Federal Register / Vol. 89, No. 22 / Thursday, February 1, 2024 / Notices 6525 

November 27, 2023. No comments were 

received. 

Obtaining Copies of Proposals: 

Requesters may obtain a copy of the 

information collection documents from 

the GSA Regulatory Secretariat Division, 

by calling 202–501–4755 or emailing 

GSARegSec@gsa.gov. Please cite 

‘‘Information Collection 3090–0322’’, in 

all correspondence. 

Jeffrey Koses, 

Senior Procurement Executive, Office of 

Acquisition Policy, Office of Governmentwide Policy. 

[FR Doc. 2024–02040 Filed 1–31–24; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Inpatient Severe Maternal Morbidity 

Measure Technical Specifications 

AGENCY: Agency for Healthcare Research 

and Quality, U.S. Department of Health 

and Human Services. 

ACTION: Notice of Request for 

Information. 

SUMMARY: The Agency for Healthcare 

Research and Quality (AHRQ) Center for 

Quality Improvement and Patient Safety 

(CQuIPS) Division of Quality 

Measurement and Improvement (QMI) 

invites public comment in response to 

this Request for Information (RFI). The 

AHRQ Quality Indicators (QI) program 

maintains inpatient quality indicators 

(https://qualityindicators.ahrq.gov/ 

measures/IQI_TechSpecTechSpec) and 

patient safety indicators (https://

qualityindicators.ahrq.gov/measures/ 

PSI_TechSpec), several of which are 

relevant to maternal health care. 

Specifically, the QI program maintains 

measures of obstetric trauma, birth 

trauma, and cesarean delivery 

calculated at the hospital level using 

administrative data. However, severe 

maternal morbidity during an inpatient 

stay may result from a host of 

complications, such as sepsis, cardiac 

failure, stroke, respiratory distress, and 

renal failure. While state-level rates of 

severe maternal morbidity are available 

from AHRQ (https://datatools.ahrq.gov/ 

hcup-fast-stats/?tab=specialemphasis&dash=92), experts have noted 

some shortcomings of this measure. 

This RFI seeks comments on the 

usability, feasibility, and likely uptake 

of a measure of severe maternal 

morbidity to be validated, refined, and 

maintained by the QI program, with the 

goal of providing data for maternal 

health service improvements. While a 

measure of severe maternal morbidity is 

currently available from AHRQ and the 

Health Resources and Service 

Administration (HRSA), several experts 

have suggested that this algorithm could 

benefit from refinements. 

DATES: Comments on this notice must be 

received at the address provided below 

within 30 days of publication of this 

notice, no later than March 4, 2024. 

ADDRESSES: Interested parties may 

submit comments electronically to 

askahrq@ahrq.hhs.gov. When 

submitting comments or requesting 

information, please include the 

document identifier number and project 

title ‘‘Inpatient Severe Maternal 

Morbidity Measure Technical 

Specifications’’ for reference. 

FOR FURTHER INFORMATION CONTACT: 

Questions may be addressed to Judy 

George, Program Lead for the AHRQ 

Quality Indicators, Judy.george@

ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: Maternal 

health, including maternal behavioral 

health, is a national priority in the 

United States. Strengthening data 

collection and evaluation is part of the 

first goal of the White House Blueprint 

for Addressing the Maternal Health 

Crisis (https://www.whitehouse.gov/wpcontent/uploads/2022/06/MaternalHealth-Blueprint.pdf), which is to 

increase access to and coverage of 

comprehensive high-quality maternal 

health services, including behavioral 

health services. Unexpected 

complications and outcomes around 

labor and delivery may lead to short- or 

long-term consequences to women’s 

health (https://

pubmed.ncbi.nlm.nih.gov/27560600/), 

which have been defined as severe 

maternal morbidity (https://

www.cdc.gov/reproductivehealth/ 

maternalinfanthealth/ 

severematernalmorbidity.htmlhtml). 

National and state rates of severe 

maternal morbidity are currently 

available on AHRQ’s Healthcare Cost 

and Utilization Project (HCUP) Fast 

Stats dashboard (https://

datatools.ahrq.gov/hcup-fast-stats/ 

?tab=special-emphasis&dash=92). 

However, there are measurement 

concerns for some of indicators 

included in this measure (eclampsia, 

disseminated intravascular coagulation, 

and blood transfusions) and additional 

validation and refinement may be 

warranted. 

In collaboration with federal partners 

from the Department of Health and 

Human Services, AHRQ is exploring 

potential refinements to this measure of 

severe maternal morbidity for use at an 

area level (e.g., county, state) using 

administrative data. AHRQ aims to 

assess the validity and reliability of 

potential refinements to this severe 

maternal morbidity measure. In 

addition, AHRQ is considering 

incorporating a measure of severe 

maternal morbidity into its measure 

portfolio, including the production of 

technical specifications and the 

dissemination of software to calculate 

this measure through the AHRQ QI 

program. 

Many users of quality measures, such 

as state and local governments, largely 

rely on administrative data that lack the 

robust clinical information found in 

electronic health records (EHRs). For 

example, Centers for Medicaid and 

Medicare Services (CMS) has developed 

Electronic Clinical Quality Measures 

(ECQMs) for severe obstetric 

complications which relies upon EHR 

data. AHRQ aims to provide 

measurement resources that are broadly 

accessible across organizations, 

including for those lacking access to 

extensive clinical data. 

To support measurement resources 

that are broadly accessible across 

organizations, AHRQ requests public 

comment on the usability, feasibility, 

and likely uptake of an inpatient severe 

maternal morbidity measure, produced 

through the QI program using 

administrative data, with the intent of 

promoting maternal health service 

improvements at an area level (e.g., 

county, state). AHRQ invites 

stakeholders representing consumers, 

state/regional/local health departments, 

accountable care organizations, 

community health centers, birthing 

centers, providers/health systems, 

critical access/rural hospitals, 

professional associations, payers, rural 

and community health groups, 

community health workers, doulas, 

maternal health advocacy groups, 

researchers, and other members of the 

public to comment. 

Specific questions of interest include, 

but are not limited to: 

1. If you are currently measuring 

severe maternal morbidity in your 

organization, what measure(s) are you or 

your organization using? How do you 

use these measures? What data sources 

are you using? Please specify 

organization type in your answer. 

2. If you or your organization are not 

currently measuring severe maternal 

morbidity, what quantitative data would 

you need to make maternal health 

service improvements? Please specify 

organization type in your answer. 

3. At what level—state, county, or 

some other level—would information be 


ddrumheller on DSK120RN23PROD with NOTICES1
6526 Federal Register / Vol. 89, No. 22 / Thursday, February 1, 2024 / Notices 

most helpful for improving maternal 

health services? In what ways? 

4. The measure currently used by 

AHRQ for severe maternal morbidity 

uses 21 indicators (https://www.cdc.gov/ 

reproductivehealth/ 

maternalinfanthealth/smm/severemorbidity-ICD.htm) identified with 

ICD–10CM10CM/PCS codes in 

administrative data. Considering these 

indicators, 

a. What codes might be missing? Are 

there changes you would you 

recommend? 

b. In what ways would the changes 

that you propose make a severe 

maternal morbidity measure more 

useful to your organization? 

c. Would a measure with the 

refinements you propose be useful for 

surveillance? Population health 

management? Clinical quality 

improvement? Program evaluation? 

Research? Public reporting or 

accountability programs? In what ways? 

5. What other measures of maternal 

health and/or morbidity would your 

organization find useful/effective for 

improving maternal health services, 

including any potential measures for 

use in either the prenatal or postpartum 

time periods? 

AHRQ is interested in all of the 

questions listed above, but respondents 

are welcome to address as many or as 

few as they choose and to address 

additional areas of interest not listed. It 

is helpful to identify the question to 

which a particular answer corresponds. 

This RFI is for planning purposes 

only and should not be construed as a 

policy, solicitation for applications, or 

as an obligation on the part of the 

Government to provide support for any 

ideas in response to it. AHRQ will use 

the information submitted in response 

toto this RFI at its discretion and will 

not provide comments to any 

respondent’s submission. However, 

responses to this RFI may be reflected 

in future solicitation(s) or policies. The 

information provided will be analyzed 

and may appear in reports. 

Dated: January 29, 2024. 

Marquita Cullom, 

Associate Director. 

[FR Doc. 2024–02021 Filed 1–31–24; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Reorganization of the National Center 

for Environmental Health 

AGENCY: Centers for Disease Control and 

Prevention (CDC), the Department of 

Health and Human Services (HHS). 

ACTION: Notice. 

SUMMARY: CDC has modified its 

structure. This notice announces the 

reorganization of the National Center for 

Environmental Health (NCEH). NCEH 

retitled three branches and established 

the Environmental Public Health 

Tracking Branch. 

DATES: This reorganization was 

approved by the Director of CDC on 

January 26, 2024 and became effective 

January 26, 2024. 

FOR FURTHER INFORMATION CONTACT: 

D’Artonya Graham, Office of Strategic 

Business Initiatives, Office of the Chief 

Operating Officer, Office of the Director, 

Centers for Disease Control and 

Prevention, 1600 Clifton Road NE, MS 

TW–2, Atlanta, GA 30329; Telephone 

770–488–4401; Email: reorgs@cdc.gov. 

SUPPLEMENTARY INFORMATION: Part C 

(Centers for Disease Control and 

Prevention) of the Statement of 

Organization, Functions, and 

Delegations of Authority of the 

Department of Health and Human 

Services (45 FR 67772–76, dated 

October 14, 1980, and corrected at 45 FR 

69296, October 20, 1980, as amended 

most recently at 88 FR 69188–69190, 

dated October 5, 2023) is amended to 

reflect the reorganization of the National 

Center for Environmental Health, 

Centers for Disease Control and 

Prevention. Specifically, the changes are 

as follows: 

I. Under Part C, Section C–B, 

Organization and Functions, make the 

following changes: 

• Update the functional statements and 

retitle all references to the Asthma 

and Community Health Branch 

(CNCC) to the Asthma and Air Quality 

Branch (CNCC) 

• Update the functional statements and 

retitle all references to the Lead 

Poisoning Prevention and 

Environmental Health Tracking 

Branch (CNCD) to the Lead Poisoning 

Prevention and Surveillance Branch 

(CNCD) 

• Update the functional statements and 

retitle the Emergency Management, 

Radiation, and Chemical Branch 

(CNCE) to the Emerging 

Environmental Hazards and Health 

Effects Branch (CNCE) 

II. Under Part C, Section C–B, 

Organization and Functions, after the 

Emerging Environmental Hazards and 

Health Effects Branch insert the 

following organizational unit: 

• Environmental Public Health 

Tracking Branch (CNCG) 

III. Under Part C, Section C–B, 

Organization and Functions, insert the 

following: 

Asthma and Air Quality Branch 

(CNCC) (1) develops, implements, and 

evaluates asthma programs and 

strategies that are part of the National 

Asthma Control Program to reduce 

asthma morbidity and mortality; (2) 

conducts epidemiologic research and 

investigations of asthma morbidity and 

mortality; (3) develops program, 

conducts epidemiologic analysis and 

supports other activities to address 

social determinants of health related to 

asthma disparities; (4) supports 

surveillance activities for asthma, and 

other respiratory diseases, as 

appropriate, to quantify burden and 

guide programs; (5) identifies the 

evidence for, promotes, and tracks 

interventions that reduce the burden of 

asthma, focusing on populations with a 

disproportionate burden of the disease; 

(6) develops and disseminates training, 

tools, communication products, and 

other resources to strengthen and 

sustain asthma control activities and 

technical capacity among national, state, 

tribal, local, territorial and other 

program partners; (7) provides technical 

consultation to state, local, private, 

international, and other federal agencies 

on asthma control, surveillance, 

epidemiology, and evaluation 

(including economic evaluation; (8) 

disseminates and promotes information 

from surveillance and health studies 

related to asthma control; (9) conducts 

epidemiologic research and 

investigations of the potential health 

effects of ambient air pollutants, 

including wildfire smoke; (10) designs 

and evaluates behavioral, 

communication, policy, technological, 

and community design interventions to 

reduce exposures to air pollution and 

improve health; (11) supports activities 

to reduce indoor air pollution; (12) 

develops and coordinates training and 

decision support tools to strengthen and 

sustain air pollution activities and 

technical capacity among national, state, 

tribal, local, and territorial program 

partners; (13) provides technical 

consultation to federal, state, tribal, 

local, territorial, private, and 

international agencies on environmental 

issues related to air pollutants; (14) 


ddrumheller on DSK120RN23PROD with NOTICES1