Federal Register / Vol. 79, No. 67 / Tuesday, April 8, 2014 / Notices 19333 

continuing the success of these 

programs. The current Alliant GWACs 

for Information Technology services are 

among GSA’s most successful 

acquisition programs for the federal 

government with 50 federal agencies 

doing more than $20 billion in business 

volume since their inception in 2009. 

GSA Alliant and Alliant Small Business 

GWACs are used for complex IT 

requirements involving data center 

consolidation, systems integration, 

cloud computing, cyber security, help 

desk support, and other IT disciplines. 

The Alliant II and Alliant Small 

Business II Interact communities will 

serve as the one-stop-shop for updates 

and information regarding the nextgeneration Alliant GWACs. The scope of 

the Alliant GWACs is built on the 

foundation of Federal Enterprise 

Architecture allowing for in-scope 

acquisition of new and emerging 

technologies. The GSA GWAC Program 

is widely acclaimed for superior 

customer service, scope reviews, and 

acquisition support. 

Dated: April 2, 2014. 

Christopher Fornecker, 

Director, Center for GWAC Programs, Office 

of Strategic Programs, Integrated Technology 

Service. 

[FR Doc. 2014–07794 Filed 4–7–14; 8:45 am] 

BILLING CODE 6820–XX–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Advisory Council on Alzheimer’s 

Research, Care, and Services; Meeting 

AGENCY: Assistant Secretary for 

Planning and Evaluation, HHS. 

ACTION: Notice of meeting. 

SUMMARY: This notice announces the 

public meeting of the Advisory Council 

on Alzheimer’s Research, Care, and 

Services (Advisory Council). The 

Advisory Council on Alzheimer’s 

Research, Care, and Services provides 

advice on how to prevent or reduce the 

burden of Alzheimer’s disease and 

related dementias on people with the 

disease and their caregivers. During the 

April meeting, the Advisory Council 

will hear presentations from the three 

subcommittees (Research, Clinical Care, 

and Long-Term Services and Supports). 

The Advisory Council will hear updates 

to the 2014 plan. The Advisory Council 

will also hear presentations on state and 

local plans to address dementia. 

DATES: The meeting will be held on 

April 29th, 2014 from 9:00 a.m. to 5:00 

p.m. EDT. 

ADDRESSES: The meeting will be held in 

Room 800 in the Hubert H. Humphrey 

Building, 200 Independence Avenue 

SW., Washington, DC 20201. 

Comments: Time is allocated midmorning on the agenda to hear public 

comments. In lieu of oral comments, 

formal written comments may be 

submitted for the record to Rohini 

Khillan, OASPE, 200 Independence 

Avenue SW., Room 424E, Washington, 

DC 20201. Comments may also be sent 

to napa@hhs.gov. Those submitting 

written comments should identify 

themselves and any relevant 

organizational affiliations. 

FOR FURTHER INFORMATION CONTACT: 

Rohini Khillan (202) 690–5932, 

rohini.khillan@hhs.gov. Note: Seating 

may be limited. Those wishing to attend 

the meeting must send an email to 

napa@hhs.gov and put ‘‘April 29 

meeting attendance’’ in the Subject line 

by Friday, April 18, so that their names 

may be put on a list of expected 

attendees and forwarded to the security 

officers at the Department of Health and 

Human Services. Any interested 

member of the public who is a non-U.S. 

citizen should include this information 

at the time of registration to ensure that 

the appropriate security procedure to 

gain entry to the building is carried out. 

Although the meeting is open to the 

public, procedures governing security 

and the entrance to Federal buildings 

may change without notice. If you wish 

to make a public comment, you must 

note that within your email. 

SUPPLEMENTARY INFORMATION: Notice of 

these meetings is given under the 

Federal Advisory Committee Act (5 

U.S.C. App. 2, section 10(a)(1) and 

(a)(2)). Topics of the Meeting: The 

Advisory Council will hear 

presentations from the three 

subcommittees (Research, Clinical Care, 

and Long-Term Services and Supports), 

which will inform the 2014 

recommendations. The Advisory 

Council will discuss the G8 Dementia 

Summit that was held on December 11, 

2013. 

Procedure and Agenda: This meeting 

is open to the public. Please allow 30 

minutes to go through security and walk 

to the meeting room. The meeting will 

also be webcast at www.hhs.gov/live. 

Authority: 42 U.S.C. 11225; Section 2(e)(3) 

of the National Alzheimer’s Project Act. The 

panel is governed by provisions of Public 

Law 92–463, as amended (5 U.S.C. Appendix 

2), which sets forth standards for the 

formation and use of advisory committees. 

Dated: March 24, 2014. 

Rima Cohen, 

Acting Assistant Secretary for Planning and 

Evaluation. 

[FR Doc. 2014–07596 Filed 4–7–14; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: ‘‘Taking 

Efficiency Interventions in Health 

Services Delivery to Scale.’’ In 

accordance with the Paperwork 

Reduction Act of 1995, Public Law 104– 

13 (44 U.S.C. 3506(c)(2)(A)), AHRQ 

invites the public to comment on this 

proposed information collection. 

DATES: Comments on this notice must be 

received by June 9, 2014. 

ADDRESSES: Written comments should 

be submitted to: Doris Lefkowitz, 

Reports Clearance Officer, AHRQ, by 

email at doris.lefkowitz@ahrq.hhs.gov. 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at doris.lefkowitz@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Taking Efficiency Interventions in 

Health Services Delivery to Scale 

The primary care workforce is facing 

imminent clinician shortages and 

increased demand. With the 

implementation of the Affordable Care 

Act (ACA), Federally Qualified Health 

Centers (FQHCs) are expected to play a 

major role in addressing the large 

numbers of people who become eligible 

for health insurance as well as continue 

in their role as safety net providers. 

Thus, understanding new models of 

service delivery and improving 

efficiency within FQHCs is of national 

policy import. The proposed data 

collection supports this goal through 

studying outcomes associated with a 

‘‘delegate model,’’ which is designed to 

improve provider and team efficiency, 

and the spread of this model throughout 

a large FQHC. 

Recent models of practice 

transformation have documented the 

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19334 Federal Register / Vol. 79, No. 67 / Tuesday, April 8, 2014 / Notices 

use of an Organized Team Model that 

distributes responsibility for patient 

care among an interdisciplinary team, 

thus allowing physicians to manage a 

larger panel size while practicing high 

quality care. This delegate model 

requires that all team members perform 

at the top of their skill level, and that 

tasks currently performed by clinicians 

are delegated to non-clinician team 

members in a safe and effective manner. 

Researchers at the University of 

California, San Francisco have 

estimated that delegation may allow 

physicians to increase their panel size 

by shifting tasks to non-physician team 

members. More specifically, if portions 

of preventive and chronic care services 

are delegated to non-physicians, 

primary care practices can meet 

recommended quality and care 

guidelines while maintaining panel 

sizes with a limited primary care 

physician workforce. This study will 

examine the real-world implementation 

of such a model in order to build 

evidence of whether such delegation 

can achieve the predicted increases in 

panel sizes. 

AHRQ is working with John Snow, 

Inc. (JSI) and its partner, Penobscot 

Community Health Center (PCHC), to 

evaluate the effectiveness and spread of 

a delegate model in 5 of PCHC’s 15 

primary care service sites. The model 

will be spread from an initial pilot 

physician-medical assistant team to 

other clinics, as well as to other teams 

within each clinic. PCHC is an FQHC 

located in Bangor, Maine that serves 

northeastern Maine. Currently, PCHC’s 

primary care providers (PCPs, which 

include medical doctors, osteopaths, 

nurse practitioners, and physician 

assistants) each work with a Medical 

Assistant (MA). Under the delegate 

model, a pair of PCPs will be assigned 

an ‘‘administrative’’ MA to enhance 

their team. This position will enable 

shifting of responsibilities among the 

team, with the intent of relieving the 

PCPs of administrative tasks and 

incorporating new tasks that will 

enhance team efficiency. Examples of 

tasks that an administrative MA may 

take on include standardized 

prescription renewals, schedule 

management, in-box management, 

scribing, pre-visit planning with preappointment laboratory tests, and 

identification of patients for ancillary 

referrals (e.g., behavioral health and 

case management). 

This study has the following goals: 

(1) To evaluate the spread and 

effectiveness of the delegate model in 

five of PCHC’s primary care sites; 

(2) To evaluate the influence of the 

delegate model on provider satisfaction, 

team functioning, and patient 

satisfaction; 

(3) To assess the contextual factors 

influencing the above outcomes; and 

(4) To disseminate findings. 

This study is being conducted by 

AHRQ through its contractor, JSI, 

pursuant to AHRQ’s statutory authority 

to conduct and support research on 

healthcare and on systems for the 

delivery of such care, including 

activities with respect to the quality, 

effectiveness, efficiency, 

appropriateness and value of healthcare 

services and with respect to quality 

measurement and improvement. 42 

U.S.C. 299a(a)(1) and (2). 

Method of Collection 

AHRQ seeks approval for the 

following data collection activities: 

• Team Survey that will be 

disseminated to all members of both 

delegate and non-delegate primary care 

teams to assess job satisfaction and team 

functioning in all participating sites at 

two points in time. 

• Key Informant Interviews (KII) 

conducted with staff in each of the 

participating sites during two rounds of 

site visits, with key informants to 

include the Medical Director, Practice 

Director, members of primary care teams 

implementing the delegate model, and 

ancillary staff. A condensed version of 

the interview will be used for a 

conference call with each participating 

site’s Medical Director and Practice 

Director as an interim activity between 

the two site visits. 

The information yielded from this 

study is expected to inform a wide cross 

section of audiences and stakeholders 

about provider efficiency, practice 

redesign, team-based care, workforce 

strategies, and spread of an innovation. 

This study is not intended to make 

broad generalizations about the 

effectiveness of the delegate model of 

care, but rather to build initial evidence 

about this promising new model, its 

ability to increase panel size in FQHCs, 

and provide guidance on how similar 

models might be spread and evaluated. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden for the respondents’ 

time to participate in this research. 

Information will be collected through an 

internet-based team survey and inperson and telephone interviews. Note 

that some respondents may be doublecounted, so the total number of 

respondents may be less than 80. For 

example, a respondent may fill out a 

survey as well as participate in a phone 

interview. 

Exhibit 2 shows the estimated 

annualized cost burden associated with 

the respondents’ time to participate in 

this research. The total annual cost 

burden is estimated to be $25,151. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses 

per 

respondent 

Hours per 

response 

Total 

burden 

hours 

Team Survey: 

—Providers ............................................................................................... 21 2 15/60 11 

—Other Clinical Staff ................................................................................ 34 2 15/60 17 

Total ................................................................................................... 55 2 15/60 28 

Key Informant Interviews (Site visits): 

—Medical Director .................................................................................... 2 2 30/60 2 

—Practice Director ................................................................................... 2 2 30/60 2 

—Providers ............................................................................................... 5 2 30/60 5 

—Other Clinical Staff ................................................................................ 10 2 30/60 10 

Total ................................................................................................... 19 2 30/60 19 

Key Informant Interviews (Phone calls): 

—Medical Director .................................................................................... 3 1 1 3 

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Federal Register / Vol. 79, No. 67 / Tuesday, April 8, 2014 / Notices 19335 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS—Continued 

Form name Number of 

respondents 

Number of 

responses 

per 

respondent 

Hours per 

response 

Total 

burden 

hours 

—Practice Director ................................................................................... 3 1 1 3 

Total ................................................................................................... 6 1 1 6 

Total ................................................................................................................. 80 na na 53 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total 

burden 

hours 

Average 

hourly 

wage rate* 

Total 

cost 

burden 

Team Survey: 

—Providers ............................................................................................... 21 11 a $62.13 $14,352 

—Other Clinical Staff ................................................................................ 34 17 b 14.69 8,491 

Total ................................................................................................... 55 28 na 22,843 

Key Informant Interviews (Site Visit): 

—Medical Director .................................................................................... 2 2 c 92.08 368 

—Practice Director ................................................................................... 2 2 d 47.34 189 

—Providers ............................................................................................... 5 2 a 62.13 621 

—Other Clinical Staff ................................................................................ 10 2 b 14.69 294 

Total ................................................................................................... 19 8 na 1,472 

Key Informant Interviews (Phone calls): 

—Medical Director .................................................................................... 3 2 c 92.08 552 

—Practice Director ................................................................................... 3 2 d 47.34 284 

Total ................................................................................................... 6 4 na 836 

Total ................................................................................................................. 80 na na 25,151 

* National Compensation Survey: Occupational wages in the United States May 2012, ‘‘U.S. Department of Labor, Bureau of Labor Statistics.’’ aBased on the average mean wages for three categories of primary care provider ($92.08—MDs; $44.45 PAs; and $43.97—NPs). 

bBased on the mean wage of Medical Assistants. 

cBased on the mean wages for MDs. 

dBased on the mean wages for Medical and Health Services Managers. 

eBased on the mean wages for Data Analyst (Computer and Information Analyst). 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, comments on AHRQ’s 

information collection are requested 

with regard to any of the following: (a) 

Whether the proposed collection of 

information is necessary for the proper 

performance of AHRQ health care 

research and health care information 

dissemination functions, including 

whether the information will have 

practical utility; (b) the accuracy of 

AHRQ’s estimate of burden (including 

hours and costs) of the proposed 

collection(s) of information; (c) ways to 

enhance the quality, utility, and clarity 

of the information to be collected; and 

(d) ways to minimize the burden of the 

collection of information upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 

comments will become a matter of 

public record. 

Dated: March 31, 2014. 

Richard Kronick, 

AHRQ Director. 

[FR Doc. 2014–07795 Filed 4–7–14; 8:45 am] 

BILLING CODE 4160–90–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Meeting for Software Developers on 

the Common Formats for Patient 

Safety Data Collection and Event 

Reporting—Agenda & Registration 

Information 

In reference to Federal Register, Vol. 

79, No. 15, pages 3815–3816, published 

on January 23, 2014 (https://

www.federalregister.gov/articles/2014/

01/23/2014-01242/meeting-for-softwaredevelopers-on-the-common-formats-forpatient-safety-data-collection-andevent), AHRQ is now providing 

additional information on the Software 

Developers Meeting—AHRQ Common 

Formats meeting agenda and 

registration. 

As indicated in the previous notice, 

the PSO Privacy Protection Center 

(PSOPPC) is coordinating the meeting. 

On Friday, April 25, 2014, the meeting 

will start at 10:00 a.m. with welcome 

and updates on data submissions issues. 

After a networking lunch, a keynote 

presentation will focus on electronic 

health record (EHR) technology, patient 

safety, and federal regulation. Finally, 

the meeting will conclude with 

presentations on and discussion of 

federal initiatives involving the 

Common Formats. Throughout the 

meeting there will be interactive 

discussion to allow meeting participants 

not only to provide input, but also to 

respond to the input provided by others. 

Meeting information, including the full 

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