[Federal Register Volume 86, Number 236 (Monday, December 13, 2021)]
[Notices]
[Pages 70841-70842]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-26903]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[30Day-22-0891]


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 ``World Trade Center Health Program 
Enrollment, Petitions, Designated Representative/HIPAA Authorization, 
and Member Satisfaction'' 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 
July 22, 2021 to obtain comments from the public and affected agencies. 
CDC received three comments related to the previous notice but were 
unrelated to the package. 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, using 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 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

    World Trade Center Health Program Enrollment, Petitions, Designated 
Representative/HIPAA Authorization, and Member Satisfaction (OMB 
Control No. 0920-0891, Exp. 12/31/2021)--Revision--National Institute 
for Occupational Safety and Health (NIOSH), Centers for Disease Control 
and Prevention (CDC).

Background and Brief Description

    NIOSH seeks to request OMB approval to revise the currently 
approved information collection activities that support the World Trade 
Center (WTC) Health Program. The James Zadroga 9/11 Health and 
Compensation Act of 2010 (Pub. L. 111-347, as amended by Pub. L. 114-
113) created the WTC Health Program to provide medical monitoring and 
treatment benefits to eligible firefighters and related personnel, law 
enforcement officers, and rescue, recovery, and cleanup workers who 
responded to the September 11, 2001, attacks in New York City, at the 
Pentagon, and in Shanksville, Pennsylvania (responders), and to 
eligible persons who were present in the dust or dust cloud on 
September 11, 2001, or who worked, resided, or attended school, 
childcare, or adult daycare in the New York City disaster area 
(survivors).
    Since its inception in 2011, the WTC Health Program has been 
approved to collect information from applicants and Program members 
concerning enrollment, appointment of a designated representative or 
third party, member satisfaction, and petitions regarding adding a new 
WTC-related health condition to determine coverage under the Program. 
The currently approved total estimated burden is 14,063 hours annually 
(see OMB Control No. 0920-0891, Exp. 12/31/2021). The WTC Health 
Program has determined that some existing forms need to be updated and 
some need to be removed from the burden table.
    For this revision, the burden hours on the WTC Health Program 
Applications for Enrollment increased due to an expected increase of 
application volume. The Program updated the enrollment applications for 
plain language and improved processing. We estimate 15,837 individuals 
will submit either a FDNY, General Responder, Pentagon/Shanksville 
Responder, or WTC Survivor application annually. The burden estimate 
for the applications is 7,919 hours. This is an increase from 2018 when 
the estimated annualized burden was 2,251. Of the Applications for 
Enrollment, we expect to receive per year, we estimate 3,830 of them 
are General Responder applications from the NY/NJ area and will have to 
select which clinic they would like to visit. It is expected that it 
will take the member 0.25 hours to complete the postcard. The burden 
hours for the General Responder Clinic Postcard are 958 hours.
    The Program finds it necessary to update and add new forms to allow 
applicants and Program members to grant permission to share information 
with a designated representative or third person about an individual's 
application or case. We estimate that 1,300 applicants and members will 
submit a Designated Representative Appointment Form and Designated 
Representative HIPAA Authorization Form annually. These forms will take 
approximately 0.25 hours to complete. The burden estimate for these 
forms is 650 hours.
    The Program proposes to extend this information collection to 
account for adding the WTCHP HIPAA Authorization for Deceased 
Individuals, WTCHP General HIPAA Authorization to Third Parties, and 
Designated Representative Revocation Form. The WTCHP HIPAA 
Authorization for Deceased Individuals was created so a family member 
and/or personal representative of a deceased applicant or member can 
request program documentation and/or medical records related to the 
deceased applicant/member. The WTCHP General HIPAA Authorization to 
Third Parties was created for members to give the Program permission to 
share information about their case with a third party, such as a 
lawyer. The Designated Representative Revocation Form was created for 
members who wish to remove or replace a currently appointed designated 
representative. We estimate that 30 applicants or members will submit a

[[Page 70842]]

WTCHP HIPAA Authorization for Deceased Individuals, 30 applicants will 
submit a WTCHP General HIPAA Authorization to Third Parties form, and 
15 applicants or members will submit a Designated Representative 
Revocation Form annually. These forms will take no longer than 0.25 
hours to complete. The total burden estimate for the WTCHP HIPAA 
Authorization for Deceased Individuals form and the WTCHP General HIPAA 
Authorization to Third Parties form is eight hours. The total burden 
estimate for the Designated Representative Revocation Form is four 
hours.
    The Program also finds it necessary to add a Member Satisfaction 
Survey. This survey is for WTC Health Program members and asks for 
feedback about their satisfaction in the Program, at their clinic, and 
how they would like to receive Program communications. The survey 
should take no longer than 0.5 hours to complete for a burden estimate 
of 3,300 burden hours.
    The Petition for the addition of a new WTC-Related Health Condition 
for Coverage was previously approved in 2018. The burden hours for the 
Petition form decreased to 35 as the Program has received less 
petitions than anticipated in 2018. The Zadroga Act identified a list 
of health conditions for which individuals who are enrolled in the WTC 
Health Program may be monitored or treated [Title XXXIII, Sec.  
3312(a)(3)]; those conditions are reiterated and expanded in the 
associated WTC Health Program regulations at 42 CFR 88.15. Under the 
regulations, interested parties may submit a petition to request that a 
new health condition be added to the list of conditions specified in 
Sec.  88.15. The forms should take no longer than one hour to complete 
for a burden estimate of 35 burden hours.
    CDC requests OMB approval for an estimated 12,882 burden hours. 
There are no costs to respondents other than their time to participate.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                                       Average
                                                                         Number of      Number of     burden per
          Type of respondents                     Form name             respondents   responses per    response
                                                                                       respondent     (in hours)
----------------------------------------------------------------------------------------------------------------
FDNY Responder........................  WTC Health Program FDNY                 140               1        30/60
                                         Responder Eligibility
                                         Application for Enrollment.
General Responder.....................  WTC Health Program Responder          6,215               1        30/60
                                         Eligibility Application for
                                         Enrollment (Other than FDNY).
Pentagon/Shanksville Responder........  WTC Health Program Pentagon/            242               1        30/60
                                         Shanksville Responder
                                         Application for Enrollment.
WTC Survivor..........................  WTC Health Program Survivor           9,240               1        30/60
                                         Eligibility Application for
                                         Enrollment (all languages).
General responder.....................  Clinic Selection Postcard for         3,830               1        15/60
                                         new general responders in NY/
                                         NJ to select a clinic.
Interested Party......................  Petition for the addition of             35               1            1
                                         health conditions.
Program Applicants or Members.........  Designated Representative             1,300               1        15/60
                                         Appointment Form.
Program Applicants or Members.........  Designated Representative             1,300               1        15/60
                                         HIPAA Release Form to allow
                                         the sharing of member
                                         information with a third
                                         party.
Program Members.......................  Member Satisfaction Survey...         6,600               1        30/60
General Public........................  WTCHP HIPAA Authorization for            30               1        15/60
                                         Deceased Individuals.
Designated Representative.............  WTCHP General HIPAA                      30               1        15/60
                                         Authorization to Third
                                         Parties.
Designated (DR) Representative          DR form that removes the                 15               1        15/60
 Revocation Form.                        members current designated
                                         representative.
----------------------------------------------------------------------------------------------------------------


Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2021-26903 Filed 12-10-21; 8:45 am]
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