[Federal Register Volume 88, Number 220 (Thursday, November 16, 2023)]
[Notices]
[Pages 78755-78756]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-25322]


=======================================================================
-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Submission for Office of Management and Budget Review; Serious 
Medical Procedure Request (SMR) Form (Office of Management and Budget 
#: 0970-0561)

AGENCY: Office of Refugee Resettlement, Administration for Children and 
Families, U.S. Department of Health and Human Services.

ACTION: Request for public comments.

-----------------------------------------------------------------------

SUMMARY: The Administration for Children and Families' (ACF) Office of 
Refugee Resettlement is requesting a 3-year extension of the Serious 
Medical Procedure Request (SMR) Form (Office of Management and Budget 
(OMB) #0970-0561, expiration February 29, 2024). Revisions are proposed 
to the currently approved form.

DATES: Comments due within 30 days of publication. OMB must make a 
decision about 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.

ADDRESSES: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. You can 
also obtain copies of the proposed collection of information by 
emailing <a href="/cdn-cgi/l/email-protection#fb92959d94989497979e988f929495bb9a989dd5939388d59c948d"><span class="__cf_email__" data-cfemail="056c6b636a666a69696066716c6a6b456466632b6d6d762b626a73">[email protected]</span></a>. Identify all emailed requests by 
the title of the information collection.

SUPPLEMENTARY INFORMATION: 
    Description: ACF's ORR places unaccompanied children in their 
custody in care provider programs until unification with a qualified 
sponsor. Care provider programs are required to provide children with a 
range of services including medical, dental, and mental healthcare. 
Children identified as having a serious medical or dental condition may 
require a procedure while in ORR custody to maintain and promote their 
health and wellbeing. Procedures requiring general anesthesia, 
surgeries, and invasive diagnostic procedures (e.g., cardiac 
catheterization, invasive biopsy, amniocentesis) require advance ORR 
approval. Before ORR can approve, data must be collected on the SMR 
form and submitted to ORR by the care provider program (e.g., care 
provider program's contact information, child demographics, authorized 
consenter, unification status) and the lead surgeon (e.g., reason for 
the procedure, potential risks/complications/adverse outcomes if the 
procedure is not performed, timing, recovery timeframe, planned follow-
up procedures, hospital points of contact). ORR will waive the 
completion of the SMR form if it is deemed to be in the best interest 
of the child (e.g., during a hospitalization or emergency department 
visit, related to a medical emergency).
    The form is used as a worksheet for care provider program staff and 
surgeons to compile information that would otherwise have been 
collected during the health evaluation. Once completed, care provider 
program staff upload the form and supporting documentation into ORR's 
secure, electronic data record system and send an email notification to 
ORR staff that the SMR packet is ready for review.
    ORR has incorporated changes to the form to streamline the flow of 
data collection, clarify intent and purpose of the form and fields, 
improve data quality, and ensure alignment with ORR program policies. 
The overall estimated time per form has increased by 1 minute and has 
been adjusted to reflect a decrease by 1 minute for care provider 
program staff and an increase by 2 minutes for surgeons.
    Respondents: Care provider program staff, surgeons.

Annual Burden Estimates

    There are currently about 250 programs that use the SMR form. Over 
the past 2 years, an annual average of 115 SMR forms were submitted 
across all programs. For each form, a care provider program staff 
member completes page 1, and a surgeon completes pages 2 and 3.

[[Page 78756]]



                                                        Estimated Reporting Time for Respondents
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                         Total number of  Average burden
                Instrument                          Respondent           Total number     responses per      hours per     Total burden    Annual burden
                                                                        of respondents     respondent        response          hours           hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
SMR Form.................................  Care Provider Program Staff             250              1.38             .07           24.15               8
                                           Surgeons...................             250              1.38             .17           58.65              20
                                                                       ---------------------------------------------------------------------------------
    Total Annual Burden Estimate.........  ...........................  ..............  ................  ..............  ..............              28
--------------------------------------------------------------------------------------------------------------------------------------------------------


                                                              Estimated Recordkeeping Time
--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                         Total number of  Average burden
                Instrument                          Respondent           Total number     responses per      hours per     Total burden    Annual burden
                                                                        of respondents     respondent        response          hours           hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
SMR Form.................................  Care Provider Program Staff             250              1.38             .08            27.6               9
--------------------------------------------------------------------------------------------------------------------------------------------------------

    Authority: 6 U.S.C 279: Exhibit 1, part A.2 of the Flores 
Settlement Agreement (Jenny Lisette Flores, et al., v. Janet Reno, 
Attorney General of the United States, et al., Case No. CV 85-4544-RJK 
[C.D. Cal. 1996]).

Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2023-25322 Filed 11-15-23; 8:45 am]
BILLING CODE 4184-45-P


</pre><script data-cfasync="false" src="/cdn-cgi/scripts/5c5dd728/cloudflare-static/email-decode.min.js"></script></body>
</html>