[Federal Register Volume 65, Number 108 (Monday, June 5, 2000)]
[Notices]
[Page 35653]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 00-13986]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration

[Document Identifier: HCFA-3070]


Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), 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 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.
    Type of Information Collection Request: Reinstatement, with change, 
of a previously approved collection for which approval has expired; 
Title of Information Collection: Intermediate Care Facility for the 
Mentally Retarded or Persons with Related Conditions ICF/MR Survey 
Report Form (3070G-I) and Supporting Regulations at 42 CFR 431.52, 
431.151, 435.1009, 440.150, 440.220, 442.1, 442.10-442.16, 442 .30, 
442.40, 442.42, 442.100-442.119, 483.400-483.480, 488.332, 488.400, and 
498.3-498.5; Form No.: HCFA-3070 (0938-0062); Use: The survey forms are 
needed to ensure provider compliance. In order to participate in the 
Medicaid program as an ICF/MR, a providers must meet Federal standards. 
The survey report form is used to record providers' level of compliance 
with the individual standard and report it to the Federal government; 
Frequency: Annually; Affected Public: Business or other for-profit, 
Not-for-profit institutions; Number of Respondents: 6,763; Total Annual 
Responses: 6,763; Total Annual Hours: 21,600.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access HCFA's 
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail 
your request, including your address, phone number, OMB number, and 
HCFA document identifier, to <a href="/cdn-cgi/l/email-protection#5e0e3f2e3b2c29312c351e363d383f70393128"><span class="__cf_email__" data-cfemail="9dcdfcedf8efeaf2eff6ddf5fefbfcb3faf2eb">[email protected]</span></a>, or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 60 days of this notice directly to the HCFA Paperwork Clearance 
Officer designated at the following address:
    HCFA, Office of Information Services, Security and Standards Group, 
Division of HCFA Enterprise Standards, Attention: Julie Brown, Room N2-
14-26, 7500 Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: May 25, 2000.
John P. Burke III,
Reports Clearance Officer, Security and Standards Group, Division of 
HCFA Enterprise Standards.
[FR Doc. 00-13986 Filed 6-2-00; 8:45 am]
BILLING CODE 4120-03-P


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