### 3208 Federal Register / Vol. 79, No. 12 / Friday, January 17, 2014 / Notices

Information Collection: Community First Choice Option; Use: This project is an evaluation of the implementation and progress of the Community First Choice (CFC) Option. The results of the study will be included in the final Report to Congress, to be delivered by the Secretary of Health and Human Services in 2015. The project is designed to assist CMS and Congress in their understanding of: States’ CFC implementation plans, the effectiveness of the CFC Option on individuals receiving home- and community-based attendant care, and States’ spending on long-term services and supports.

Researchers will request data from States approved for CFC via a data form and semi-structured interviews. Information obtained will be used to better understand CFC program design, the targeted patient population, and intended outcomes. At this time, we have only approved California’s program. To provide comparative information to the Secretary, researchers will also collect data from States that have decided not to pursue the CFC option. Data will be analyzed and developed into a report to Congress which will evaluate the effectiveness of the CFC option, the program’s impact on participants’ physical and emotional health, and a comparative analysis of the costs of community-based services and those provided in institutional settings. Form Number: CMS–10462 (OCN: 0938—New); Frequency: Once; Affected Public: Individuals and households, private sector (business or other for-profits and not-for-profit institutions), and State, Local, or Tribal Governments; Number of Respondents: 108; Total Annual Responses: 126; Total Annual Hours: 225. (For policy questions regarding this collection contact Elizabeth Garbarczyk at 410– 786–0426).

Dated: January 14, 2014. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2014–00916 Filed 1–16–14; 8:45 am]

**BILLING CODE 4120–01–P DEPARTMENT OF HEALTH AND**  **HUMAN SERVICES**

**Centers for Medicare & Medicaid Services** 

**[Document Identifiers: CMS–1561, CMS–R– 216, and CMS–R–262]** 

**Agency Information Collection Activities: Submission for OMB**  **Review; Comment Request**

**ACTION :**  Notice.

**SUMMARY :**  The Centers for Medicare & Medicaid Services (CMS) is announcing an opportunity for the public to comment on CMS’ intention to collect information from the public. Under the Paperwork Reduction Act of 1995 (PRA), federal agencies are required to publish notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, and to allow a second opportunity for public comment on the notice. Interested persons are invited to send comments regarding the 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.

**DATES :**  Comments on the collection(s) of information must be received by the OMB desk officer by February 18, 2014:

**ADDRESSES :**  When commenting on the proposed information collections, please reference the document identifier or OMB control number. To be assured consideration, comments and recommendations must be received by the OMB desk officer via one of the following transmissions: OMB, Office of Information and Regulatory Affairs, Attention: CMS Desk Officer, Fax Number: (202) 395–5806 OR, Email: OIRA

_submission@omb.eop.gov.

To obtain copies of a supporting statement and any related forms for the proposed collection(s) summarized in this notice, you may make your request using one of following:

1. Access CMS’ Web site address at http://www.cms.hhs.gov/ PaperworkReductionActof1995.

2. Email your request, including your address, phone number, OMB number, and CMS document identifier, to Paperwork@cms.hhs.gov.

3. Call the Reports Clearance Office at (410) 786–1326.

**FOR FURTHER INFORMATION CONTACT :**  Reports Clearance Office at (410) 786–
1326.

**SUPPLEMENTARY INFORMATION :**  Under the Paperwork Reduction Act of 1995 (PRA) (44 U.S.C. 3501–3520), federal agencies must obtain approval from the Office of Management and Budget (OMB) for each collection of information they conduct or sponsor. The term ‘‘collection of information’’ is defined in 44 U.S.C. 3502(3) and 5 CFR 1320.3(c) and includes agency requests or requirements that members of the public submit reports, keep records, or provide information to a third party. Section 3506(c)(2)(A) of the PRA (44 U.S.C. 3506(c)(2)(A)) requires federal agencies to publish a 30-day notice in the Federal Register concerning each proposed collection of information, including each proposed extension or reinstatement of an existing collection of information, before submitting the collection to OMB for approval. To comply with this requirement, CMS is publishing this notice that summarizes the following proposed collection(s) of information for public comment:

1. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Health Insurance Benefit Agreement; Use: Applicants to the Medicare program are required to agree to provide services in accordance with federal requirements. The CMS–1561 is essential in that is allows us to ensure that applicants are in compliance with the requirements. Applicants will be required to sign the completed form and provide operational information to us to assure that they continue to meet the requirements after approval. Form Number: CMS–1561 (OCN: 0938–0832); Frequency: Yearly; Affected Public: Private sector—(Business or other for-profits and Notfor-profit institutions); Number of Respondents: 3,000; Total Annual Responses: 3,000; Total Annual Hours: 500. (For policy questions regarding this collection contact Shonte Carter at 410– 786–3532).

2. Type of Information Collection Request: Extension of a currently approved collection; Title of Information Collection: Procedures for Advisory Opinions Concerning Physicians’ Referrals and Supporting Regulations; Use: The information collection requirements contained in 42 CFR 411.372 and 411.373 allow us to consider requests for advisory opinions


### 3209 Federal Register / Vol. 79, No. 12 / Friday, January 17, 2014 / Notices

and provide accurate and useful opinions. The information is read and analyzed to develop and issue an advisory opinion to the individual or entity that submitted the information. Form Number: CMS–R–216 (OCN: 0938–0714); Frequency: Occasionally; Affected Public: Private sector (Business or other for-profits and Not-for-profit institutions); Number of Respondents: 25; Total Annual Responses: 25; Total Annual Hours: 500. (For policy questions regarding this collection contact Jacqueline Proctor at 410–786– 0661).

3. Type of Information Collection Request: Revision of a currently approved collection; Title of Information Collection: CY 2015 Plan Benefit Package (PBP), Formulary, and Supporting Regulations; Use: We require Medicare Advantage and Prescription Drug Plan organizations submit a completed plan benefit package (PBP) and formulary as part of the annual bidding process. During this process, organizations prepare their proposed plan benefit packages for the upcoming contract year and submit them to us for review and approval. We publish beneficiary education information using a variety of formats. Specific education initiatives that utilize PBP and formulary data include web application tools on medicare.gov and the plan benefit insert in the Medicare & You handbook. In addition, organizations utilize the PBP data to generate their Summary of Benefits marketing information. The package has been revised subsequent to the publication of the 60-day Federal Register notice (78 FR 65656); Form Number: CMS–R–262 (OCN: 0938– 0763); Frequency: Yearly; Affected Public: Private sector (Business or other for-profits and Not-for-profit institutions); Number of Respondents: 652; Total Annual Responses: 6,265; Total Annual Hours: 57,477. (For policy questions regarding this collection contact Kristy Holtje at 410–786–2209).

Dated: January 14, 2014. Martique Jones, Deputy Director, Regulations Development Group, Office of Strategic Operations and Regulatory Affairs.
[FR Doc. 2014–00915 Filed 1–16–14; 8:45 am]

**BILLING CODE 4120–01–P**

**DEPARTMENT OF HEALTH AND HUMAN SERVICES** 

**Administration for Children and Families** 

**Submission for OMB Review; Comment Request** 

Title: Planning Grants To Develop a Model Intervention for Youth/Young Adults with Child Welfare Involvement At-Risk of Homelessness.

OMB No.: New Collection. Description: The Administration for Children and Families (ACF), U.S. Department of Health and Human Services intends to collect data for an process evaluation of the ‘‘Planning Grants to Develop a Model Intervention for Youth/Young Adults with Child Welfare Involvement at-Risk of Homelessness’’ program. This two year program, funded by the Children’s Bureau within ACF, will support planning grants to develop a model for intervening with youth who have experienced time in foster care and are most likely to have a challenging transition to adulthood, including the possibility of homelessness or unstable housing.

Respondents: Members of the planning team, which includes: Directors and staff from grantee agencies and partner agencies. Partner agencies may vary by site, but they are expected to include child welfare, mental health, and youth housing/homelessness agencies.



### ANNUAL 

### B URDEN 

### E STIMATES

Instrument Total number of respondents Annual number of respondents Annual number of responses per respondent Average burden hours per response Annual burden hours

Survey Sampling Form ........................................................ 36 18 1 .25 5 Survey of Organizational Readiness and Partnership ........ 540 270 1 1 270

Estimated Total Annual Burden Hours: 275.

Additional Information: Copies of the proposed collection may be obtained by writing to the Administration for Children and Families, Office of Planning, Research and Evaluation, 370 L’Enfant Promenade SW., Washington, DC 20447, Attn: OPRE Reports Clearance Officer. All requests should be identified by the title of the information collection. Email address: OPREinfocollection@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, Email: OIRA

_ SUBMISSION@OMB.EOP.GOV, Attn: Desk Officer for the Administration for Children and Families.

Karl Koerper, OPRE Reports Clearance Officer.
[FR Doc. 2014–00854 Filed 1–16–14; 8:45 am]

**BILLING CODE 4184–01–P DEPARTMENT OF HEALTH AND**  **HUMAN SERVICES**

**Food and Drug Administration**

**[Docket No. FDA–2010–D–0319]**

**Agency Information Collection Activities; Announcement of Office of**  **Management and Budget Approval; Guidance for Industry and Food and**  **Drug Administration Staff on Dear Health Care Provider Letters:**  **Improving Communication of Important Safety Information** 

**AGENCY :**  Food and Drug Administration, HHS.

**ACTION :**  Notice.

**SUMMARY :**  The Food and Drug Administration (FDA) is announcing