[Federal Register Volume 84, Number 216 (Thursday, November 7, 2019)]
[Notices]
[Pages 60095-60096]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-24278]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request; Information Collection 
Request Title: Healthy Start Evaluation and Quality Improvement, OMB 
No. 0915-0338--Revision

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA 
has submitted an Information Collection Request (ICR) to the Office of 
Management and Budget (OMB) for review and approval. Comments submitted 
during the first public review of this ICR will be provided to OMB. OMB 
will accept further comments from the public during the review and 
approval period.

DATES: Comments on this ICR should be received no later than December 
9, 2019.

ADDRESSES: Submit your comments, including the ICR Title, to the desk 
officer for HRSA, either by email to [email protected] or by 
fax to (202) 395-5806.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email Lisa Wright-Solomon, the 
HRSA Information Collection Clearance Officer at [email protected] or 
call (301) 443-1984.

SUPPLEMENTARY INFORMATION:
    Information Collection Request Title: Healthy Start Evaluation and 
Quality Improvement. OMB No. 0915-0338--Revision.
    Abstract: The National Healthy Start Program, funded through HRSA's 
Maternal and Child Health Bureau (MCHB), has the goal of reducing 
racial and ethnic disparities in infant mortality and other adverse 
perinatal outcomes. The program began as a demonstration project with 
15 grantees in 1991 and since then has expanded to 101 grantees serving 
communities in 34 states, Washington, DC, and Puerto

[[Page 60096]]

Rico. Healthy Start grantees serve communities with high rates of poor 
perinatal outcomes, including infant mortality at least 1.5 times the 
U.S. national average. These communities are often low-income and in 
geographically, racially, ethnically, and linguistically diverse areas. 
Healthy Start offers services during the perinatal period (before, 
during, and after pregnancy) and the program works with women, infants, 
and families through the first 18 months after birth. The Healthy Start 
program uses four approaches to reduce infant mortality through 
individual services and community support to women, infants, and 
families: (1) Improve women's health, (2) improve family health and 
wellness, (3) promote systems change, and (4) assure impact and 
effectiveness. Over the past few years, MCHB has sought to implement a 
uniform set of data elements for monitoring and conducting an 
evaluation to assess grantees' progress towards these program 
approaches. Under the current OMB approval, the data collection 
instruments for this evaluation include the following: The National 
Healthy Start Program Survey; Community Action Network Survey; Healthy 
Start Site Visit Protocol; Healthy Start Participant Focus Group 
Protocol; and six client-level screening tools: (1) Demographic Intake 
Form, (2) Pregnancy Status/History, (3) Preconception, (4) Prenatal, 
(5) Postpartum, and (6) Interconception/Parenting.
    In this proposed revision, MCHB plans to retain the client-level 
tools, and to eliminate the National Healthy Start Program Survey, 
Community Action Network Survey, Healthy Start Site Visit Protocol, and 
Healthy Start Participant Focus Group Protocol instruments. These 
instruments have been removed to streamline this data collection 
activity for the evaluation. For the six client-level tools, MCHB plans 
to consolidate these into three forms: (1) Background, (2) Prenatal, 
and (3) Parent/Child. These tools have been revised based on the public 
comments received during the 60-day comment period. The purpose of 
these changes is to consolidate items that are duplicated across the 
forms. In addition to consolidating questions across tools, many 
individual items have been eliminated or in some cases reworded in 
order to focus the evaluation more clearly on individual and 
programmatic progress on performance measures. This will shorten the 
revised instruments, center them more clearly on program improvement, 
and decrease the number of personal/sensitive questions.
    In addition to the elimination, consolidation, and rewording of 
several items, questions designed to increase efficiency and accuracy 
in reporting have been added. Specifically, many of the grantees' 
annual reporting requirements require calculations based on infants' 
birth dates, estimated due dates, dates enrolled in the Healthy Start 
program, trimester in which certain health-related activities occurred, 
and so on. These revised tools include the information necessary to 
make these calculations so that annual aggregate reporting will be 
based on individual client-level data. This will increase 
accountability, efficiency, and accuracy in terms of the clients served 
as well as reduce overall burden on the grantees by streamlining 
reporting systems.
    A 60-day notice was published in the Federal Register on January 
31, 2019, vol. 84, no. 21, pp. 753-754. There were 16 public comments.
    Need and Proposed Use of the Information: The purpose of the 
revised data collection instruments will be to assess grantee and 
client-level progress towards meeting Healthy Start program performance 
measures. The data will be used to conduct ongoing performance 
monitoring of the program; thus, meeting program needs for 
accountability, programmatic decision-making, and ongoing quality 
assurance.
    Likely Respondents: Respondents include pregnant women and non-
pregnant women of reproductive age who are served by the Healthy Start 
program as well as any of their spouses/partners or other caregivers 
who are participating in receiving Healthy Start services.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose or provide the 
information requested. This includes the time needed to review 
instructions; to develop, acquire, install and utilize technology and 
systems for the purpose of collecting, validating and verifying 
information, processing and maintaining information, and disclosing and 
providing information; to train personnel and to be able to respond to 
a collection of information; to search data sources; to complete and 
review the collection of information; and, to transmit or otherwise 
disclose the information. Compared to the versions submitted for the 
60-day approval process in January, estimated burden hours have 
increased somewhat as a result of implementing the feedback provided in 
public comments during the 60-day comment period. The total annual 
burden hours estimated for this ICR are summarized in the table below.

                                     Total Estimated Annualized Burden Hours
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                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         hours
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Background......................        * 55,550               1          55,550             .50          27,775
Prenatal........................        * 30,300               1          30,300             .17           5,151
Parent/Child....................        * 30,300               1          30,300             .42          12,726
rrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrr
    Total.......................         116,150  ..............         116,150  ..............          45,652
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* All participants (55,550) complete the Background form, and a subset of these same individuals (30,300) also
  complete the Prenatal or Parent/Child forms, for a total of 116,150 responses.


Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2019-24278 Filed 11-6-19; 8:45 am]
 BILLING CODE 4165-15-P