[Federal Register Volume 86, Number 78 (Monday, April 26, 2021)]
[Notices]
[Pages 22055-22056]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-08573]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-21-1108]


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 December 
3, 2020 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. 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. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. 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 Control 
No. 0920-1108, Exp. 09/30/2022)--Revision--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. However, many 
strokes are preventable, or patient outcomes post-stroke can be 
improved through coordinated care that begins at stroke onset, and is 
delivered in a timely manner.
    Through the Paul Coverdell National Acute Stroke Program (PCNASP), 
CDC has continuously worked to measure and improve acute stroke care 
using well-known quality improvement strategies coupled with frequent 
evaluation of results. There remains a national need to understand best 
practices of stroke systems of care, which includes prevention and 
awareness, use of EMS, in-hospital care, and rehabilitation and 
recovery. PCNASP awardees work statewide with participating hospitals, 
Emergency Medical Services (EMS) agencies, and other healthcare 
partners (e.g., community clinical partners) to improve quality of care 
for stroke patients. These efforts include implementing strategies to 
close the gap on stroke disparities, identifying effective stroke 
treatment centers, building capacity and infrastructure to ensure that 
stroke patients are routed to effective treatment centers in a timely 
manner, and improving transitions of care from the hospital to the next 
care setting.
    The PCNASP's current five-year cooperative agreement started on 
July 1, 2015 and includes nine state health department awardees and 
their selected partners (hospitals, EMS agencies, other healthcare 
facilities). This current funding period 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

[[Page 22056]]

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 currently has OMB approval for the collection of pre-
hospital (EMS), in-hospital, and post-hospital patient care data, as 
well as hospital inventory data (OMB Control No. 0920-1108, Exp. 09/30/
2022). CDC plans to request a revision of this currently approved 
collection, with an extension of three years, reflecting a new Notice 
of Funding Opportunity (NOFO). The new PCNASP cooperative agreement 
will be expanded to include 13 awardees, which will be awarded on or 
about July 1, 2021.
    In-hospital patient care data will continue to align with standards 
set by The Joint Commission (TJC) and the American Heart Association's 
Get With The Guidelines (GWTG) Program. Estimated burden for the 
collection of in-hospital data will increase by a net increase of eight 
hours due to added program awardees under the new cooperative 
agreement. The average burden per response remains 30 minutes for 
awardees, for a total of 26 hours annually.
    Data collection methods for pre-hospital care will continue to be 
collected similarly to the two current methods, depending on awardees' 
access to data sources. These two methods are existing data systems 
currently available to awardees, including the AHA's GWTG and the 
National Emergency Medical Services Information System (NEMSIS). CDC 
has worked to reduce the overall number of required data elements and 
identified areas of alignment with AHA's GWTG. Total average burden 
will decrease due to the reduction in data elements under the new NOFO. 
Depending on the awardees' access to data sources (GWTG or NEMSIS), the 
average burden per response will vary from 30 minutes to one hour. 
Thus, the burden for pre-hospital data is estimated to decrease from 60 
to 46 burden hours annually.
    Under the scope of the new NOFO, patient level post-hospital 
quality of care data will not be collected. Post-stroke transitions of 
care, rehabilitation, and follow-up will be assessed in alignment with 
existing CDC cooperative agreements, such as supporting the development 
of approaches to link patients with community resources and clinical 
services through CDC-RFA-DP18-1817. As a result, burden for this 
collection and transmission will not be included in the overall 
estimation of average burden.
    Primary data collection of hospital inventory data will continue to 
be collected to understand the capacity and infrastructure of the 
hospitals that admit and treat stroke patients. Each hospital will 
report inventory information to its PCNASP awardee annually. The 
average burden per response remains 30 minutes for hospitals. In 
addition, each PCNASP awardee prepares an annual aggregate hospital 
inventory file for transmission to CDC. The average burden of reporting 
hospital inventory information for each PCNASP awardee remains eight 
hours per response. Based on current data and expected number of 
awardees under the new NOFO, we are estimating the number of hospital 
partners per awardee to be 50 hospitals. Due to this increase in 
awardees, the estimated number of hospital respondents is anticipated 
to increase from 378 to 650. Thus, there is a net increase of 136 hours 
for hospitals to collect and transmit this data. The total burden for 
hospital inventory data is increasing from 189 to 325 hours annually.
    These requested changes will result in a net increase in total 
average burden from 361 to 501 hours. All patient, hospital, and EMS 
provider data that is submitted to CDC by PCNASP awardees will be de-
identified and occur 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. CDC requests approval 
for an estimated 501 annualized burden hours. Participation is 
voluntary, and there are no costs to respondents other than their time.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                     Number of    Average burden
          Type of respondents                   Form name            Number of     responses per   per response
                                                                    respondents     respondent      (in hours)
----------------------------------------------------------------------------------------------------------------
PCNASP Awardee........................  Hospital inventory......              13               1               8
                                        In-hospital care data...              13               4           30/60
                                        Pre-hospital care data..               3               4           30/60
                                                                              10               4               1
PCNASP Hospital Partners..............  Hospital Inventory......             650               1           30/60
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-08573 Filed 4-23-21; 8:45 am]
BILLING CODE 4163-18-P