Federal Register / Vol. 74, No. 175 / Friday, September 11, 2009 / Notices 46773 

requirements and are achieving desired 

outcomes for children and families, help 

ensure that claims by States for title IV– 

E funds are made only on behalf of title 

IV–E eligible children, and require 

States to revise applicable statutes, 

rules, policies and procedures, and 

provide proper training to staff, through 

the development and implementation of 

corrective action plans. These reviews 

not only address compliance with 

eligibility requirements but also assist 

States in enhancing the capacities to 

serve children and families. In 

computing the number of burden hours 

for this information collection, ACF 

based the annual burden estimates on 

ACF’s and States’ experiences in 

conducting reviews and developing 

program improvement plans. 

Respondents: State Title IV–B and 

Title IV–E Agencies. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

45 CFR 1356.7(i) Program Improvement Plan (FCER) .................................. 7 1 90 630 

45 CFR 1366.33(b) Statewide Assessment (CFSR).. ..................................... 13 1 240 3,120 

45 CFR 1355.33(c) On-site Review (CFSR) ................................................... 13 1 1,170 15,210 

45 CFR 1355.35(a) Program Improvement Plan (CFSR) ............................... 13 1 240 3,120 

45 CFR 1355.38(b) and (c) Corrective Action ................................................. 1 1 780 780 

Estimated Total Annual Burden 

Hours: 22,860. 

Additional Information: Copies of the 

proposed collection may be obtained 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. All requests 

should be identified by the title of the 

information collection. E-mail address: 

infocollection@acf.hhs.gov. 

OMB Comment: OMB is required to 

make a decision concerning the 

collection of information between 30 

and 60 days after publication of this 

document in the Federal Register. 

Therefore, a comment is best assured of 

having its full effect if OMB receives it 

within 30 days of publication. Written 

comments and recommendations for the 

proposed information collection should 

be sent directly to the following: Office 

of Management and Budget, Paperwork 

Reduction Project, Fax: 202–395–7245, 

Attn: Desk Officer for the 

Administration for Children and 

Families. 

Dated: September 4, 2009. 

Robert Sargis, 

Reports Clearance Officer. 

[FR Doc. E9–21890 Filed 9–10–09; 8:45 am] 

BILLING CODE 4184–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier CMS–10291 and CMS– 

10292] 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services. 

In compliance with the requirement 

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

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS) is publishing the 

following summary of proposed 

collections 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. 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Dental Provider 

and Benefit Information Posted on 

Insure Kids Now! Web site; Form 

Number: CMS–10291 (OMB#: 0938– 

1065); Use: Section 501 of the 

Children’s Health Insurance Program 

Reauthorization Act (CHIPRA) requires 

the Secretary to work with States, 

pediatric dentists, and other dental 

providers to include on the Insure Kids 

Now (IKN) Web site, a ‘‘current and 

accurate list of all dentists and 

providers within each State that provide 

dental services to children enrolled in 

the State plan (or waiver) under 

Medicaid or the State child health plan 

(or waiver) under CHIP. Section 501 of 

CHIPRA also requires the Secretary to 

ensure the list is updated at least 

quarterly and includes the description 

of the dental services provided under 

Medicaid or CHIP and whether the 

services are provided through a State 

plan or waiver. The Secretary shall also 

post on the IKN Web site State specific 

information on available dental benefits. 

This information collection requirement 

will allow States to collect the 

information on the dental providers and 

dental benefits in accordance with 

CHIPRA. Frequency: Yearly and 

Quarterly; Affected Public: State, Tribal 

and Local governments; Number of 

Respondents: 51; Total Annual 

Responses: 255; Total Annual Hours: 

9,180. (For policy questions regarding 

this collection contact Nancy 

Goetschius at 410–786–0707. For all 

other issues call 410–786–1326.) 

2. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: State Medicaid 

HIT Plan and Templates for 

Implementation of Section 4201 of 

ARRA; Form Number: CMS–10292 

(OMB#: 0938–NEW); Use: This 

information is being requested in order 

that States can submit documentation to 

CMS for review and approval in order 

that States can implement the Medicaid 

program and draw down Federal 

financial participation. The American 

Reinvestment and Recovery Act of 2009 

(ARRA) provides States with the 

flexibility to request funds to develop a 


cprice-sewell on DSKGBLS3C1PROD with NOTICES
46774 Federal Register / Vol. 74, No. 175 / Friday, September 11, 2009 / Notices 

health information technology vision 

and road to get to the ultimate goal of 

meaningful use of certified electronic 

health records technology. We will be 

sending State Medicaid Directors letters 

and templates for the State Medicaid Hit 

Plan (SMHP), the Planning Advance 

Planning Document (PAPD) and the 

Implementation Advance Planning 

Document (IAPD) to States in an effort 

to request these changes if they so 

choose to make the process as simple as 

possible. Frequency: Yearly, once and/ 

or occasionally; Affected Public: State, 

Tribal and Local governments; Number 

of Respondents: 56; Total Annual 

Responses: 56; Total Annual Hours: 

280. (For policy questions regarding this 

collection contact Donna Schmidt at 

410–786–5532. For all other issues call 

410–786–1326.) 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, access CMS’ Web Site 

at http://www.cms.hhs.gov/ 

PaperworkReductionActof1995, or email your request, including your 

address, phone number, OMB number, 

and CMS document identifier, to 

Paperwork@cms.hhs.gov, or call the 

Reports Clearance Office on (410) 786– 

1326. 

In commenting on the proposed 

information collections please reference 

the document identifier or OMB control 

number. To be assured consideration, 

comments and recommendations must 

be submitted in one of the following 

ways by November 10, 2009: 

1. Electronically. You may submit 

your comments electronically to http:// 

www.regulations.gov. Follow the 

instructions for ‘‘Comment or 

Submission’’ or ‘‘More Search Options’’ 

to find the information collection 

document(s) accepting comments. 

2. By regular mail. You may mail 

written comments to the following 

address: CMS, Office of Strategic 

Operations and Regulatory Affairs, 

Division of Regulations Development, 

Attention: Document Identifier/OMB 

Control Number, Room C4–26–0,5, 7500 

Security Boulevard, Baltimore, 

Maryland 21244–1850. 

Dated: September 4, 2009. 

Michelle Shortt, 

Director, Regulations Development Group, 

Office of Strategic Operations and Regulatory 

Affairs. 

[FR Doc. E9–21956 Filed 9–10–09; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[Document Identifier: CMS–10078, CMS– 

10288, CMS–10289 and CMS–10097] 

Agency Information Collection 

Activities: Submission for OMB 

Review; Comment Request 

AGENCY: Centers for Medicare & 

Medicaid Services, HHS. 

In compliance with the requirement 

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

Paperwork Reduction Act of 1995, the 

Centers for Medicare & Medicaid 

Services (CMS), Department of Health 

and Human Services, is publishing the 

following summary of proposed 

collections 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 function; 

(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. 

1. Type of Information Collection 

Request: Extension without change of a 

currently approved collection; Title of 

Information Collection: Matching Grants 

to States for the Operation of High Risk 

Pools; Use: CMS is requiring this 

information as a condition of eligibility 

for grants that were authorized in the 

Trade Act of 2002, the Deficit Reduction 

Act of 2005 and the State High Risk Pool 

Funding Extension Act of 2006. The 

information is necessary to determine if 

a State applicant meets the necessary 

eligibility criteria for a grant as required 

by law. The respondents will be States 

that have a high risk pool as defined in 

sections 2741, 2744, or 2745 of the 

Public Health Service Act. The grants 

will provide funds to States that incur 

losses in the operation of high risk 

pools. High risk pools are set up by 

States to provide health insurance to 

individuals that cannot obtain health 

insurance in the private market because 

of a history of illness; Form Numbers: 

CMS–10078 (OMB#: 0938–0887); 

Frequency: Recordkeeping, Reporting— 

Occasionally; Affected Public: State, 

Local and Tribal Governments; Number 

of Respondents: 31; Total Annual 

Responses: 31; Total Annual Hours: 

1,240. (For policy questions regarding 

this collection contact Paul Scholz at 

410–786–6178. For all other issues call 

410–786–1326.) 

2. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: State Plan PrePrint to Implement Required Dental 

Benefits Pursuant of Children’s Health 

Insurance Program Reauthorizing Act 

(CHIPRA) 2009; Use: Section 501 of 

CHIPRA 2009 amends XXI and requires 

that ‘‘child health assistance provide to 

a targeted low-income child shall 

include coverage of dental services 

necessary to prevent disease and 

promote oral health, restore oral 

structures to health and function, and 

treat emergency conditions.’’ States that 

provide coverage in a separate 

Children’s Health Insurance Program 

may choose between two methods of 

providing the dental services required 

in Section 501. The State may define the 

services in the dental benefit package 

and demonstrate that it includes all the 

required services. Alternatively, the 

State may provide a dental benefit 

package that is equivalent to one of the 

three benchmark packages described in 

the statute. In order to implement one 

of these options and comply with the 

statute, States must amend their State 

Plan using the State Plan pre-print. 

Form Number: CMS–10288 (OMB#: 

0938–NEW); Frequency: Reporting Onetime; Affected Public: State, Local, or 

Tribal Governments; Number of 

Respondents: 51; Total Annual 

Responses: 51; Total Annual Hours: 

1530. (For policy questions regarding 

this collection contact Nancy 

Goetschius at 410–786–0707. For all 

other issues call 410–786–1326.) 

3. Type of Information Collection 

Request: New Collection; Title of 

Information Collection: Optional Dentalonly Supplemental Coverage State Plan 

Amendment Template; Use: CHIPRA 

2009 provides States with an option to 

provide supplemental dental-only 

coverage to children who would be 

eligible to enroll in the State’s 

Children’s Health Insurance Program 

(CHIP), except that they already have 

health insurance coverage, either 

through a group health plan or employer 

sponsored insurance. If the health 

insurance plan the child is enrolled in 

does not provide dental benefits, the 

State may provide the child with the 

same State-defined dental package or 

benchmark benefit plan provided to 

children who are eligible for the entire 

CHIP benefit package. The child will 

only be entitled to the dental services 

provided to other CHIP children. 

In order to choose this option, States 

must comply with all other 


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