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 


emcdonald on DSK67QTVN1PROD with NOTICES
Federal Register / Vol. 79, No. 12 / Friday, January 17, 2014 / Notices 3209 

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 BURDEN ESTIMATES

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 


emcdonald on DSK67QTVN1PROD with NOTICES