[Federal Register Volume 89, Number 215 (Wednesday, November 6, 2024)]
[Notices]
[Pages 88053-88055]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-25717]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Proposed Collection: 
Public Comment Request; Information Collection Request Title: Medicare 
Rural Hospital Flexibility Program Performance

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services.

ACTION: Notice.

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[[Page 88054]]

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 should be received no later than January 6, 
2025.

ADDRESSES: Submit your comments to <a href="/cdn-cgi/l/email-protection#631302130611140c1108230b1110024d040c15"><span class="__cf_email__" data-cfemail="700011001502071f021b30180203115e171f06">[email protected]</span></a> or mail the HRSA 
Information Collection Clearance Officer, Room 14N39, 5600 Fishers 
Lane, Rockville, Maryland 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 <a href="/cdn-cgi/l/email-protection#bcccddccd9cecbd3ced7fcd4cecfdd92dbd3ca"><span class="__cf_email__" data-cfemail="c0b0a1b0a5b2b7afb2ab80a8b2b3a1eea7afb6">[email protected]</span></a> or call Joella Roland, the 
HRSA Information Collection Clearance Officer, at (301) 443-3983.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the ICR title for reference.
    Information Collection Request Title: Medicare Rural Hospital 
Flexibility Program Performance, OMB No. 0915-0363--Revision.
    Abstract: The mission of the Federal Office of Rural Health Policy 
(FORHP) within HRSA is to sustain and improve access to quality care 
services for rural communities. FORHP administers the Medicare Rural 
Hospital Flexibility Program (Flex Program) authorized by section 
1820(g) of the Social Security Act (42 U.S.C. 1395i-4(g)). The purpose 
of the Flex Program is to enable state designated entities to support 
critical access hospitals in quality improvement, quality reporting, 
and performance improvement; to assist facilities seeking designation 
as critical access hospitals; and to create a program to establish or 
expand the provision of rural emergency medical services. HRSA 
currently collects information from grant recipients that participate 
in the Flex Program using an OMB-approved set of performance measures, 
the Medicare Rural Hospital Flexibility Program Performance Measures, 
and seeks to revise its approved information collection. HRSA is 
proposing significant changes to the method by which performance 
measures are collected, the organization of the measures, and the 
measures themselves.
    Need and Proposed Use of the Information: These measures cover 
principal topic areas of interest to FORHP, including: (a) quality 
reporting, (b) quality improvement interventions, (c) financial and 
operational improvement initiatives, (d) population health management, 
and (e) rural EMS integration. In addition to informing HRSA's progress 
toward meeting the goals set in the Government Performance and Results 
Act, the information is important in identifying and understanding 
programmatic improvement across program areas, as well as guiding 
future iterations of the Flex Program and prioritizing areas of need 
and support.
    Performance measures are collected electronically in the 
Performance Improvement and Measurement System (PIMS), which awardees 
currently access through the HRSA Electronic Handbooks, a data 
collection platform. As part of a broader change affecting all programs 
across FORHP, HRSA proposes to change the method of PIMS report 
submission from the Electronic Handbooks to a different electronic data 
collection platform. In addition, HRSA proposes to reduce the total 
number of forms submitted. The current collection involves eight forms 
and HRSA proposes reducing this to six forms, one for recipients to 
select which program areas they are working in and one for each program 
area selected.
    Performance measures in PIMS are currently organized by a series of 
checkboxes, where a state entity selects which hospitals are 
participating in a funded intervention, and if that hospital has shown 
improvement after that intervention. HRSA proposes to change the 
organization of the measures to align with a format that would resemble 
a work plan submission, which is an existing requirement recipients 
must meet. Instead of the series of checkboxes used in the current 
collection, we are proposing a series of dropdown menus where 
respondents can choose more specific information.
    Finally, HRSA proposes revisions to performance measures in PIMS 
that include changes to align with current terminology used by HRSA and 
a broadening of scope for some activities, as well as providing 
examples of more specific measures. Dropdown menus would contain lists 
of both common projects completed across the Flex Program and common 
outcome measures associated with each project. Respondents would not be 
required to collect all of the measures listed, rather they would be 
able to choose from a list of examples.
    With these changes, HRSA estimates the burden on the recipients 
would remain the same. Even though HRSA is proposing to include more 
specific performance measures in PIMS reporting, the additional 
measures reflect data the recipients are currently collecting, in 
outside forms and spreadsheets. The reporting in PIMS to HRSA currently 
does not include all the specific outcome measure information collected 
by recipients, so the changes to the measure collection system would 
include that specific outcome measure information. However, instead of 
moving between multiple forms and spreadsheets outside of the PIMS 
system and copying information into it, recipients will be able to 
simply update their work plan in PIMS following the end of the program 
year with their outcome data.
    Likely Respondents: Respondents are the Flex Program recipients. 
There are currently 45 states participating in the Flex Program.
    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.

[[Page 88055]]



                                     Total Estimated Annualized Burden Hours
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                                                                                            Average
                                                Number of      Number of        Total      burden per    Total
                  Form name                    respondents   responses per    responses     response     burden
                                                               respondent                  (in hours)    hours
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Performance Improvement Measurement System..            45                1           45           70      3,150
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    Total...................................            45  ...............           45  ...........      3,150
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    HRSA specifically requests comments on: (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.

Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2024-25717 Filed 11-5-24; 8:45 am]
BILLING CODE 4165-15-P


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