Federal Register / Vol. 78, No. 17 / Friday, January 25, 2013 / Notices 5459 

1Please see U.S. Department of Health and 

Human Services, Report to Congress, National 

Strategy for Quality Improvement in Health Care, 

(March 2011), available at http:// 

www.healthcare.gov/law/resources/reports/ 

nationalqualitystrategy032011.pdf. 

control’’ or ‘‘non-pain symptom 

management,’’ as well as publicly 

available instruments for capturing 

family members’ or friends’ experiences 

with hospice care. We are interested in 

instruments and items that can measure 

quality of care from the family member/ 

friend’s perspective, including all 

potential hospice settings (for example, 

home, nursing home, hospital, and freestanding hospice) and instruments that 

track changes over time. 

We are looking for suggested topic 

areas and publicly available instruments 

in which the information was identified 

by family members/friends as important 

to them in evaluating hospice care. 

Existing instruments are preferred if 

they have been tested, have a high 

degree of reliability and validity, and 

report evidence of wide use. 

The following information would be 

especially helpful in any comments 

responding to this request for 

information: 

• A brief cover letter summarizing the 

information requested for submitted 

instruments and topic areas, 

respectively, and how the submission 

will help fulfill the intent of the survey. 

• (Optional) Information about the 

person submitting the material for the 

purposes of follow up questions about 

the submission which includes the 

following: 

++ Name. 

++ Title. 

++ Organization. 

++ Mailing address. 

++ Telephone number. 

++ Email address. 

++ Indication that the instrument is 

publicly available. 

• When submitting topic areas, we 

encourage including to the extent 

available the following information: 

++ Detailed descriptions of the 

suggested topic area(s) and specific 

purpose(s). 

++ Relevant peer-reviewed journal 

articles or full citations. 

• When submitting publicly available 

instruments or survey questions, we 

encourage including to the extent 

available the following information: 

++ Name of the instrument. 

++ Copies of the full instrument in all 

available languages. 

++ Topic areas included in the 

instrument. 

++ Measures derived from the 

instrument. 

++ Instrument reliability (internal 

consistency, test-retest, etc) and 

validity (content, construct, criterionrelated). 

++ Results of cognitive testing (one-onone testing with a small number of 

respondents to ensure that they 

understand the questionnaire.) 

++ Results of field testing. 

++ Current use of the instrument (who 

is using it, what it is being used for, 

what population it is being used with, 

how instrument findings are reported, 

and by whom the findings are used). 

++ Relevant peer-reviewed journal 

articles or full citations. 

++ CAHPS® trademark status. 

++ National Quality Forum (NQF) 

endorsement status. 

++ Survey administration instructions. 

++ Data analysis instructions. 

++ Guidelines for reporting survey data. 

CMS is developing this survey and 

plans to submit it to AHRQ for 

recognition as a Consumer Assessment 

of Healthcare Providers and Systems 

(CAHPS®) survey. The survey will be 

developed in accordance with CAHPS®

Survey Design Principles and 

implementation instructions will be 

based on those for CAHPS® instruments 

(https://www.cahps.AHRQ.gov/AboutCAHPS/Principles.aspx). 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: December 5, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2013–01299 Filed 1–24–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–4171–NC] 

Medicare Program; Request for 

Information To Aid in the Design and 

Development of a Survey Regarding 

Patient Experiences With Hospital 

Outpatient Surgery Departments/ 

Ambulatory Surgery Centers and 

Patient-Reported Outcomes From 

Surgeries and Procedures Performed 

in These Settings 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Request for information. 

SUMMARY: This document is a request for 

information regarding hospital 

outpatient surgery departments (HOSDs) 

and ambulatory surgery centers (ASCs), 

as well as patient-reported outcomes 

from surgeries or other procedures 

performed in these settings. 

DATES: The information solicited in this 

notice must be received at the address 

provided below by March 26, 2013. 

ADDRESSES: In responding to this 

solicitation, please reply via email to 

AmbSurgSurvey@cms.hhs.gov or by 

postal mail at Centers for Medicare and 

Medicaid Services, Attention: Memuna 

Ifederah, Mailstop C1–25–05, 7500 

Security Boulevard, Baltimore, MD 

21244–1850. 

FOR FURTHER INFORMATION CONTACT: 

Memuna Ifederah, (410) 768–6849 or 

Caren Ginsberg (410) 786–0713. 

SUPPLEMENTARY INFORMATION: 

I. Background 

In accordance with section 3011 of 

the Affordable Care Act, the Department 

of Health and Human Services (HHS) 

developed the National Quality Strategy 

to create national aims and priorities to 

guide local, state, and national efforts to 

improve the quality of health care. The 

National Quality Strategy established 

three aims supported by six priorities. 

The 3 aims are as follows: 

• Better Care: Improve the overall 

quality, by making health care more 

patient-centered, reliable, accessible, 

and safe. 

• Healthy People/Healthy 

Communities: Improve the health of the 

U.S. population by supporting proven 

interventions to address behavioral, 

social, and environmental determinants 

of health in addition to delivering 

higher quality care. 

• Affordable Care: Reduce the cost of 

quality health care for individuals, 

families, employers, and government.1

The six priorities are: ‘‘(1) Making 

care safer by reducing harm caused by 

the delivery of care; (2) ensuring that 

each person and family are engaged as 

partners in their care; (3) promoting 

effective communication and 

coordination of care; (4) promoting the 

most effective prevention and treatment 

practices for the leading causes of 

mortality, starting with cardiovascular 

disease; (5) working with communities 

to promote wide use of best practices to 

enable health living; and (6) making 

quality care more affordable for 

individuals, families, employers and 

governments by developing and 

spreading new health care delivery 

models’’. 

Surveys focusing on the patient 

experience as well as the Hospital 

Outpatient Surgery Department/ 

mstockstill on DSK4VPTVN1PROD with 

5460 Federal Register / Vol. 78, No. 17 / Friday, January 25, 2013 / Notices 

Ambulatory Surgery Patient Experience 

of Care Survey now under development 

support the National Quality Strategy of 

better care and the priorities of— 

• Ensuring that each person and 

family are engaged as partners in their 

care (priority #2); and 

• Promoting effective communication 

and coordination of care (priority #3). 

Since 1995, the Agency for Healthcare 

Research and Quality (AHRQ) and its 

Consumer Assessment of Healthcare 

Providers and Systems (CAHPS®) 

Consortium, in partnership with the 

Centers for Medicare & Medicaid 

Services (CMS), has developed 

standardized CAHPS® Surveys and 

tools for a variety of populations to 

collect data on patient’s experiences 

with and ratings of care. CMS and 

AHRQ have developed CAHPS® surveys 

for in-center hemodialysis facilities, 

nursing homes, and clinician and group 

practices. CMS has already 

implemented CAHPS® surveys for 

health and drug plans, hospitals, and 

home health agencies. 

We are developing a standardized 

Hospital Outpatient Surgical 

Department/Ambulatory Surgical Center 

(HOSD/ASC) Experience of Care Survey 

to evaluate the care received in these 

facilities from the patient’s perspective. 

Two related CAHPS® surveys exist; 

however, they do not collect 

information specific to the patient 

experience of care in HOSD/ASC 

facilities. In 2006, CMS began 

implementing the Hospital CAHPS®

(HCAHPS) Survey, which collects data 

on hospital inpatients experiences with 

and ratings of hospital inpatient care. 

The HCAHPS Survey includes neither 

patients who receive outpatient surgical 

care from hospital-based outpatient 

surgical departments, nor patients who 

received such care from freestanding 

ASCs. The Surgical Care CAHPS®

Survey, developed by the American 

College of Surgeons (ACS) and the 

Surgical Quality Alliance (SQA) focuses 

on both inpatient and outpatient 

surgeries and includes questions related 

to the patient’s experience before, 

during, and after surgery. However, this 

survey focuses on the care provided by 

the physician rather than the facility. 

Hospital outpatient surgery departments 

and ASCs will be the unit of analysis for 

this HOSD/ASC survey instrument. The 

Hospital Outpatient Surgery 

Department/Ambulatory Surgery Center 

Patient Experience of Care Survey will 

be used to help consumers make 

informed choices about providers as 

well as improving the quality of care. 

II. Solicitation of Information 

This document solicits input for 

developing this new patient experience 

survey, including the following: 

• Relevant topic areas such as 

communication between patients and 

health care providers; access to care; 

customer service; provision of pre- and 

post-surgical care information; access to 

follow-up care; care coordination; 

patient preferences; environment; and 

safety. 

• Publicly available surveys, survey 

questions, and measures indicating— (1) 

patient experience and/or level of 

patient satisfaction with experience in 

HOSDs/ASCs; and (2) patient-reported 

outcomes from surgeries or other 

procedures (for example, colonoscopies, 

endoscopies) performed in HOSDs and 

ASCs. These surveys, survey questions, 

and measures should measure and 

assess quality of care and patientreported outcomes from the patient’s 

perspective, and track changes over 

time. 

We are interested in suggestions for 

topic areas, and publicly available 

surveys, questions or measures that 

address the following specifically for 

outpatient surgery: 

• Issues that are that are highly 

relevant to DHHS and CMS, because 

they support DHHS’s and CMS’s efforts 

for improved quality and efficiency of 

care and are included in or facilitate 

alignment with other CMS programs. 

• Identification of gaps in the quality 

of care delivered in outpatient surgical 

departments. 

• Measures of surgical care 

coordination and related care 

coordination activities. 

• Identification and assessment of 

patient-reported outcomes, such as pain, 

nausea and vomiting, deep vein 

thrombosis, infection, pneumonia, and 

urinary retention. 

We are looking for suggested topic 

areas, as well as any publicly available 

surveys, questions and measures in 

which—(1) the source of information is 

from patients who directly received care 

at HOSDs or ASCs; and (2) patients 

identified the topic areas such as those 

listed above as important to them in 

evaluating HOSD or ASC care (for 

example, wait time and medical staff 

and physician communication). We are 

seeking topic areas, surveys, questions 

and measures that are applicable across 

outpatient surgical settings (for 

example, freestanding settings, hospital 

based settings, for-profit settings; notfor-profit settings; rural settings; urban 

settings; multi-specialty and singlespecialty surgery departments/centers). 

We prefer existing surveys, questions, 

and measures that have been tested and 

have a high degree of reliability and 

validity, and for which there is evidence 

of wide use. 

This request for information solicits 

input from consumers, researchers, 

vendors, health plans, HOSDs, ASCs, 

surgeons, advocacy organizations, 

community-based providers, and other 

stakeholders and interested parties. This 

call for topic areas, publicly available 

surveys, questions, and measures is 

occurring now because of the multiphased survey development and testing 

process necessary to produce a 

standardized instrument. The target 

population for the survey is adults 

(defined in CAHPS surveys as 18 years 

old and older) who recently have had 

surgery or other procedures, such as a 

colonoscopy or endoscopy, in a surgical 

outpatient setting. 

CMS is developing this survey and 

plans to submit it to AHRQ for 

recognition as a CAHPS® survey. The 

survey will be developed in accordance 

with CAHPS® Survey Design Principles 

and implementation instructions will be 

based on those for CAHPS® instruments 

(https://www.cahps.AHRQ.gov/AboutCAHPS/Principles.aspx). 

We are asking respondents to include 

the following in their submissions: 

• A brief cover letter summarizing the 

information requested above for 

submitted topic areas, surveys, 

questions, and measures, and how the 

submission will help fulfill the intent of 

the patient experiences survey. 

• (Optional) Information about the 

person submitting the material for 

purposes of follow-up questions about 

the submission, including the following: 

++ Name. 

++ Title. 

++ Organization. 

++ Mailing address. 

++ Telephone number. 

++ Email address. 

++ Indication that the topic area or 

instrument is publicly available. 

• When submitting topic areas, 

respondents should include to the 

extent available the following 

information: 

++ Detailed descriptions of the 

suggested topic area(s) and specific 

purpose(s). 

++ Sample questions, in all available 

languages. 

++ Relevant peer-reviewed journal 

articles or full citations. 

++ Name of the instrument. 

++ Copies of the full instrument in all 

available languages. 

++ Topic areas included in the survey. 

++ Measures derived from the survey. 

++ Survey reliability (internal 

consistency, test-retest, etc.) and 

mstockstill on DSK4VPTVN1PROD with 

Federal Register / Vol. 78, No. 17 / Friday, January 25, 2013 / Notices 5461 

validity (content, construct, criterionrelated). 

++ Results of cognitive testing (one-onone testing with a small number of 

respondents to ensure that they 

understand the questionnaire). 

++ Results of field testing. 

++ Current use of the instrument (who 

is using it, what it is being used for, 

what population it is being used with, 

how instrument findings are reported, 

and by whom the findings are used). 

++ Relevant peer-review journal articles 

or full citations. 

++ CAHPS® trademark status. 

++ Survey administration instructions. 

++ Data analysis instructions. 

++ Guidelines for reporting survey data. 

(Catalog of Federal Domestic Assistance 

Program No. 93.773, Medicare—Hospital 

Insurance; and Program No. 93.774, 

Medicare—Supplementary Medical 

Insurance Program) 

Dated: December 13, 2012. 

Marilyn Tavenner, 

Acting Administrator, Centers for Medicare 

& Medicaid Services. 

[FR Doc. 2013–01300 Filed 1–24–13; 8:45 am] 

BILLING CODE 4120–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects 

Title: Guidance for Tribal TANF. 

OMB No.: 0970–0157. 

Description 

42 U.S.C. 612 (Section 412 of the 

Social Security Act) requires each 

Indian Tribe that elects to administer 

and operate a TANF program to submit 

a TANF Tribal Plan. The TANF Tribal 

Plan is a mandatory statement 

submitted to the Secretary by the Indian 

Tribe, which consists of an outline of 

how the Indian Tribes TANF program 

will be administered and operated. It is 

used by the Secretary to determine 

whether the plan is approvable and to 

determine that the Indian Tribe is 

eligible to receive a TANF assistance 

grant. It is also made available to the 

public. 

Respondents 

Indian Tribes applying to operate a 

TANF program. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total Burden 

hours 

Request for State Data Needed to Determine the Amount of a Tribal Family 

Assistance Grant .......................................................................................... 23 1 68 1564 

Estimated Total Annual Burden 

Hours: 1564. 

In compliance with the requirements 

of Section 506(c)(2)(A) of the Paperwork 

Reduction Act of 1995, the 

Administration for Children and 

Families is soliciting public comment 

on the specific aspects of the 

information collection described above. 

Copies of the proposed collection of 

information can be obtained and 

comments may be forwarded by writing 

to the Administration for Children and 

Families, Office of Planning, Research 

and Evaluation, 370 L’Enfant 

Promenade, SW., Washington, DC 

20447, Attn: ACF Reports Clearance 

Officer. Email address: 

infocollection@acf.hhs.gov. All requests 

should be identified by the title of the 

information collection. 

The Department specifically requests 

comments 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) 

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. 

Consideration will be given to 

comments and suggestions submitted 

within 60 days of this publication. 

Robert Sargis, 

Reports Clearance Officer. 

[FR Doc. 2013–01450 Filed 1–24–13; 8:45 am] 

BILLING CODE 4184–01–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Proposed Information Collection 

Activity; Comment Request 

Proposed Projects 

Title: ANA Project Impact Assessment 

Survey. 

OMB No.: 0970–0379 

Description: The information 

collected by the Project Impact 

Assessment Survey is needed for two 

main reasons: (1) To collect crucial 

information required to report on the 

Administration for Native Americans’ 

(ANA) established Government 

Performance and Results Act (GPRA) 

measures, and (2) to properly abide by 

ANA’s congressionally-mandated 

statute (42 United States Code 2991 et 

seq.) found within the Native American 

Programs Act of 1974, as amended, 

which states that ANA will evaluate 

projects assisted through ANA grant 

dollars ‘‘including evaluations that 

describe and measure the impact of 

such projects, their effectiveness in 

achieving stated goals, their impact on 

related programs, and their structure 

and mechanisms for delivery of 

services.’’ The information collected 

with this survey will fulfill ANA’s 

statutory requirement and will also 

serve as an important planning and 

performance tool for ANA. 

Respondents: Tribal Governments, 

Native American nonprofit 

organizations, and Tribal Colleges and 

Universities. 

mstockstill on DSK4VPTVN1PROD with