[Federal Register Volume 90, Number 118 (Monday, June 23, 2025)]
[Notices]
[Pages 26592-26594]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-11444]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request; Health Resources and 
Services Administration Uniform Data System

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 
submitted an Information Collection Request (ICR) to the Office of 
Management and Budget (OMB) for

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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 23, 
2025.

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 HRSA 
Information Collection Clearance Officer, at [email protected] or call 
(301) 443-3983.

SUPPLEMENTARY INFORMATION: 
    Information Collection Request Title: HRSA Uniform Data System 
(UDS), OMB No. 0915-0193--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. Sec.  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 15,500 service delivery sites that provide primary health 
care to more than 31 million people in every U.S. state, the District 
of Columbia, Puerto Rico, the U.S. Virgin Islands, and the Pacific 
Basin.
    HRSA uses the UDS for required annual reporting of program-specific 
data by Health Center Program awardees (those funded under section 330 
of the PHS Act); Health Center Program look-alikes (entities meeting 
requirements of, but not funded under, section 330 of the PHS Act); and 
Nurse Education, Practice, Quality and Retention (NEPQR) and Advanced 
Nursing Education (ANE) Program awardees (specifically those funded 
under the practice priority areas of sections 831(b) and 811 of the PHS 
Act). Some NEPQR and ANE Program awardees establish and expand nursing 
practice arrangements in noninstitutional settings to demonstrate 
methods to improve access to primary health care in areas with unmet 
primary health care needs. Such grantees implementing nursing practice 
arrangements have historically used the same data collection system as 
the Health Center Program for their required annual reporting of 
program-specific data.
    A 60-day notice was published in the Federal Register on November 
22, 2024 (89 FR 92692-94). There were 18 public comments. Below is a 
summary of key themes raised in the comments and HRSA's response:
     Many stakeholders expressed strong support for the 
proposed addition of UDS measures and collection, acknowledging their 
potential to enhance care quality and patient outcomes;
     Stakeholders sought clarification on how to accurately 
report on the proposed measures;
     Others leveraged the Federal Register notice comment 
period as an opportunity to propose new measures in the UDS instrument;
     Some commenters expressed concerns about the potential 
increase in reporting burden associated with the proposed changes, 
particularly for health centers without designated Health 
Informaticists; and
     Several commenters recommended expanding upon 2025 UDS 
proposed measures in a future ICR to include mechanisms for assessing 
the outcomes of proposed interventions.
    HRSA directly responded to each stakeholder who submitted comments, 
acknowledging the considerations raised and committed to the continued 
evaluation and exploration of downstream implications for the proposed 
2025 UDS changes. There will be opportunities for stakeholders to 
propose new measures for consideration in future instruments. HRSA did 
not make any changes to the ICR in response to comments received.
    Need and Proposed Use of the Information: HRSA requires the 
collection of information through UDS to monitor and evaluate the 
performance of health centers under section 330 and select NEPQR and 
ANE recipients under sections 831(b) and 811. These data aid in program 
compliance, guide quality improvement initiatives, and inform federal 
health policy decisions. HRSA also leverages UDS data to assess the 
impact of health centers and NEPQR and ANE recipients on patient health 
outcomes and to allocate funding and resources effectively across the 
Health Center Program. To keep this instrument relevant and responsive 
to the Health Center Program's needs and the evolving primary 
healthcare and clinical measurement landscape, periodic updates are 
essential. Updates for the performance year 2025 UDS data collection 
include:

Table 3B (Demographic Characteristics) Updates

     Removal of Patients by Sexual Orientation and Gender 
Identity: Data elements related to sexual orientation and gender 
identity will be removed to align with Administration priorities.

Table 6A (Selected Diagnoses and Services Rendered) Additions

     Tobacco Use Cessation Pharmacotherapies: A new measure is 
being added to line 26c2 to identify the number of visits where 
patients received tobacco cessation pharmacotherapies as an 
intervention and the number of patients who received this pharmacologic 
treatment. While the Preventive Care and Screening: Tobacco Use: 
Screening and Cessation Intervention electronic-specified clinical 
quality measure (CMS138v12) (Table 6B, Line 14a) that is currently 
reported in the UDS assesses for cessation, the way the measure is 
specified for reporting by its measure steward does not allow the 
disaggregation for the percentage of patients receiving counseling or 
recommendation to cessation pharmacotherapies. Adding a unique UDS line 
for reporting tobacco use cessation pharmacotherapies will promote 
greater understanding of the breadth of tobacco cessation interventions 
provided at health centers, specifically allowing HRSA to see 
differences in tobacco use cessation approaches.
     Medications for Opioid Use Disorder (MOUD): A new measure 
for MOUD services will be reported on line 26c3 for the number of 
visits where MOUD was administered and the number of patients who 
received this medication-based intervention. This new measure will 
complement and enhance the existing MOUD-related measures currently 
reported in Appendix E: Other Data Elements (e.g., number of providers 
who treat opioid use disorder with MOUD). The inclusion of this measure 
is critical for enhancing efforts to address the ongoing opioid 
epidemic. Additional examination of the use of MOUD in health centers 
is necessary to better understand existing services and identify 
potential healthcare gaps.
     Alzheimer's Disease and Related Dementias (ADRD) 
Screening: A new measure is being added to line 26f to capture the 
number of visits where patients received ADRD screenings and

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the number of patients who received the screenings. This measure will 
encompass assessments representing standardized tools used for the 
evaluation of cognition and mental status of older adults. The addition 
of this measure to capture screening of ADRD will be valuable in 
understanding the level of need and resources required to continue to 
support the growing aging population served by the Health Center 
Program and will foster early detection of ADRD.

Table 6B (Quality of Care Measures) Addition

     Initiation and Engagement of Substance Use Disorder 
Treatment: A new measure with two distinct rates is being added to 
Lines 23a and b to capture the initiation and engagement of substance 
use disorder treatment, in alignment with electronic-specified clinical 
quality measure CMS137v13. This measure will report on the percentage 
of patients 13 years and older with a new substance use disorder 
episode who received treatment, including (a) those who initiated 
treatment within 14 days and (b) those who engaged in ongoing treatment 
within 34 days of the initiation. By incorporating this measure, HRSA 
strengthens its alignment with national performance standards and gains 
greater insight into health centers' effectiveness in initiating and 
engaging patients in substance use disorder treatment.

Table 6B (Quality of Care Measures) and Table 7 (Health Outcomes) 
Updates

     Tables 6B and 7 collect UDS clinical quality measures,\1\ 
and where applicable, clinical quality measures will be updated in 
alignment with specifications of the issued performance year 2025 
electronic-specified clinical quality measures. These specifications 
were released by the Centers for Medicare & Medicaid Services on May 2, 
2024, for use by eligible providers.\2\ Clinical performance measure 
alignment across national programs promotes data standardization, 
quality, and transparency, and decreases reporting burden for providers 
and organizations participating in multiple federal programs.
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    \1\ https://www.cms.gov/medicare/quality/measures.
    \2\ https://ecqi.healthit.gov/now-available-updated-ecqm-specifications-and-implementation-resources-2025-performance/reporting-period.
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    Likely Respondents: Respondents will include Health Center Program 
award recipients and Health Center Program look-alikes carrying out 
programs under section 330 of the PHS Act and NEPQR and ANE award 
recipients funded under the practice priority areas of section 831(b) 
and 811 of the PHS Act.
    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      Number of
           Form name              respondents   responses per      Total      Average burden per   Total burden
                                       *          respondent     responses   response (in hours)       hours
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Universal Report...............      1,538.00             1.00     1,538.00  238................      366,044.00
Grant Report...................        420.00             1.22       512.40  22.................       11,272.80
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    Total......................      1,958.00  ...............     2,050.40  ...................      377,316.80
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* The estimated number of respondents for the Universal Report consists of 1,363 Health Center Program awardees,
  133 Health Center Look-alikes, and 42 NEPQR and ANE respondents. The estimated number of respondents for the
  ``Grant Report'' is based on the number of reports submitted by health centers in 2024: 339 (1 report), 70 (2
  reports), 11 (3 reports).


Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2025-11444 Filed 6-20-25; 8:45 am]
BILLING CODE 4165-15-P