[Federal Register Volume 87, Number 199 (Monday, October 17, 2022)]
[Notices]
[Pages 62861-62863]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-22510]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Public Comment Request; Information Collection Request Title: Health 
Center Program Forms OMB No. 0915-0285 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 requirement for opportunity for public 
comment on proposed data collection projects of the Paperwork Reduction 
Act of 1995, HRSA announces plans to submit an Information Collection 
Request (ICR), described below, to the Office of Management and Budget 
(OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the 
public regarding the burden estimate, below, or any other aspect of the 
ICR.

DATES: Comments on this ICR should be received no later than December 
16, 2022.

ADDRESSES: Submit your comments to [email protected] or mail the HRSA 
Information Collection Clearance Officer, Room 14N136B, 5600 Fishers 
Lane, Rockville, MD 20857.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the data collection plans and 
draft instruments, email [email protected] or call Samantha Miller, 
the acting HRSA Information Collection Clearance Officer at (301) 443-
9094.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the information request collection title 
for reference.
    Information Collection Request Title: Health Center Program Forms, 
OMB No. 0915-0285 Revision.
    Abstract: The Health Center Program, administered by HRSA, is 
authorized under section 330 of the Public Health Service (PHS) Act (42 
U.S.C. 254b). Health centers are community-based and patient-directed 
organizations that deliver affordable, accessible, quality, and cost-
effective primary health care services to patients regardless of their 
ability to pay. Nearly 1,400 health centers operate approximately 
14,000 service delivery sites that provide primary health care to more 
than 30 million people in every U.S. state, the District of Columbia, 
Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin. HRSA uses 
forms for new and existing health centers and other entities to apply 
for various grant and non-grant opportunities, renew grant and non-
grant designations, report progress, and change their scopes of 
project.
    Need and Proposed Use of the Information: Health Center Program-
specific forms are necessary for award processes and oversight of the 
Health Center Program and other relevant programs. These forms provide 
HRSA staff and objective review committee panels with information 
essential for application evaluation, funding recommendation and 
approval, designation, and monitoring. These forms also provide HRSA 
staff with information essential for evaluating compliance with Health 
Center Program statutory and regulatory requirements.

[[Page 62862]]

HRSA intends to make several changes to its forms:
     HRSA will modify the following forms to streamline and 
clarify data currently being collected: 1A, 1B, 1C, 2, 4, 6A, 8, 
Checklist for Adding a New Service, Checklist for Adding a New Service 
Delivery Site, Checklist for Adding a New Target Population, Checklist 
for Deleting Existing Service, Checklist for Deleting Existing Service 
Delivery Site, Expanded Services Patient Impact, Health Center 
Controlled Networks Progress Report, Native Hawaiian Health Care 
Improvement Act (NHHCIA) Non-Competing Continuation (NCC) Clinical and 
Financial Performance Measures, NHHCIA NCC Income Analysis Form, NHHCIA 
NCC Project Work Plan Progress Report, NHHCIA NCC Project Work Plan 
Update, Operational Plan, Project Narrative Update, Project Overview 
Form, Project Work Plan, and the Summary Page--Service Area 
Competition.
     HRSA will add forms necessary for funding applications and 
program monitoring: Applicant Qualification Criteria Form, Financial 
Performance Indicators, Funding Request Summary Form, fiscal year (FY) 
2022 Accelerating Cancer Screening Progress Report, Patient Impact 
Form, Project Cover Page, Progress Report--Non-Capital Investments, 
School-Based Health Center Location Form, Quality Improvement Fund 
(QIF) Evaluative Measures Report, QIF Project Plan Form and QIF 
Progress Report.
     HRSA will remove forms to further streamline information 
collected by HRSA and reduce burden: Clinical Performance Measures, 
Diabetes Action Plan, Expanded Services, Financial Performance 
Measures, FY 2018 Expanding Access to Quality Substance Use Disorder--
Mental Health Integrated Behavioral Health Services Progress Reporting, 
Health Center Program Supplemental Information, HRSA Electronic 
Handbooks Action Plan, and the Program Specific Form Instructions.
    Likely Respondents: Health Center Program award recipients (those 
funded under section 330 of the PHS Act) and Health Center Program 
look-alikes, state and national technical assistance organizations, and 
other organizations seeking funding.
    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.
    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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Applicant Qualification Criteria             500               1             500            1.00             500
 Form...........................
Capital Semi Annual Progress               1,317               2           2,634            1.00           2,634
 Report.........................
Checklist for Adding a New                   450               1             450            2.00             900
 Service........................
Checklist for Adding a New                 1,480               1           1,480            2.00           2,960
 Service Delivery Site..........
Checklist for Adding a New                   100               1             100            2.00             200
 Target Population..............
Checklist for Deleting Existing              500               1             500            2.00           1,000
 Service........................
Checklist for Deleting Existing              750               1             750            2.00           1,500
 Service Delivery Site..........
Environmental Information and                750               1             750            0.50             375
 Documentation..................
Equipment List..................           1,375               1           1,375            0.50             688
Expanded Services Patient Impact             996               1             996            1.00             996
Federal Object Class Categories              735               1             735            0.25             184
 Form...........................
Financial Performance Indicators              20               1              20            1.00              20
Form 12: Organization Contacts..           1,058               1           1,058            1.00           1,058
Form 1A: General Information               1,058               1           1,058            1.00           1,058
 Worksheet......................
Form 1B: Funding Request Summary           1,000               1           1,000            0.75             750
Form 1C: Documents on File......           1,058               1           1,058            0.50             529
Form 2: Staffing Profile........           1,058               1           1,058            1.00           1,058
Form 3: Income Analysis.........           1,058               1           1,058            1.00           1,058
Form 3A: Look-Alike Budget                    50               1              50            1.00              50
 Information....................
Form 4: Community                          1,058               1           1,058            1.00           1,058
 Characteristics................
Form 5A: Services Provided......           1,058               1           1,058            1.00           1,058
Form 5B: Service Sites..........           1,058               1           1,058            1.00           1,058
Form 5C: Other Activities/                 1,058               1           1,058            1.00           1,058
 Locations......................
Form 6A: Current Board Member              1,058               1           1,058            1.00           1,058
 Characteristics................
Form 6B: Request for Waiver of             1,058               1           1,058            1.00           1,058
 Board Member Requirements......
Form 8: Health Center Agreements           1,058               1           1,058            1.00           1,058
Funding Request Summary Form                 500               1             500            0.50             250
 School-Based Health Center.....
Funding Sources.................             735               1             735            0.50             368
FY2020 Ending the HIV Epidemic               182               1             182            1.00             182
 Primary Care HIV Prevention
 PCHP Progress Reporting........
FY2022 Accelerating Cancer                    10               1              10            1.50              15
 Screening Progress Report......
Health Center Controlled                      90               1              90            1.00              90
 Networks Progress Report.......
Health Center Program Progress               735               1             735            1.00             735
 Report.........................
HRSA Loan Guarantee Program                   20               1              20            1.00              20
 Application....................
NHHCIA NCC Clinical Performance                6               1               6            1.50               9
 Measures.......................
NHHCIA NCC Financial Performance               6               1               6            0.50               3
 Measures.......................
NHHCIA NCC Income Analysis Form.               6               1               6            0.15               1
NHHCIA NCC Project Work Plan                   6               1               6            0.15               1
 Progress Report................

[[Page 62863]]

 
NHHCIA NCC Project Work Plan                   6               1               6            0.15               1
 Update.........................
Operational Plan................             500               1             500            3.00           1,500
Other Requirements for Sites....             600               1             600            0.50             300
Participating Health Centers                  90               1              90            1.00              90
 List...........................
Patient Impact Form.............             500               1             500            1.00             500
Patient Target and Calculations.           1,058               1           1,058            1.00           1,058
Progress Report--Non-Capital               1,400               4           5,600            1.50           8,400
 Investments....................
Project Cover Page..............             735               1             735            1.00             735
Project Narrative Update........             883               1             883            4.00           3,532
Project Overview Form...........             182               1             182            1.00             182
Project Plan....................             182               3             546            1.50             819
Project Qualification Criteria..             735               1             735            1.00             735
Project Work Plan...............             135               1             135            4.00             540
Proposal Cover Page.............             735               1             735            1.00             735
QIF Evaluative Measures Report..              12               1              12            1.50              18
QIF Progress Report.............              12               1              12            1.50              18
QIF Project Plan Form...........             100               1             100            1.00             100
Summary Page (New Access Point-              500               1             500            1.00             500
 Funding Type)..................
Summary Page Service Area                    450               1             450            0.50             225
 Competition....................
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    Total.......................          33,830  ..............          39,711  ..............          46,586
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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. 2022-22510 Filed 10-14-22; 8:45 am]
BILLING CODE 4165-15-P