 to 378 hospital partners due to increased 
participation in PCNASP. Thus, the burden for hospital inventory data 
is increasing from 230 to 261 hours annually.
    These requested changes will result in a net decrease in total 
average burden from 382 to 361 hours. All patient, hospital, and EMS 
provider data that is submitted to CDC by PCNASP awardees will be de-
identified and transmitted through secure data systems. Proposed data 
elements and quality indicators may be updated over time to include new 
or revised items based on evolving recommendations and standards in the 
field to improve the quality of stroke care.
    OMB approval is requested for three years. Participation is 
voluntary and there are no costs to respondents other than their time.

[[Page 28822]]



                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                                      Average
                                                                     Number of       Number of      burden per
          Type of respondents                   Form name           respondents    responses per   response  (in
                                                                                    respondent        hours)
----------------------------------------------------------------------------------------------------------------
PCNASP Awardee........................  Hospital inventory......               9               1               8
--                                      In-hospital care data...               9               4           30/60
                                        Pre-hospital care data..               2               4           30/60
                                        7                                      4               2
                                        Post-hospital transition               7               4           30/60
                                         of care data.
                                        2                                      4               1
PCNASP Hospital Partners..............  Hospital Inventory......             378               1           30/60
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2019-13054 Filed 6-19-19; 8:45 am]
 BILLING CODE 4163-18-P