17128 Federal Register / Vol. 76, No. 59 / Monday, March 28, 2011 / Notices 

information collections must be directed 

to the OS Paperwork Clearance Officer 

at the above e-mail address within 60- 

days. 

Proposed Project: Application Packets 

for Real Property for Public Health 

Purposes—OMB No. 0937–0191— 

Extension—Office of Assistant Secretary 

for Administration– Program Support 

Center/Federal Property Assistance 

Program. 

Abstract: These applications are 

completed and submitted to HHS by 

State and local governments and 

nonprofit institutions when applying for 

acquisition of excess/surplus, 

underutilized/unutilized, and/or off-site 

Federal real property. Submitted 

applications are used to determine if 

institutions/organizations are eligible to 

purchase, lease or use property under 

the provisions of the surplus real 

property program. 

ESTIMATED ANNUALIZED BURDEN TABLE

Type of respondent Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Total burden 

hours 

State, local, or tribal governments, nonprofits ................................................. 20 1 200 4,000 

Seleda Perryman, 

Office of the Secretary, Paperwork Reduction 

Act Clearance Officer. 

[FR Doc. 2011–7168 Filed 3–25–11; 8:45 am] 

BILLING CODE 4151–17–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

[Document Identifier: 0990–New; 60-Day 

Notice] 

Agency Information Collection 

Request. 60-Day Public Comment 

Request 

AGENCY: Office of the Secretary, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Office of the Secretary (OS), Department 

of Health and Human Services, is 

publishing the following summary of a 

proposed information collection request 

for public comment. Interested persons 

are invited to send comments regarding 

this burden estimate or any other aspect 

of this collection of information, 

including any of the following subjects: 

(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. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, email your request, 

including your address, phone number, 

OMB number, and OS document 

identifier, to 

Sherette.funncoleman@hhs.gov, or call 

the Reports Clearance Office at (202) 

690–6162. Written comments and 

recommendations for the proposed 

information collections must be directed 

to the OS Paperwork Clearance Officer 

at the above e-mail address within 60- 

days. 

Proposed Project: The Children’s 

Health Insurance Program 

Reauthorization Act (CHIPRA) 10-State 

Evaluation—OMB No. 0990–NEW— 

Assistant Secretary Planning and 

Evaluation (ASPE). 

Abstract: The Office of the Assistant 

Secretary for Planning and Evaluation 

(ASPE) is requesting the Office of 

Management and Budget (OMB) 

approval on a new collection to provide 

the Federal government with new and 

detailed insights into how the 

Children’s Health Insurance Program 

(CHIP) has evolved since its early years, 

what impacts on children’s coverage 

and access to care have occurred, and 

what new issues have arisen as a result 

of policy changes related to CHIPRA 

and the Patient Protection and 

Affordable Care Act (The Affordable 

Care Act) of 2010 (Pub. L. 111–148). The 

evaluation will address numerous key 

questions regarding the structure and 

impact of CHIP and Medicaid programs 

for children. To answer these questions, 

ASPE will draw on three new primary 

data collection efforts, including a 

survey of selected CHIP enrollees and 

disenrollees in 10 states (and Medicaid 

enrollees and disenrollees in 3 of these 

states), qualitative case studies in the 10 

states, and a survey of State Program 

Administrators in all 50 States and the 

District of Columbia. This current 

request seeks clearance for the first two 

information collections; ASPE will seek 

clearance for the third information 

collection at a later date. All data 

collection will take place one time only 

over a three year period. The survey 

component includes a sample of 

children in 10 selected states, recently 

enrolled or disenrolled in CHIP or 

Medicaid. Survey data will be collected 

using computer-assisted telephone 

interviewing with an in-person followup. The qualitative case studies will 

include site visit interviews with CHIP 

and Medicaid administrators and public 

and child health stakeholders, plus 

focus groups with parents or family 

members of CHIP enrollees. 

ESTIMATED ANNUALIZED BURDEN TABLE

Forms Type of respondent Number of 

respondents 

Number of 

responses per 

respondent 

Average burden 

per response 

(in hours) 

Total burden 

hours 

Survey of CHIP Enrollees and 

Disenrollees.

CHIP enrollees and 

disenrollees.

15,000 1 30/60 7,500 

Survey of Medicaid Enrollees 

and Disenrollees.

Medicaid enrollees and 

disenrollees.

4,500 1 30/60 2,250 

Site Visits .................................. CHIP and Medicaid personnel—1.300 1 1 300 

Focus Groups ........................... Parents and other family members of children—2.80 1 2 160 


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Federal Register / Vol. 76, No. 59 / Monday, March 28, 2011 / Notices 17129 

ESTIMATED ANNUALIZED BURDEN TABLE—Continued 

Forms Type of respondent Number of 

respondents 

Number of 

responses per 

respondent 

Average burden 

per response 

(in hours) 

Total burden 

hours 

Total Burden ...................... ................................................... ............................ ............................ ............................ 10,210 

Seleda Perryman, 

Office of the Secretary, Paperwork Reduction 

Act Clearance Officer. 

[FR Doc. 2011–7169 Filed 3–25–11; 8:45 am] 

BILLING CODE 4150–05–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

[Document Identifier: OS–0990–0371] 

Agency Information Collection 

Request. 60-Day Public Comment 

Request 

AGENCY: Office of the Secretary, HHS. 

In compliance with the requirement 

of section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995, the 

Office of the Secretary (OS), Department 

of Health and Human Services, is 

publishing the following summary of a 

proposed information collection request 

for public comment. Interested persons 

are invited to send comments regarding 

this burden estimate or any other aspect 

of this collection of information, 

including any of the following subjects: 

(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. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, e-mail your request, 

including your address, phone number, 

OMB number, and OS document 

identifier, to 

Sherette.funncoleman@hhs.gov, or call 

the Reports Clearance Office on (202) 

690–6162. Written comments and 

recommendations for the proposed 

information collections must be directed 

to the OS Paperwork Clearance Officer 

at the above email address within 7 

days. 

Proposed Project: Evaluation of 

SAMHSA Primary and Behavioral 

Health Care Integration Grant Program. 

OMB No. 0990–0371—Revision— 

Assistant Secretary for Planning and 

Evaluation (ASPE). 

Abstract: The Assistant Secretary for 

Planning and Evaluation (ASPE) and the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) are 

funding an independent evaluation of 

the Substance Abuse and Mental Health 

Services Administration/Center for 

Mental Health Services’ (SAMHSA/ 

CMHS) Primary and Behavioral Health 

Care Integration (PBHCI) grant program. 

Four-year PBHCI grants for up to 

$500,000 per year were awarded to 

thirteen grantees on September 30, 

2009. A second group of nine grants and 

a third group of 34 grants were awarded 

September 30, 2010, for a total of 56 

grants. The purpose of the PBHCI 

program is to improve the overall 

wellness and physical health status of 

people with serious mental illnesses 

(SMI), including individuals with cooccurring substance use disorders, by 

supporting communities to coordinate 

and integrate primary care services into 

publicly-funded community mental 

health and other community-based 

behavioral health settings. The 

information collected through the 3 year 

evaluation will assist SAMHSA in 

assessing whether integrated primary 

care services produce improvements in 

the physical and mental health of the 

SMI population receiving services from 

community-based behavioral health 

agencies. Data will be collected from 

grantee staff at all sites and from clients 

at up to 10 sites (client exam/survey). 

An Emergency Clearance Request 

covering the first six months of data 

collection starting February 15, 2011 

and ending August 14, 2011 was 

approved February 15, 2011. This 

submission will cover data collection 

for the period starting August 15, 2011 

and ending October 1, 2013. 

ESTIMATED ANNUALIZED BURDEN TABLE

Type of respondent Instrument name Number of 

respondents 

Number 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Total burden 

hours 

Grantee Data Staff ............................ Individual Service Utilization Data ... 56 4 8 1,792 

Grantee Data Staff ............................ TRAC Indicators ............................... 56 1,000 5/60 4,667 

Grantee Project Directors ................. Quarterly Reports ............................. 56 4 2 448 

SMI Clients ........................................ Client Exam and Survey-Baseline ... 1,000 1 45/60 750 

SMI Clients ........................................ Client Exam and Survey-Follow-up 1667 1 45/60 1,250 

Grantee Leadership .......................... Site Visit Interview ............................ 40 1 2 80 

Grantee MH Providers ...................... Site Visit Interview ............................ 40 1 1 40 

Grantee PH Providers ....................... Site Visit Interview ............................ 40 1 1.5 60 

Grantee Care Coordinators .............. Site Visit Interview ............................ 20 1 1.5 30 

Control Site Leadership .................... Site Visit Interview ............................ 50 1 2 100 

Grantee Key Staff ............................. Web Survey ...................................... 560 1 1.5 840 

Total ........................................... ........................................................... ........................ ........................ ........................ 10,057 


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