29798 Federal Register / Vol. 83, No. 123 / Tuesday, June 26, 2018 / Notices 

standards and measures for future 

iterations. 

Payment Structure 

Summary of Comments 

Most commenters agreed with the 

tiered payment method but highlighted 

the importance of clearly messaging that 

funding tiers are not indicative of 

different levels of quality or engagement 

for the first phase of the CHGME QBS. 

One commenter offered, ‘‘the bonus 

payments would have a more significant 

effect in transforming the quality of 

CHGME programs if the payments were 

funded at a level larger than $3 million 

and were in excess of current program 

funding.’’ 

Response 

HRSA will continue to message 

clearly that the FY 2019 CHGME QBS 

payment tiers are not reflective of the 

quality of the initiatives. The payment 

tiers were developed taking into account 

the size of the training programs and 

CHGME payments typically awarded. In 

future years, once the data sources were 

better developed HRSA would work to 

develop a payment structure that takes 

into account both the size of the 

program and quality. As noted earlier, 

the amount of funding available for the 

QBS is provided for in statute and the 

$3 million funding amount is an 

estimation, assuming funding levels and 

mechanisms remain constant. 

For FY 2019, QBS payments will be 

disbursed with the CHGME FY 2019 

reconciliation payments. CHGME 

hospitals that submit the required 

documentation with the FY 2019 

reconciliation application will receive a 

portion of the available funds for the 

CHGME QBS payment. Amounts will be 

distributed according to a three-tiered 

payment structure detailed in the 

Federal Register, 82 FR 48102. 

HRSA expects that future quality 

measures will likely be a combination of 

both quantitative and qualitative 

measures, where payment will be 

directly linked to the level of 

achievement of an individual hospital. 

We will continue to seek additional 

input from stakeholders and experts on 

the appropriate measures and metrics 

for future iterations of the CHGME QBS. 

Documentation, Reporting 

Requirements and Reducing Reporting 

Burden 

Summary of Comments 

Several commenters indicated that 

HRSA already collects quite a bit of 

information through the annual report 

and recommended that HRSA build on 

its existing reporting requirements to 

minimize reporting burden. These 

commenters suggested that new 

reporting requirements would add an 

administrative burden and deter 

maximum participation in the QBS. One 

commenter questioned whether HRSA 

would publicly share the QBS data. 

Response 

HRSA agrees that participation in the 

QBS should not be overly burdensome 

and will work to create reasonable 

documentation requirements. HRSA 

acknowledges that it is already 

collecting some quality-related data in 

the annual CHGME performance 

measures and is developing ways to 

improve these fields. In addition, as part 

of the further development of the QBS, 

HRSA will be reviewing the different 

sets of data that children’s hospitals 

already report to identify if any of the 

measures could be used as part of the 

QBS. A long-term goal would be to have 

transparency regarding the QBS data 

and HRSA will make sure to include 

that topic in stakeholder discussions. 

Any new data collection form(s) that are 

developed will require Office and 

Management and Budget (OMB) 

approval. Stakeholders will be able to 

provide public comments on any new 

data collection form(s) developed. 

Implementation Timeline for FY 2020 

and Beyond 

Summary of Comments 

Half of commenters recommended a 

longer timeline to phase in the full FY 

2020 and beyond QBS proposed 

framework, in order to ensure a 

thorough stakeholder engagement 

process in which pediatric experts are 

adequately involved in establishing 

metrics and measures, identifying 

quality outcomes, and evaluating QBS 

standards. 

Response 

HRSA recognizes concerns about the 

QBS implementation timeline. We 

understand that there are many 

important factors that must be taken 

into account when implementing the 

QBS, and each requires thorough and 

well-informed consideration. In 

addition, QBS-related data collection 

must align with existing reporting and 

payment schedules for the CHGME 

Payment Program. The first phase of the 

CHGME QBS is planned to start in FY 

2019, and we have taken into 

consideration feedback collected 

through this FRN. The data collected 

during the FY 2019 QBS will give HRSA 

an indication of the current experiences 

across our children’s hospitals so that 

we can establish reasonable parameters 

and measures moving forward. In 

addition, HRSA is examining using 

existing reporting requirements to 

establish components of the QBS for FY 

2020 and beyond. HRSA will continue 

collaborating with stakeholders and 

experts to inform future phases and 

measures for the CHGME QBS. As new 

QBS measures will affect a fiscal year 

payment, any updates or changes will 

be included in that year’s NOFO. 

Conclusion 

HRSA appreciates the comments and 

recommendations received and has used 

them to guide the development of the 

FY 2019 CHGME QBS and inform future 

iterations of the CHGME QBS. Final 

guidance for the FY 2019 CHGME QBS 

will be published in the FY 2019 

CHGME NOFO. If you have questions or 

concerns about comments that were not 

addressed in this notice, please contact 

MCrawford@hrsa.gov. 

Dated: June 19, 2018. 

George Sigounas, 

Administrator. 

[FR Doc. 2018–13592 Filed 6–25–18; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Submission to OMB for 

Review and Approval; Public Comment 

Request; National Survey of Organ 

Donation Attitudes and Practices, OMB 

No. 0915–0290—Reinstatement With 

Change 

AGENCY: Health Resources and Services 

Administration (HRSA), Department of 

Health and Human Services. 

ACTION: Notice. 

SUMMARY: In compliance with the 

Paperwork Reduction Act of 1995, 

HRSA has submitted an Information 

Collection Request (ICR) to the Office of 

Management and Budget (OMB) for 

review and approval. The ICR is for 

reinstatement with change of a 

previously approved information 

collection, assigned OMB control 

number 0915–0290, which expired on 

March 31, 2015. Comments submitted 

during the first public review of this ICR 

will be provided to OMB. OMB will 

accept further comments from the 

public during the review and approval 

period. 

DATES: Comments on this ICR should be 

received no later than July 26, 2018. 


sradovich on DSK3GMQ082PROD with NOTICES
Federal Register / Vol. 83, No. 123 / Tuesday, June 26, 2018 / Notices 29799 

ADDRESSES: Submit your comments, 

including the ICR Title, to the desk 

officer for HRSA, either by email to 

OIRA_submission@omb.eop.gov or by 

fax to 202–395–5806. 

FOR FURTHER INFORMATION CONTACT: To 

request a copy of the clearance requests 

submitted to OMB for review, email Lisa 

Wright-Solomon, the HRSA Information 

Collection Clearance Officer at 

paperwork@hrsa.gov or call (301) 443– 

1984. 

SUPPLEMENTARY INFORMATION: 

Information Collection Request Title: 

National Survey of Organ Donation 

Attitudes and Practices, OMB No. 0915– 

0290—Reinstatement with Change. 

Abstract: HRSA is requesting 

approval from OMB for reinstatement 

with change of a previously approved 

collection of information (OMB control 

number 0915–0290). The National 

Survey of Organ Donation Attitudes and 

Practices (NSODAP) is conducted 

approximately every 6–7 years and 

serves a critical role in providing HRSA 

and the donation community with data 

regarding why Americans choose to 

donate organ, current barriers to 

donation, and potential new approaches 

to increasing donations. Survey data 

and derived analytic insights inform 

HRSA’s public outreach and 

educational initiatives. HRSA is 

improving the quality and relevance of 

the data collected by making the 

following changes: 

(1) HRSA is increasing the ability to 

produce more precise results by 

targeting 10,000 completed surveys 

(increased from 3,250 in 2012). This 

increase will allow for a more accurate 

and robust analysis of the attitudes and 

donation practices of important 

subgroups such as Americans over the 

age of 50 and various minority 

populations. Although the precision of 

the results from the survey will 

increase, the respondent burden will be 

reduced, and survey completion costs 

will be lower resulting in a cost neutral 

change. 

(2) HRSA is streamlining the data 

collection process to minimize 

respondent burden. Of the 10,000 

targeted completed surveys, 8,000 will 

be completed online by a nationally 

representative web panel composed of 

Americans over the age of 18 who have 

already agreed to participate in a survey. 

Web panels target a representative 

section of a population used by other 

approved surveys. HRSA will complete 

the remaining 2,000 surveys by 

telephone. In 2012, all 3,250 surveys 

were conducted by telephone and 

respondents were contacted using 

random-digit dialing, a process that 

yielded a low response rate. Contacting 

respondents by telephone will remain a 

part of the survey protocol to compare 

current data to the 2012 data. However, 

for this survey, identification of a 

sample of adults over the age of 18 for 

a telephone survey will be from a 

national list of home addresses. Before 

contact, those selected for the telephone 

survey will receive a mailed prenotification letter with information 

about the survey. This mailing will 

improve survey cooperation and reduce 

the number of people contacted for the 

survey. Additionally, it is more time 

and cost effective to take the survey 

online than taking the survey by phone 

as the average response will be 0.1 hour 

shorter, and the cost of an online survey 

can range $3–$4 per survey compared to 

$50–$100 for a high-quality phone 

survey. 

(3) To improve the relevance of the 

data collected and in response to the 

comments received during the 60-day 

public comment period, HRSA revised 

the instrument to add, remove, or edit 

a few questions. Example changes 

include removing certain questions that 

were only relevant for a random-digitdialing sample design, editing certain 

questions to add clarity, and adding 

questions to highlight emerging topics 

such as receiving organ donation 

information through a hand-held device 

or mobile apps. 

Need and Proposed Use of the 

Information: HRSA is the primary 

federal entity responsible for oversight 

of organ and blood stem cell transplant 

systems and initiatives to increase organ 

donor registration and donation in the 

United States. This survey is the 

primary method by which HRSA can 

obtain information from Americans 

about organ donation attitudes and 

beliefs. OMB previously approved this 

survey, and HRSA fielded it during 

2005 and 2012. HRSA uses the resulting 

information from the survey to inform 

practice, policy, and other public 

awareness and education activities 

related to organ donation and 

transplantation. This type of 

information is essential for planning, 

targeting, and implementing outreach 

efforts to increase public donation 

commitment as well as for tracking the 

results of such efforts over time. 

Members of the donation and 

transplantation community also make 

use of the findings of the survey in their 

outreach efforts and research efforts. 

Increasing the number of completed 

cases via a web panel for online survey 

completion and modifying the survey 

instrument without increasing the 

survey length will dramatically improve 

the quality and precision of the results 

while minimizing respondent burden as 

much as possible. The modified 

instrument and survey fielding methods 

will allow research on the attitudes and 

behaviors of important subgroups of 

Americans as well as research on 

emerging topics related to organ 

donation. 

Likely Respondents: A nationally 

representative sample of adults over the 

age of 18 with a high number of 

responses from populations of interest 

such as racial-ethnic minorities, 

including African American, Asian, 

Native American, and Hispanic 

respondents, as well as respondents of 

all age groups and education levels. 

Burden Statement: Burden in this 

context means the time expended by 

persons to generate, maintain, retain, 

disclose or provide the information 

requested. This includes the time 

needed to review instructions; to 

develop, acquire, install and utilize 

technology and systems for the purpose 

of collecting, validating and verifying 

information, processing and 

maintaining information, and disclosing 

and providing information; to train 

personnel and to be able to respond to 

a collection of information; to search 

data sources; to complete and review 

the collection of information; and to 

transmit or otherwise disclose the 

information. The total annual burden 

hours estimated for this ICR are 

summarized in the table below. 

TOTAL ESTIMATED ANNUALIZED BURDEN—HOURS

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Total 

responses 

Average 

burden per 

response 

(in hours) 

Total 

burden 

hours 

National Survey of Organ Donation Attitudes and Practices—Telephone (English and Spanish Versions) .......... 2,000 1 2,000 .37 740 


sradovich on DSK3GMQ082PROD with NOTICES
29800 Federal Register / Vol. 83, No. 123 / Tuesday, June 26, 2018 / Notices 

TOTAL ESTIMATED ANNUALIZED BURDEN—HOURS—Continued 

Form name Number of 

respondents 

Number of 

responses per 

respondent 

Total 

responses 

Average 

burden per 

response 

(in hours) 

Total 

burden 

hours 

National Survey of Organ Donation Attitudes and Practices—Web Online Panel (English and Spanish 

Versions) .......................................................................... 8,000 1 8,000 .27 2,160 

Total .............................................................................. 10,000 ........................ 10,000 ........................ 2,900 

Amy P. McNulty, 

Acting Director, Division of the Executive 

Secretariat. 

[FR Doc. 2018–13590 Filed 6–25–18; 8:45 am] 

BILLING CODE 4165–15–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Proposed Collection: Public 

Comment Request Information 

Collection Request Title: Health 

Resources and Service Administration 

Uniform Data System, OMB No. 0915– 

0193—Revision 

AGENCY: Health Resources and Services 

Administration (HRSA), Department of 

Health and Human Services. 

ACTION: Notice. 

SUMMARY: In compliance with the 

requirement for opportunity for public 

comment on proposed data collection 

projects of the Paperwork Reduction Act 

of 1995, HRSA announces plans to 

submit an Information Collection 

Request (ICR), described below, to the 

Office of Management and Budget 

(OMB). Prior to submitting the ICR to 

OMB, HRSA seeks comments from the 

public regarding the burden estimate, 

below, or any other aspect of the ICR. 

DATES: Comments on this ICR must be 

received no later than August 27, 2018. 

ADDRESSES: Submit your comments to 

paperwork@hrsa.gov or mail the HRSA 

Information Collection Clearance 

Officer, Room 14N39, 5600 Fishers 

Lane, Rockville, MD 20857. 

FOR FURTHER INFORMATION CONTACT: To 

request more information on the 

proposed project or to obtain a copy of 

the data collection plans and draft 

instruments, email paperwork@hrsa.gov 

or call Lisa Wright-Solomon, HRSA 

Information Collection Clearance Officer 

at (301) 443–1984. 

SUPPLEMENTARY INFORMATION: When 

submitting comments or requesting 

information, please include the 

information request collection title for 

reference. 

Information Collection Request Title: 

HRSA Uniform Data System (UDS), 

OMB No. 0915–0193—Revision. 

Abstract: HRSA utilizes the UDS for 

annual reporting by certain HRSA 

award recipients, including Health 

Center Program awardees (those funded 

under section 330 of the Public Health 

Service (PHS) Act), Health Center 

Program look-alikes, and Nurse 

Education, Practice, Quality and 

Retention (NEPQR) Program awardees 

(specifically those funded under the 

practice priority areas of section 831(b) 

of the PHS Act). 

Need and Proposed Use of the 

Information: HRSA collects UDS data 

annually to ensure compliance with 

legislative and regulatory requirements, 

improve clinical and operational 

performance, and report overall program 

accomplishments. These data help to 

identify trends over time, enabling 

HRSA to establish or expand targeted 

programs and to identify effective 

services and interventions that will 

improve the health of medically 

underserved communities. HRSA 

compares UDS data with other national 

health-related data sets to compare 

HRSA award recipient patient 

populations and the overall U.S. 

population. 

HRSA is considering several changes 

for 2019 UDS data collection: 

• Substance Use Disorder and Mental 

Health Services: Collect substance use 

disorder and mental health services by 

provider specialty to better assess which 

providers are delivering behavioral 

health services; support investments in 

these priority areas; and better describe 

comprehensive, integrated models of 

care. 

• Closing the Referral Loop: Receipt 

of Specialist Report (https://

ecqi.healthit.gov/ecqm/measures/ 

cms050v6t): Add a clinical quality 

measure from the Centers for Medicare 

and Medicaid Services (CMS) 

electronic-specified clinical quality 

measures to address care coordination. 

• Health Information Technology 

(health IT): Streamline and clarify 

health IT questions regarding utilization 

of health IT to include information 

sharing, patient engagement, quality 

improvement, and program evaluation 

and research. 

• Statin Therapy for the Prevention 

and Treatment of Cardiovascular 

Disease (https://ecqi.healthit.gov/ecqm/ 

measures/cms347v1): Replace the 

current non-specified Coronary Artery 

Disease measure with an e-specified 

measure that aligns with the Centers for 

Disease Control and Prevention and the 

CMS Million Hearts® clinical quality 

measures relating to statin therapy. 

• Telemedicine and Virtual Visits: 

Collect information on services 

provided via telemedicine or virtual 

visits by provider in order to capture the 

changing health care delivery 

landscape. 

• Tenure for Health Center Staff: 

Retire Table 5A related to the tenure for 

staff. 

• Workforce: Collect workforce 

related information, including 

workforce satisfaction and health 

professional training. 

Likely Respondents: The respondents 

will include Health Center Program 

awardees, Health Center Program lookalikes, and NEPQR Program awardees 

funded under the practice priority areas 

of section 831(b) of the PHS Act. 

Burden Statement: Burden includes 

the time expended by persons to 

generate, maintain, retain, disclose or 

provide the information requested. This 

includes the time needed to review 

instructions; to develop, acquire, install, 

and utilize technology and systems for 

the purpose of: Collecting, validating 

and verifying information, processing 

and maintaining information, disclosing 

and providing information. It also 

accounts for time to train personnel, 

respond to a collection of information, 

search data sources, complete and 

review the collection of information, 

and transmit or otherwise disclose the 

information. The total annual burden 

hours estimated for this ICR are 

summarized in the table below. 


sradovich on DSK3GMQ082PROD with NOTICES