[Federal Register Volume 87, Number 111 (Thursday, June 9, 2022)]
[Notices]
[Pages 35220-35223]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-12391]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Public Comment Request; Maternal and Child Health Bureau Performance 
Measures for Discretionary Grant Information System (DGIS), OMB No. 
0915-0298--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. OMB may act on HRSA's ICR only after the 30-day 
comment period for this Notice has closed.

DATES: Comments on this ICR should be received no later than July 11, 
2022.

ADDRESSES: Written 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 Review--Open for 
Public Comments'' or by using the search function.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email Samantha Miller, the acting 
HRSA Information Collection Clearance Officer at [email protected] or 
call (301) 443-9094.

SUPPLEMENTARY INFORMATION: 
    Information Collection Request Title: Maternal and Child Health 
Bureau (MCHB) Performance Measures for Discretionary Grant Information 
System (DGIS), OMB No. 0915-0298--Revision.
    Abstract: Approval from OMB is sought to implement minor revisions 
to the MCHB Performance Measures for DGIS. Most of these measures are 
specific to certain types of programs and are not required of all 
grantees. The measures are categorized by domain (Adolescent Health, 
Capacity Building, Child Health, Children with Special Health Care 
Needs, Lifecourse/Crosscutting, Maternal/Women Health, and Perinatal/
Infant Health), in addition to some program-specific measures. Grant 
programs are assigned domains based on their activities and individual 
grantees respond to only a limited number of performance measures that 
are relevant to their specific program.
    HRSA intends to change the numbering sequence of the DGIS forms in 
an approach different from what was outlined in the Federal Register 
notice (87 FR 3313) published on January 21, 2022. The approach 
outlined in the January 21, 2022, notice provided for the re-use of 
form numbers by reordering the form sequence to accommodate the forms 
being removed and added. After further consideration, HRSA intends to 
retire the number associated with the six DGIS forms being removed and 
give the new DGIS Training form the next number in the numbering 
sequence (Training Form 15, which was previously labeled as Training 
Form 14 in the January 21, 2022, notice). This streamlined approach 
will prevent confusion among grantees and HRSA when referencing the 
forms after they are updated in DGIS.
    No additional forms are proposed to be added, removed, or revised 
beyond what was specified in the January 21, 2022, notice. As noted in 
the January 21, 2022, notice, HRSA is making the following changes to 
the current information collection for MCHB DGIS to more closely align 
data collection forms with the program activities:
    Removing the following existing forms: Core 1 (Grant Impact), 
Capacity Building 2 (Technical Assistance), Capacity Building 7 (Direct 
Annual Access to MCH Data), Training Form 13 (Diverse Adolescent 
Involvement (Leadership Education in Adolescent Health Program -
specific)), Financial Form 2 (Project Funding Profile), and Financial 
Form 4 (Project Budget and Expenditures);
    Adding the following new forms: Training Form 15 (Consultation and 
Training for Mental and Behavioral Health) and Leadership, Education, 
and Advancement in Undergraduate Pathways Training Program Trainee 
Information Form. The title of Training Form 15 was changed from 
``Teleconsultation'' to ``Consultation'' to acknowledge that some 
programs that report on this form may also have an in-person 
consultation component. Therefore, the form was updated to capture both 
teleconsults and in-person consults and the title was adjusted to 
represent this change;
    Revising the following existing forms: F2F (Family to Family Form 
1), Financial Form 1 (MCHB Project Budget Details), Financial Form 4 
(new name:

[[Page 35221]]

Maternal & Child Health Discretionary Grant Project Abstract), MCH 
Training Program Data Forms, Core 3 (Health Equity), Financial Form 3 
(Budget Details by Types of Individuals Served), Financial Form 5 
(Number of Individuals Served (Unduplicated)), and Financial Form 6 
(Project Abstract); and
    Moving the following form to a new category: Core 2 (Quality 
Improvement) will become Capacity Building 8 (Quality Improvement). 
Moving this form out of the Core category and into the Capacity 
Building category will allow HRSA to assign this form to only 
applicable grantees. Note that in the January 21, 2022, notice, Core 2 
was proposed to become Capacity Building 4, however, due to the 
decision to change the numbering sequence in the DGIS, the form will 
now use the next number in the numbering sequence (following Capacity 
Building 7).
    Non-substantive revisions also include updates to terminology, 
goals, benchmark data sources, and significance sections included in 
the measures' detail sheets. A performance measure detail sheet defines 
and describes each performance measure. Forms and detail sheets showing 
the proposed revisions are available upon request.
    In response to the notice published on January 21, 2022, HRSA 
received six requests to view the proposed revisions and six public 
comments. One comment, with which the Department agrees, conveyed 
support for the proposed DGIS form updates and relayed that it will 
improve their organization's ability to understand trainees with 
relation to gender diversity and decrease the burden of completing DGIS 
reporting. Another comment also conveyed support for removing several 
forms to alleviate reporting burden, with which the Department agrees. 
In addition, this same commenter supported the proposal to align the 
age ranges across DGIS measures, specifically between Form 5 and Form 
3, with which the Department also agrees. This commenter also relayed 
concern over the administrative burden required to count and report 
specialty providers by specialty type for trainings and requested 
clearer guidance for how to accurately count provider types in Training 
Form 15 (referenced as Training Form 14 in the January 21, 2022, 
notice). Finally, the commenter relayed concern that requiring 
providers to submit data to HRSA (for purposes of Training Form 15) 
could preclude providers from participating in the program given their 
limited resources. The Department appreciates the challenges of 
providers reporting data; however, this information is critical for 
HRSA to be able to track program impact.
    Similar comments regarding count of providers by specialty type 
were received by a third commenter, with a focus on the difficulty to 
collect this data related to depression training and additional burden 
that is created when the count is required to be de-duplicated by 
provider type. The Department acknowledges counting and reporting 
specialty providers by specialty type requires more effort than 
counting and reporting providers without specialty type. However, 
provider specialty type is crucial to HRSA's ability to measure 
programmatic reach and impact, which is used to inform programmatic and 
policy decision making. To provide better guidance, the form has been 
updated to include ``non-specialty'' to the applicable sections of the 
tables to assist with reporting and the Department will ensure Training 
Form 15 is programmed into DGIS in such a way that it is clearer to the 
grantee that any provider type not listed should be counted in an 
``Other'' category. Additionally, grantees are not expected to de-
duplicate training counts by provider type. If grantees do not have 
information on the type of providers who attended a training, it is 
acceptable to place counts under ``Other.''
    Additional comments received by a fourth commenter on Training Form 
15 included feedback regarding the difficulty for their 
teleconsultation line staff to track and report the number of enrolled 
providers who may be eligible to call the line; the need for 
clarification on how a care coordinator/patient navigator is defined; 
the need for clarification on what ``teleconsultation'' specifically 
entails and what level of provider needs to provide this service; the 
need for clarification around specific terms, including: polysubstance 
use, disruptive, impulse-control, conduct disorders as well as co-
occurring mental and substance use disorders; a request for HRSA to 
make the individuals served screening-level measure optional for 
Maternal Depression and Related Behavioral Disorders (MDRBD) grantees 
similar to Pediatric Mental Health Care Access program (PMHCA) 
grantees; feedback that depending on the specific modality used to 
obtain practice-level screening data, the numerator and denominator 
time frame may not fully align with the federal fiscal year; and a 
request for clarification regarding reporting the number of referrals 
given with a suggestion that HRSA define this measure not as the number 
of referrals provided, but rather as the number of referrals services/
supports that could be offered.
    In response to these comments, the Department has made the 
following updates to Training Form 15: ``if applicable'' has been added 
in the first table requesting the number of providers enrolled AND 
participating; consultation language has been clarified by changing 
``teleconsultation'' to ``consultation,'' which includes both 
teleconsultation and in-person consultation. If a call/contact includes 
both consultation and care coordination support the contact should be 
reported in the ``Both'' category; polysubstance use and co-occurring 
mental and substance use disorders have been removed from the list of 
condition(s) to report why providers contact the program for 
consultation; and the individuals served screening-level measure now 
reflects as optional for MDRBD grantees similar to PMHCA grantees.
    The Department wishes to clarify that family visitors and doulas 
should be reported as Care Coordinators/Patient Navigators if that is 
the role they are filling and reporting the number of referrals given 
is solely for referral and treatment recommendations for providers who 
contact the program. Grantees should be able to collect this 
information at the time the provider contacts the program and no 
updates have been made to the form regarding this question.
    This commenter also provided feedback on the Core Health Equity 
Form, Women and Maternal Health (WMH) 1, 2, and 4, and Financial Forms 
2, 3, and 5 (now Financial Forms 3, 5, and 7). While the commenter 
welcomes the revisions of the Core Health Equity form, they clarified 
that specific health equity goals and objectives being pursued may be 
overarching and aligned with organizational equity aims, and as such, 
progress toward achieving them may be hard to quantify and/or specify 
from a programmatic-level.
    The Department recognizes there may be some overlap with larger 
organizational aims, however, health equity is a focus of MCHB programs 
and it is necessary to capture how grantees are advancing health 
equity. With regards to WMH 1 and 2, the commenter provided feedback 
that it remains difficult to specify/stratify training counts specific 
to pregnancy and postpartum care given that most training is specific 
to the perinatal period. As a result, grantees whose focus spans the 
entirety of the perinatal period like MDRBD grantees would benefit from

[[Page 35222]]

additional reporting instruction on how best to fill out these forms 
and whether to include training counts only in Training Form 15 or in 
WMH 1 and 2 forms as well. The Department recognizes that some programs 
may span pregnancy and postpartum periods, however, there is a need to 
capture prenatal care (WMH 1) in the first trimester and timely 
postpartum visit (WMH 2) separately to demonstrate each of these 
measures are improving.
    The Department wishes to clarify that for programs with trainings 
that may cover pregnancy and post-partum care, these trainings should 
be counted under both WMH 1 and WMH2. These trainings however should 
include content on timely prenatal and timely postpartum care.
    Finally, the commenter requested HRSA consider making the Tier 4 
measure for WMH 4 optional given reporting difficulty and the amount of 
time it would take to enact needed electronic medical record 
modifications and reporting protocols to obtain treatment/referral 
information; any immediate information provided in this area would 
require manual tracking. After further consideration, the Tier 4 
measure for WMH 4 has been updated to reflect its optional status, 
bringing it into alignment with the updates made to Training Form 15. 
Additional comments received by a final commenter on Training Form 15 
included requested clarification on the definition of ``enrolled 
provider,'' guidance for how to classify the reason for provider 
contact, requested clarification on how to count the number and types 
of providers trained, an example for what constitutes ``treatment 
strategies,'' and a specific definition for the term ``treatment.''
    As a result of this feedback, the form has been updated to include 
a footnote which clarifies that an ``Enrolled'' provider is one who is 
currently enrolled in the program even if initial enrollment occurred 
prior to the current reporting period. With regards to classifying the 
reason for a provider contact, the Department clarifies that the intent 
is to not limit responses to specific diagnoses for this question. If a 
specific diagnosis can be captured at the time of the call, it should 
be captured as such. If it cannot, and the reason(s) for the call are 
not included in the provided list, the grantee should capture the 
reason for the call under the response option titled, ``Other (please 
specify).'' In addition, the form has been updated to state ``Treatment 
modality-focused trainings'' instead of ``Treatment strategies-related 
trainings.'' Finally, recognizing each grantee may define ``Treatment'' 
differently, the Department clarifies that ``Treatment'' is broadly 
defined for both PMHCA and MDRBD programs as, ``the provision, 
coordination, or management of health care and related services among 
health care providers.''
    Two additional commenters provided feedback on the Family-to-Family 
(F2F) Form 1. The first commenter provided the following: a 
recommendation that parents of children and youth with special health 
care needs be specified in the definition of the numerator as they are 
in other related statements in the document; concern about the removal 
of the details ``family centered, comprehensive, and coordinated 
system'' in the benchmark data sources replaced with ``a system of 
care,'' with a recommendation of listing additional other benchmarks 
here, such as Healthy People 2030 MICH-19; language that states F2F 
services are either one-to-one or through group training and events, 
with a recommendation to replace ``one-to-one'' with ``individual total 
number of families receiving one-to-one services (including small group 
individualized assistance); use of a Likert scale when capturing the 
percentage of one-to-one services and trainings provided by topic, as 
well as when capturing the percentage of services and trainings to 
professionals/providers provided by topic; use of the term ``American 
Indian or Alaska Native'' instead of ``tribal organization;'' and 
concern about the removal of four subcategories that were previously 
used to report the types of services/trainings provided to families, 
and removal of references to the six core outcomes in the form.
    After considering the feedback, the measure's numerator has been 
revised to state: ``The total number of families of children and youth 
with special health care needs receiving one-to-one services and 
training from Family-To-Family Health Information Centers.'' This 
revision reflects how MCHB tracks and reports program impact.
    Question 1 has been revised to include the phrase, ``small group 
individualized assistance.'' After considering the commenter's use of 
Likert scales when capturing the percentage of one-to-one services and 
trainings provided by topic, as well as when capturing the percentage 
of services and trainings to professionals/providers provided by topic, 
these questions have been removed from the form. After further 
consideration, the four subcategories that were previously used to 
report the types of services/trainings provided to families has been 
added back to the form. Finally, the form has been updated to reflect 
``American Indian or Alaska Native'' instead of ``tribal 
organization.'' This revision aligns all of the selections in table 2c 
of the F2F form to be population focused and not a mix of populations 
and organization.
    With regards to the use of MICH-19 in addition to the benchmark 
data source of MICH-20, the Department intends to proceed with the use 
of MICH-20, as ``systems of care'' includes having a medical home. 
While the title of the objective has changed, the objective of 
receiving care in a system of care is still the same. Finally, with 
regards to the removal of references to the six core outcomes in the 
form: Despite removal from the form, the six core outcomes remain 
foundational for all work to improve systems of care. The Department 
intends to proceed with removal and would like to reiterate that 
grantees can report on the six core outcomes in their annual progress 
report.
    The second commenter on the F2F form mirrored those of the first 
and no additional consideration was necessary.
    Need and Proposed Use of the Information: The performance data 
collected through the DGIS serves several purposes, including grantee 
monitoring, program planning, performance reporting, and the ability to 
demonstrate alignment between MCHB discretionary programs and the Title 
V MCH Services Block Grant program. This revision will facilitate more 
efficient and accurate reporting of information related to Capacity 
Building activities, Financial and Demographic data, and Training 
activities.
    Likely Respondents: The grantees for Maternal and Child Health 
Bureau Discretionary Grant Programs.
    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. The total annual burden hours estimated for 
this ICR are summarized in the table below.

[[Page 35223]]



                                                        Total Estimated Annualized Burden--Hours
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                                                                        Number of      Responses per        Total         Burden hours     Total burden
                                Form                                   respondents       respondent       responses       per response        hours
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Grant Report.......................................................             700                1              700               36           25,200
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    HRSA specifically requests comments on (1) the necessity and 
utility of the proposed information collection for the proper 
performance of the agency's functions, (2) the accuracy of the 
estimated burden, (3) ways to enhance the quality, utility, and clarity 
of the information to be collected, and (4) the use of automated 
collection techniques or other forms of information technology to 
minimize the information collection burden.

Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2022-12391 Filed 6-8-22; 8:45 am]
BILLING CODE 4165-15-P