Federal Register / Vol. 69, No. 200 / Monday, October 18, 2004 / Notices 61393

information systems and to prevent 

unauthorized access. 

This system will conform to all 

applicable Federal laws and regulations 

and Federal, HHS, and CMS policies 

and standards as they relate to 

information security and data privacy. 

These laws and regulations include but 

are not limited to: the Privacy Act of 

1974; the Federal Information Security 

Management Act of 2002; the Computer 

Fraud and Abuse Act of 1986; the 

Health Insurance Portability and 

Accountability Act of 1996; the EGovernment Act of 2002, the ClingerCohen Act of 1996; the Medicare 

Modernization Act of 2003, and the 

corresponding implementing 

regulations. OMB Circular A–130, 

Management Of Federal Resources, 

Appendix III, Security of Federal 

Automated Information Resources also 

applies. Federal, HHS, and CMS 

policies and standards include but are 

not limited to: all pertinent NIST 

publications; the HHS Automated 

Information Systems Security Handbook 

and the CMS Information Security 

Handbook. 

RETENTION AND DISPOSAL: 

Records are maintained in a secure 

storage area with identifiers. Disposal 

occurs three years from the last action 

on the hospital’s cost report, and should 

be coordinated with disposal of the 

reports. 

SYSTEM MANAGER AND ADDRESS: 

Director, Division of Managed Care 

Operations, Information Services 

Modernization Group, Office of 

Information Services, CMS, 7500 

Security Boulevard, N3–16–24, 

Baltimore, Maryland 21244–1850. 

NOTIFICATION PROCEDURE: 

For purpose of access, the subject 

individual should write to the systems 

manager who will require the system 

name, SSN, address, date of birth, sex, 

and for verification purposes, the 

subject individual’s name (woman’s 

maiden name, if applicable). Furnishing 

the SSN is voluntary, but it may make 

searching for a record easier and prevent 

delay. 

RECORD ACCESS PROCEDURE: 

For purpose of access, use the same 

procedures outlined in Notification 

Procedures above. Requestors should 

also reasonably specify the record 

contents being sought. (These 

procedures are in accordance with 

Department regulation 45 CFR 

5b.5(a)(2)). 

CONTESTING RECORD PROCEDURES: 

The subject individual should contact 

the system manager named above, and 

reasonably identify the record and 

specify the information to be contested. 

State the corrective action sought and 

the reasons for the correction with 

supporting justification. (These 

procedures are in accordance with 

Department regulation 45 CFR 5b.7). 

RECORD SOURCE CATEGORIES: 

Data for this system is collected from 

MCO (which obtained the data from the 

individuals concerned), Social Security 

Administration, and the Enrollment 

Database system of records. 

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS

OF THE ACT: 

None.

[FR Doc. 04–23251 Filed 10–15–04; 8:45 am] 

BILLING CODE 4120–03–P

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects 

Title: Building Strong Families 

Demonstration and Evaluation—

Baseline Information. 

OMB No.: New Collection. 

Description: The proposed 

information collection activity is for 

baseline information during eligibility 

screening and enrollment in local 

programs participating in the Building 

Strong Families (BSF) evaluation. The 

BSF evaluation is an important 

opportunity to learn if well-designed 

interventions can help low-income 

couples develop the knowledge and 

relationship skills that research has 

shown are associated with healthy 

marriages. BSF programs will provide 

instruction and support to improve 

marriage and relationship skills and 

enhance couples’ understanding of 

marriage. In addition, BSF programs 

will provide links to a variety of other 

services that could help couples sustain 

a healthy relationship (e.g., employment 

assistance). The evaluation’s goal is to 

include a maximum of six programs that 

will add a BSF component to existing 

services and enroll into the evaluation 

approximately 2,000 couples into each 

program, i.e., 1,000 couples randomly 

assigned to participate in BSF services 

and 1,000 couples in the control group, 

for a total of 12,000 couples (24,000 

individuals). The evaluation will assess 

the net impact of the BSF interventions 

on these two groups. 

Respondents: The respondents for the 

baseline data collection will be lowincome, unmarried, expectant or recent 

parents who volunteer to participate in 

the evaluation. (Some couples may have 

been recently married since the 

conception of their child.) There will be 

four forms used in the baseline data 

collection: (1) The Mother/Father 

Eligibility Checklist; (2) the Consent to 

Participate in the BSF Study Form; (3) 

the Baseline Information Form; and (4) 

the Contact Information Form. The 

Mother/Father Eligibility Checklist will 

be used by program staff to determine if 

respondents meet the minimum 

requirements for participating in the 

BSF program. We estimate that about 25 

percent of couples interviewed will 

meet the eligibility criteria for the 

program. The Consent to Participate in 

the BSF Study Form explains in detail 

the design of the evaluation, the process 

for selection, and the results of agreeing 

to participate in the study (e.g., being 

contacted for follow-up information). 

The Baseline Information Form collects 

basic demographic information about 

respondents, as well as brief 

information concerning pregnancies and 

births, family structure, employment 

and income, and emotional well-being, 

all of which is relevant for the study. 

The Contact Information Form gathers 

information on friends and relatives 

who can assist in locating respondents 

based on respondents’ agreements to 

participate in follow-up surveys that 

will be conducted many months later. 

All forms will be administered to both 

members of the couples by BSF program 

staff members. The forms will be 

administered in a number of different 

settings, but we anticipate the two most 

common will be in hospitals, following 

the birth of children, and in the 

mother’s/father’s home shortly after 

births.

61394 Federal Register / Vol. 69, No. 200 / Monday, October 18, 2004 / Notices 

ANNUAL BURDEN ESTIMATES

Instrument 

Number of 

respondents 

Number of 

responses 

per respondent 

Average burden hours per 

response participants + 

staff 

Total burden hours 

Mother/Father Eligibility Checklist ...................................................................................... 96,000 1 0.03 + 0.06 8,640 

Consent Form .................................................................................................................... 24,000 1 0.08 + 0.12 4,800 

Baseline Info Form ............................................................................................................ 24,000 1 0.25 + 0.33 13,920 

Contact Info Form .............................................................................................................. 24,000 1 0.03 + 0.06 2,160 

Estimated Total Annual Burden Hours .............................................................................. .................. .................. ........................ 29,520 

In compliance with the requirements 

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

Paperwork Reduction Act of 1995, the 

Administration for Children and 

Families is soliciting public comment 

on the specific aspects of the 

information collection described above. 

Copies of the proposed collection of 

information can be obtained and 

comments may be forwarded by writing 

to the Administration for Children and 

Families, Office of Administration, 

Office of Information Services, 370 

L’Enfant Promenade, SW., Washington, 

DC 20447, Attn: ACF Reports Clearance 

Officer, E-mail address: 

grjohnson@acf.hhs.gov. Al requests 

should be identified by the title of the 

information collection. 

The Department specifically requests 

comments on: (a) Whether the proposed 

collection of information is necessary 

for the proper performance of the 

functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information; (c) 

the quality, utility, and clarity of the 

information to be collected; and (d) 

ways to minimize the burden of the 

collection of information on 

respondents, including through the use 

of automated collection techniques or 

other forms of information technology. 

Consideration will be given to 

comments and suggestions submitted 

within 60 days of this publication.

Dated: October 12, 2004. 

Robert Sargis, 

Reports Clearance Officer.

[FR Doc. 04–23233 Filed 10–15–04; 8:45 am] 

BILLING CODE 4184–01–M

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Indian Health Service 

List of Recipients of Indian Health 

Scholarships Under the Indian Health 

Scholarship Program 

The regulations governing Indian 

Health Care Improvement Act Programs 

(Pub. L. 94–437) provide at 42 CFR 

136.334 that the Indian Health Service 

shall publish annually in the Federal 

Register a list of recipients of Indian 

Health Scholarships, including the 

name of each recipient, school and 

Tribal affiliation, if applicable. These 

scholarships were awarded under the 

authority of Sections 103 and 104 of the 

Indian Health Care Improvement Act, 25 

U.S.C. 1613–1613a, as amended by the 

Indian Health Care Amendments of 

1988, Public Law 100–713. 

The following is a list of Indian 

Health Scholarship Recipients funded 

under sections 103 and 104 for Fiscal 

Year 2004:

Abeita, Steven John, University of New 

Mexico, Pueblo of Isleta, New Mexico 

Adams-Moses, Cynthia Regina, 

Langston University, Muscogee 

(Creek) Nation, Oklahoma 

Adams, Melissa Lynn, Dr. William M. 

Scholl College of Podiatric Medicine, 

Cherokee Nation, Oklahoma 

Albers, Travis Alan, University of 

Maryland, Turtle Mountain Band of 

Chippewa Indians of North Dakota 

Alcorn, Winter Dawn, Rogers State 

College, Cherokee Nation, Oklahoma 

Alden-Diaz, Lorrie Elison, Rocky 

Mountain College, Crow Tribe of 

Montana 

Allery, Cynthia Ann, University of 

Mary, Turtle Mountain Band of 

Chippewa Indians of North Dakota 

Allery, Rhea Neachet, University of 

North Dakota, Turtle Mountain Band 

of Chippewa Indians of North Dakota 

Allick, Shannon Lynn, Minot State 

University, Turtle Mountain Band of 

Chippewa Indians of North Dakota 

Allison, Amanda, University of New 

Mexico, Navajo Nation, Arizona, New 

Mexico & Utah 

Antonio, Amber, University of New 

Mexico, Pueblo of Acoma, New 

Mexico 

Antuna, Crystal Lynn, Bacone College, 

Apache Tribe of Oklahoma 

Arnold, Carly Ellen, Northern Arizona 

University, Navajo Nation, Arizona, 

New Mexico & Utah 

Ashley, Natalie Lynn, Arizona State 

University, Navajo Nation, Arizona, 

New Mexico & Utah 

Atene, Kathleen Cheryl, Northern 

Arizona University, Navajo Nation, 

Arizona, New Mexico & Utah 

Azure, Alissa Joy, University of North 

Dakota, Turtle Mountain Band of 

Chippewa Indians of North Dakota 

Bain, Edlin David, University of New 

Mexico, Navajo Nation, Arizona, New 

Mexico & Utah 

Baker, Jennifer Lee, Oklahoma State 

University, Cherokee Nation, 

Oklahoma 

Baker, Valerie, University of New 

Mexico, Navajo Nation, Arizona, New 

Mexico & Utah 

Baker-Dotson, Elizabeth Diane, 

Northeastern State University, 

Cherokee Nation, Oklahoma 

Barnes-Enloe, Rebecca Anne, 

Northeastern State University, 

Cherokee Nation, Oklahoma 

Barnett, Stephanie Deann, University of 

Tulsa, Cherokee Nation, Oklahoma 

Barse, Frances Erin, Lake Area 

Technical Institute, Shoshone-Paiute 

Tribes of the Duck Valley Reservation, 

Nevada 

Battese, Kelly Joseph, University of 

Kansas, Miami Tribe of Oklahoma 

Beals, Bryan-James, University of North 

Dakota, Muscogee (Creek) Nation, 

Oklahoma 

Becenti, Elton, New Mexico State 

University, Navajo Nation, Arizona, 

New Mexico & Utah 

Begay, Grace Delcinia, University of 

New Mexico, Navajo Nation, Arizona, 

New Mexico & Utah 

Begay, Leilana Camille, Northern 

Arizona University, Navajo Nation, 

Arizona, New Mexico & Utah