[Federal Register Volume 89, Number 44 (Tuesday, March 5, 2024)]
[Notices]
[Page 15808]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-04609]


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 Notices
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  Federal Register / Vol. 89, No. 44 / Tuesday, March 5, 2024 / 
Notices  

[[Page 15808]]



AGENCY FOR INTERNATIONAL DEVELOPMENT


60-Day Notice of Proposed Information Collection: USAID 
Eligibility Questionnaire for HAVANA Act Payments

AGENCY: Agency for International Development.

ACTION: Notice of proposed information collection.

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SUMMARY: The United States Agency for International Development (USAID) 
is seeking Office of Management and Budget (OMB) approval for the 
information collection described below. In accordance with the 
Paperwork Reduction Act of 1995, we are requesting comments on this 
collection from all interested individuals and organizations. The 
purpose of this notice is to allow 60 days for public comment preceding 
submission of the collection to OMB.

DATES: USAID will accept comments from the public. All comments should 
be submitted within 60 calendar days from the date of this publication.

ADDRESSES: Interested parties may submit comments by one of the 
following methods:
    Email: [email protected] with the subject line, HAVANA ACT 
INFORMATION COLLECTION.
    Internet: At www.Regulations.gov, search for this document using 
the subject line, USAID HAVANA ACT PAYMENTS.
    Note that all submissions to www.regulations.gov are public, and 
USAID cannot edit the comments to remove personal information. If you 
have any concerns about your comment being viewed by the public, please 
use the email option above.

FOR FURTHER INFORMATION CONTACT: Direct requests for additional 
information regarding the collection listed in this notice, including 
requests for copies of the proposed collection instrument and 
supporting documents, should be sent to A. Michael Stern, USAID AHI 
Working Group Coordinator, [email protected], (202) 712-5568.

SUPPLEMENTARY INFORMATION: 
    Title of Information Collection: Eligibility Questionnaire for 
HAVANA Act Payments.
    Type of Request: New request for approval of information collection 
method.
    Originating Office: Office of Human Capital and Talent Management.
    Form Number: AID 442-1.
    Respondents: USAID employees, former employees, and their 
dependents, and the qualified physicians whom they have consulted.
    Estimated Number of Respondents: 30.
    Estimated Number of Responses: 30.
    Average Time per Response: 30 minutes.
    Total Estimated Burden Time: 15 hours.
    Frequency: Once.
    Obligation to Respond: Required to Obtain or Retain a Benefit.
    We are soliciting public comments to permit USAID to:
     Evaluate whether the proposed information collection is 
necessary for the proper functions of USAID.
     Evaluate the accuracy of our estimate of the time and cost 
burden for this proposed collection, including the validity of the 
methodology and assumptions used.
     Enhance the quality, utility, and clarity of the 
information to be collected.
     Minimize the reporting burden on those who are to respond, 
including the use of automated collection techniques or other forms of 
information technology.
    Please note that comments submitted in response to this Notice are 
public record. Before including any detailed personal information, you 
should be aware that your comments as submitted, including your 
personal information, will be available for public review.

Abstract of Proposed Collection

    On October 8, 2021, President Biden signed the ``Helping American 
Victims Affected by Neurological Attacks'' (HAVANA) Act of 2021 (Pub. 
L. 117-46). In this statute, Congress authorized federal agencies to 
make payments to affected current employees, former employees, and 
their dependents for qualifying injuries to the brain. The AID 442-1 
form provides the required medical substantiation for claims filed 
pursuant to the HAVANA Act and USAID's recent rule, which was issued in 
the Federal Register on June 26, 2023.

Methodology

    An individual wishing to make a claim under the HAVANA Act will 
fill out the ``Patient Demographics'' portion of the AID 442-1, and 
provide it to a U.S. board-certified physician (currently certified by 
the American Board of Psychiatry and Neurology (ABPN) or the American 
Board of Physical Medicine and Rehabilitation (ABPMR)), who will 
complete the form after examining the individual and reviewing their 
records and will fax or email the completed form to USAID.

Aaron Michael Stern,
Supervisory Program Officer.
[FR Doc. 2024-04609 Filed 3-4-24; 8:45 am]
BILLING CODE 6116-01-P