23260 Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices 

Dated: March 27, 2012. 

Kathleen Sebelius, 

Secretary. 

[FR Doc. 2012–9238 Filed 4–16–12; 11:15 am] 

BILLING CODE 4150–03–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: ‘‘CHIPRA 

Pediatric Quality Measures Program 

Candidate Measure Submission Form.’’ 

In accordance with the Paperwork 

Reduction Act, 44 U.S.C. 3501–3521, 

AHRQ invites the public to comment on 

this proposed information collection. 

DATES: Comments on this notice must be 

received by June 18, 2012. 

ADDRESSES: Written comments should 

be submitted to: Doris Lefkowitz, 

Reports Clearance Officer, AHRQ, by 

email at doris.lefkowitz@AHRQ.hhs.gov. 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at doris.lefkowitz@AHRQ.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Pediatric Quality Measures Program 

Section 401(a) of the Children’s 

Health Insurance Program 

Reauthorization Act of 2009 (CHIPRA), 

Public Law 111–3, amended the Social 

Security Act (‘‘the Act’’) to enact section 

1139A (42 U.S.C. 1320b–9a). Section 

1139A(b) charged the Department of 

Health and Human Services (HHS) with 

improving pediatric health care quality 

measures. Since CHIPRA was passed, 

AHRQ and the Centers for Medicare & 

Medicaid Services (CMS) have been 

working together to implement selected 

provisions of the legislation related to 

children’s health care quality. An initial 

core measure set for voluntary use by 

Medicaid and Children’s Health 

Insurance Programs (CHIP) was posted 

December 29, 2009 (http:// 

www.gpo.gov/fdsys/pkg/FR–2009–12– 

29/html/E9–30802.htm). In February 

2010, CMS released a State Health 

Official letter which outlined the initial 

core measures and how these measures 

would be reported to CMS. 

Subsequently, AHRQ and CMS 

established the CHIPRA Pediatric 

Quality Measures Program (PQMP) in 

accordance with section 1139A(b)(1) of 

the Act to enhance select children’s 

health care quality measures and 

develop new measures (http:// 

www.ahrq.gov/chipra). The PQMP is 

intended to increase the portfolio of 

measures available to public and private 

purchasers of children’s health care 

services, providers, and consumers. 

HHS anticipates that measures 

ultimately included in the Improved 

Core Set will also be used by public and 

private purchasers to measure pediatric 

healthcare quality. The PQMP consists 

of the following: 

(1) Seven Centers of Excellence (CoEs) 

that are developing and/or enhancing 

children’s health care quality measures 

through cooperative agreements with 

AHRQ in order to increase the portfolio 

of measures available to the public and 

private purchasers of children’s health 

care services, providers and consumers 

(http://www.ahrq.gov/chipra/ 

pqmpfact.htm); 

(2) CHIPRA Coordinating and 

Technical Assistance Center (CCTAC); 

(3) Two CHIPRA quality 

demonstration grantees (Illinois, a 

partner to the Florida grantee, and 

Massachusetts) funded by CMS to 

undertake new quality measure 

development as part of their grants 

http://www.insurekidsnow.gov/ 

professionals/CHIPRA/ 

grants_summary.html; and 

(4) The Subcommittee on Children’s 

Healthcare Quality Measures of the 

AHRQ National Advisory Council on 

Healthcare Research and Quality 

(SNAC) that will review measures 

nominated through a public call for 

measures, as well as measures 

developed or enhanced by the CoEs, and 

make recommendations for an improved 

core set of children’s health care quality 

measures and other CHIPRA purposes 

(http://www.ahrq.gov/chipra/ 

panellist11.htm). 

Section 1139A of the Act provides 

that improved core sets of children’s 

health care quality measures be 

identified beginning January 1, 2013, 

and annually thereafter, for potential 

voluntary use by Medicaid and CHIP 

programs and other CHIPRA purposes. 

AHRQ intends to solicit nominations for 

children’s health care quality measures 

for these purposes using a standard 

measure nomination form early in 

calendar years 2013 and 2014 through a 

public call for measures. These 

solicitations will be undertaken by 

AHRQ to identify children’s health care 

quality measures for review by the 

SNAC. 

Section 1139A(b)(2) of the Act 

requires that the measures in the 

improved core sets shall, at a minimum, 

be: 

(A) Evidence-based and, where 

appropriate, risk adjusted; 

(B) Designed to identify and eliminate 

racial and ethnic disparities in child 

health and the provision of health care; 

(C) Designed to ensure that the data 

required for such measures is collected 

and reported in a standard format that 

permits comparison of quality and data 

at a State, plan, and provider level; 

(D) Periodically updated; and 

(E) Responsive to the child health 

needs, services, and domains of health 

care quality described in clauses (i), (ii), 

and (iii) of subsection (a)(6)(A). 

Hence, AHRQ, CMS, and PQMP 

developed a CHIPRA Pediatric Quality 

Measures Program (PQMP) Candidate 

Measure Submission Form (hereinafter 

referred to as ‘‘CHIPRA PQMP 

Candidate Measure Submission Form’’) 

and a Glossary of Terms. The CHIPRA 

PQMP Candidate Measure Submission 

Form and Glossary of Terms detail the 

measure evaluation criteria and related 

definitions to provide operational 

guidance for the minimum evaluation 

criteria as specified in section 

1139A(b)(2) of the Act. AHRQ intends to 

use this CHIPRA PQMP Candidate 

Measure Submission Form to conduct a 

public call for measures early in 

calendar years 2013 and 2014 to solicit 

measures for consideration by the SNAC 

for the 2014 and 2015 improved core 

sets of children’s health care quality 

measures for voluntary use by Medicaid 

and CHIP programs and for other 

CHIPRA purposes. 

The goals of the CHIPRA PQMP 

Candidate Measure Form project are to: 

(1) Solicit nominations for children’s 

health care quality measures early in 

calendar years 2013 and 2014 through 

public calls for measures, using a 

standardized data collection form; 

(2) Use the information provided 

through the standardized data collection 

form to support SNAC review of 

children’s health care quality measures 

nominated by the public and measures 

developed by the seven CoEs; and 

(3) Identify measures for improved 

core sets of children’s health care 

quality measures and for other CHIPRA 

purposes. 

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Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices 23261 

The process for review of the 

measures developed by the seven COEs 

will be the same as that for measures 

submitted in response to calls for public 

nominations. 

Respondents to these public calls for 

measures in 2013 and 2014 are expected 

to include pediatricians, researchers, 

measure developers, and measure 

stewards of children’s health care 

quality measures. 

This project is being conducted by 

AHRQ pursuant to AHRQ’s statutory 

authority under Title IX of the Public 

Health Service Act to conduct and 

support research to improve health care 

quality, and to fulfill a number of 

requirements under Title IV of CHIPRA, 

including requirements to identify 

candidate measures for public posting of 

an improved core set of children’s 

health care quality measures by January 

1, 2014 and January 1, 2015. 

Method of Collection 

To achieve the goals of this project, 

AHRQ intends to solicit submission of 

measures from the members of the 

public using the CHIPRA PQMP 

Candidate Measure Submission Form, a 

standardized data collection tool. Data 

collection using the CHIPRA PQMP 

Candidate Measure Submission Form 

will be adequate to achieve the goals of 

the project. Below is an outline of the 

type of data collected through the 

CHIPRA PQMP Candidate Measure 

Submission Form and description of the 

information solicited from each 

nominator pursuant to section 

1139A(b)(2) of the Act. 

1. Basic measure information, 

including: measure name, measure 

description, denominator statement (if 

applicable), numerator statement (if 

applicable), data sources, exclusions, 

measure owner and/or copyright owner 

and any other applicable proprietary 

rights (e.g., patent or data rights), any 

confidentiality or trade secret 

protections, National Quality Forum 

(NQF) identification number (if 

applicable; i.e., if the measure has been 

endorsed by NQF), and whether part of 

a measure hierarchy (e.g., a collection of 

measures, a measure set, a measure 

subset as defined at http:// 

www.qualitymeasures.ahrq.gov/about/ 

hierarchy.aspx). 

2. Detailed measure specifications: 

Description of how a measure would be 

calculated from appropriate data 

sources. 

3. Importance of the measure: 

Description of how the measure meets 

one or more of the following criteria for 

importance, citing scientific literature 

and providing references: importance to 

Medicaid and/or CHIP program, 

including the extent to which Medicaid/ 

CHIP policies can stimulate 

improvement on the measure, and 

relevance to Early Periodic Screening, 

Diagnosis, and Treatment benefit; 

potential for quality improvement and 

reduction of disparities in quality; 

health importance/prevalence of 

condition; health importance/severity 

and burden (including impact on 

children, families and societies); overall 

cost burden to patients, families, public 

and private payers, or society more 

generally currently and over the life 

span of the child; association of measure 

topic to children’s current or future 

health; how the underlying concept of 

the measure changes in meaning and 

manifestation (if at all) across 

developmental stages. 

4. Settings, services, measure 

domains, and populations addressed by 

the measure. CHIPRA asks that the 

improved core sets cover the following 

domains of healthcare quality for 

children at a minimum: the duration of 

children’s coverage over a 12 month 

time period; the availability and 

effectiveness of a full range of: (i) 

Preventive services, treatments, and 

services for acute conditions, including 

services to promote healthy birth, 

prevent and treat premature birth, and 

detect the presence or risk of physical 

or mental conditions that could 

adversely affect growth and 

development; (ii) treatments to correct 

or ameliorate the effects of physical and 

mental conditions, including chronic 

conditions, in infants, young children, 

school-age children, and adolescents; 

(iii) the availability of care in a range of 

ambulatory and inpatient health care 

settings in which such care is furnished; 

and, (iv) the types of measures that, 

taken together, can be used to estimate 

the overall national quality of health 

care for children, including children 

with special needs, and to perform 

comparative analyses of pediatric health 

care quality and racial, ethnic, and 

socioeconomic disparities in child 

health and healthcare for children. 

Nominations will need to identify all 

settings, services, measure domains, and 

populations that a measure addresses. 

5. Evidence for focus of the measure: 

The evidence base for the focus of the 

measures included in the January 1, 

2014 and January 1, 2015 improved core 

sets will be made explicit and 

transparent; thus, it is critical for 

nominations to specify the scientific 

evidence or other basis for the focus of 

the measure, including a brief 

description of the evidence base or 

rationale for the relationship between 

the measure and a significant structure, 

process, or outcome that influences 

children’s health and health care. 

6. Scientific soundness of the 

measure: Explanation of methods to 

determine the scientific soundness of 

the measure itself, including results of 

all tests of validity and reliability, 

including description(s) of the study 

sample(s) and methods used to arrive at 

the results. Also, information on how 

characteristics of the data system/data 

sources may affect validity and 

reliability of the measure. 

7. Identification of disparities: 

CHIPRA requires that quality measures 

be able to identify disparities by race, 

and ethnicity, and be responsive to 

domains of health care quality such as 

socioeconomic status, and special 

health care needs. Nominations will 

provide evidence (if available) from 

testing of measures with diverse 

populations (considering that diversity 

may include race, ethnicity, rural 

populations, inner city populations, 

special health care needs, 

socioeconomic status, and/or insurance 

source, especially Medicaid or CHIP) to 

assess measure’s performance for 

disparities identification. 

8. Feasibility: Description of the 

measure’s feasibility, including: 

availability of data in existing data 

systems; opportunities/pathways for 

implementation; extent to which the 

measure has been used or is in use (or 

has not been used), including settings in 

which it has been used; data collection 

methods that have been used; eligible 

populations and results of testing in the 

eligible populations, including an 

estimation of the population size 

required to gain adequate numbers of 

observations for reliable comparisons, 

such as estimates of the required 

population sizes to gain adequate 

numbers for stratification by race, 

ethnicity, special health care need, and 

socioeconomic status. 

9. Levels of aggregation: CHIPRA 

states that data used in quality measures 

must be collected and reported in a 

standard format that permits 

comparison (at minimum) at State, 

health plan, and provider levels. 

Nominations will provide information 

on all levels of aggregation at which the 

measure is primarily intended to apply 

(e.g., State (Medicaid and CHIP 

populations), health plan, hospital, 

practice, provider, patient) and at which 

the measure has been tested. 

10. Understandability: CHIPRA states 

that the core set should allow 

purchasers, families, and health care 

providers to understand the quality of 

care for children. Nominations will 

include a description of the usefulness 

of the measure to purchasers, families, 

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23262 Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices 

and health care providers and present 

results from efforts to assess the 

understandability of the measure. 

11. Health Information Technology: 

Nominations will provide information 

on health information technology (HIT) 

that has been or could be incorporated 

into the measure calculation. 

12. Additional Disclosures and 

Notices: All nominations will include 

contact information for the measure 

submitter, including: (a) Name, (b) Title, 

(c) Organization, (d) Mailing address, (e) 

Telephone number, and (f) email 

address. Further, all nominations will 

include a written statement disclosing 

the proprietary and/or confidentiality 

status of the measure and full measure 

specifications, as described in the Basic 

Measure Information category. This 

statement must be signed by the 

applicable rights holder(s) or an 

individual authorized to act on its 

behalf for each submitted measure or 

instrument. If signed by an authorized 

individual, the statement must describe 

the basis for such authorization. 

Submitters are encouraged to disclose 

the terms under which the measure and 

full measure specifications are currently 

made available to interested parties—for 

example, a standard license and/or 

nondisclosure agreement, or a statement 

describing the terms thereof. Should 

HHS accept the measure for the 2014 

and/or 2015 Improved Core Measure 

Sets, full measure specifications for the 

accepted measure will be subject to 

public disclosure (e.g., on the AHRQ 

and/or CMS Web sites). In addition, 

AHRQ expects that measures and full 

measure specifications will be made 

reasonably available to all interested 

parties. 

The information resulting from this 

data collection will be used to: (a) 

Improve and strengthen the initial core 

set of measures of health care quality 

measures established under CHIPRA in 

December 2009 (http://www.gpo.gov/ 

fdsys/pkg/FR-2009–12-29/html/E9- 

30802.htm), (b) expand on existing 

pediatric quality measures used by 

public and private health care 

purchasers, and (c) increase the 

portfolio of evidence-based consensus 

pediatric quality measures available to 

public and private purchasers of 

children’s health care services, 

providers, and consumers. 

Each measure nominated by members 

of the public will be reviewed by 

members of SNAC using the categories 

of evaluation criteria detailed in the 

CHIPRA PQMP Candidate Measure 

Submission Form. SNAC will make 

recommendations to NAC which in turn 

make recommendations to the AHRQ 

Director for consideration of select 

measures for inclusion in the public 

posting of an improved core set by 

January 1, 2014 and January 1, 2015 for 

voluntary use by Medicaid and CHIP 

programs and other CHIPRA purposes. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for members 

of the public who will nominate 

measures through use of the online 

CHIPRA PQMP Candidate Measure 

Submission Form. We anticipate a 

maximum of 50 nominations each year 

with each nomination requiring three 

hours. The total burden is estimated to 

be 150 hours annually. 

Exhibit 2 shows the estimated 

annualized cost burden for respondents’ 

to complete the online submission form 

for the public call for measures. The 

total cost burden is estimated to be 

$11,801 annually. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Data collection Number of 

nominations 

Number of 

responses per 

nominations 

Hours per 

response 

Total burden 

hours 

CHIPRA PQMP Candidate Measure Submission Form .................................. 50 1 3 150 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Data collection Number of 

nominations 

Total burden 

hours 

Average 

hourly wage 

rate* 

Total cost 

burden 

CHIPRA PQMP Candidate Measure Submission Form .................................. 50 150 $78.67 $11,801 

*Based upon the mean of the average wages for 29–1065 (Pediatricians, General), $78.67 per hour, National Compensation Survey: Occupational wages in the United States May 2009, U.S. Department of Labor, Bureau of Labor Statistics. Although the measure nominations will be solicited from the general public, AHRQ is using the wage rate for pediatricians since our expectation is that respondents to the 2013 and 2014 

public call for measures will primarily be pediatricians who will be measure developers or measure stewards of children’s health care quality 

measures. 

Estimated Annual Costs to the Federal 

Government 

Exhibit 3 shows the estimated total 

and annualized cost over 3 years to the 

government for conducting this project. 

The total cost is estimated to be 

$275,270. 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost component Total cost Annualized 

cost 

Project Development ....................................................................................................................................................... $16,205 $5,402 

Data Collection Activities ................................................................................................................................................. 46,553 15,518 

Data Processing and Analysis ......................................................................................................................................... 43,190 14,397 

Publication of Results ...................................................................................................................................................... 53,938 17,979 

Project Management ........................................................................................................................................................ 22,620 7,540 

Overhead ......................................................................................................................................................................... 92,764 30,921 

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Federal Register / Vol. 77, No. 75 / Wednesday, April 18, 2012 / Notices 23263 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST—Continued 

Cost component Total cost Annualized 

cost 

Total .......................................................................................................................................................................... 275,270 91,757 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, comments on AHRQ’s 

information collection are requested 

with regard to any of the following: (a) 

Whether the proposed collection of 

information is necessary for the proper 

performance of AHRQ healthcare 

research and healthcare information 

dissemination functions, including 

whether the information will have 

practical utility; (b) the accuracy of 

AHRQ’s estimate of burden (including 

hours and costs) of the proposed 

collection(s) of information; (c) ways to 

enhance the quality, utility, and clarity 

of the information to be collected; and 

(d) ways to minimize the burden of the 

collection of information upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 

comments will become a matter of 

public record. 

Dated: April 6, 2012. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2012–9105 Filed 4–17–12; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[60Day–12–12IG] 

Proposed Data Collections Submitted 

for Public Comment and 

Recommendations 

In compliance with the requirement 

of Section 3506(c)(2)(A) of the 

Paperwork Reduction Act of 1995 for 

opportunity for public comment on 

proposed data collection projects, the 

Centers for Disease Control and 

Prevention (CDC) will publish periodic 

summaries of proposed projects. To 

request more information on the 

proposed projects or to obtain a copy of 

the data collection plans and 

instruments, call 404–639–7570 and 

send comments to Kimberly S. Lane, at 

CDC 1600 Clifton Road, MS–D74, 

Atlanta, GA 30333 or send an email to 

omb@cdc.gov. 

Comments are invited on: (a) Whether 

the proposed collection of information 

is necessary for the proper performance 

of the functions of the agency, including 

whether the information shall have 

practical utility; (b) the accuracy of the 

agency’s estimate of the burden of the 

proposed collection of information; (c) 

ways to enhance the quality, utility, and 

clarity of the information to be 

collected; and (d) ways to minimize the 

burden of the collection of information 

on respondents, including through the 

use of automated collection techniques 

or other forms of information 

technology. Written comments should 

be received within 60 days of this 

notice. 

Proposed Project 

Targeted Surveillance and Biometric 

Studies for Enhanced Evaluation of 

Community Transformation Grants— 

New—National Center for Chronic 

Disease Prevention and Health 

Promotion (NCCDPHP), Centers for 

Disease Control and Prevention (CDC). 

Background and Brief Description 

The Prevention and Public Health 

Fund (PPHF) of the Patient Protection 

and Affordable Care Act of 2010 (ACA) 

provides an important opportunity for 

states, counties, territories and tribes to 

advance public health across the 

lifespan and to reduce health 

disparities. The PPHF authorizes 

Community Transformation Grants 

(CTG) for the implementation, 

evaluation, and dissemination of 

evidence-based community preventive 

health activities. The CTG Program 

emphasizes five strategic directions: (1) 

Tobacco-free living, (2) active lifestyles 

and healthy eating, (3) high impact, 

evidence-based clinical and other 

preventive services, (4) social and 

emotional well-being, and (5) healthy 

and safe physical environments. 

The CTG Program is administered by 

the Centers for Disease Control and 

Prevention (CDC), National Center for 

Chronic Disease Prevention and Health 

Promotion (NCCDPHP). As required by 

Section 4201 of the ACA, CDC is 

responsible for conducting a 

comprehensive evaluation of the CTG 

Program which includes assessment 

over time of measures relating to each 

of the five strategic directions. CDC is 

requesting OMB approval to collect 

information needed for these 

assessments. The information collection 

will include population-level and 

targeted surveillance of high interest 

indicators for a range of age groups in 

select CTG communities, as well as 

enhanced evaluation studies designed to 

assess the potential impact of specific 

CTG strategies on health outcomes. 

CDC plans to conduct the Adult 

Targeted Surveillance Survey (ATSS) in 

20 CTG communities. Ten communities 

that have already received CTG 

cooperative agreements (group A) will 

participate in the ATSS in 2012, 2014, 

and 2016, and ten communities that will 

receive CTG funding in fiscal year 2013 

(group B) will participate in the ATSS 

in 2013, 2015, and 2017. The ATSS will 

be administered by telephone to a 

representative sample of 1,000 adult 

residents in each community for an 

estimated annualized number of 

respondents of 10,000. Respondents will 

be asked to provide information about 

household practices and their personal 

behaviors specific to the five strategic 

directions (e.g., nutrition). Responses 

will be used to monitor changes in 

relevant attitudes, risk behaviors, and 

other behavioral factors in specific 

geographic areas where CTG cooperative 

agreement awardees are implementing 

interventions related to CTG strategic 

directions. Information from the 

targeted surveillance surveys will be 

compared with data from other local, 

state or national surveillance systems. 

During the initial three-year OMB 

clearance period, the ATSS will be 

administered to a total of 20,000 

respondents in group A communities 

and 10,000 respondents in group B 

communities. 

CDC’s CTG Program evaluation plans 

also include enhanced evaluation 

activities and special studies fulfilling 

the congressional mandate to expand 

the evidence base of effective public 

health interventions across a range of 

settings, population subgroups, and 

health outcomes. These studies will 

include use of mixed-method 

approaches and observational and 

outcome data collection in select 

communities. The initial selected 

studies will address biometric changes 

specific to CTG interventions; the 

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