18424 Federal Register / Vol. 80, No. 65 / Monday, April 6, 2015 / Notices 

The Transparency Act requires the 

OMB to establish a single searchable 

database, accessible to the public, with 

information on financial assistance 

awards made by Federal agencies. The 

Transparency Act also includes a 

requirement for recipients of Federal 

grants to report information about firsttier subawards and executive 

compensation under Federal assistance 

awards. 

IHS has implemented a Term of 

Award into all IHS Standard Terms and 

Conditions, NoAs and funding 

announcements regarding the FSRS 

reporting requirement. This IHS Term of 

Award is applicable to all IHS grant and 

cooperative agreements issued on or 

after October 1, 2010, with a $25,000 

subaward obligation dollar threshold 

met for any specific reporting period. 

Additionally, all new (discretionary) 

IHS awards (where the project period is 

made up of more than one budget 

period) and where: 1) The project period 

start date was October 1, 2010 or after 

and 2) the primary awardee will have a 

$25,000 subaward obligation dollar 

threshold during any specific reporting 

period will be required to address the 

FSRS reporting. For the full IHS award 

term implementing this requirement 

and additional award applicability 

information, visit the DGM Grants 

Policy Web site at: https://www.ihs.gov/ 

dgm/index.cfm?module=dsp_dgm_

policy_topics. 

Telecommunication for the hearing 

impaired is available at: TTY (301) 443– 

6394. 

VII. Agency Contacts 

1. Questions on the programmatic 

issues may be directed to: 

Mr. Chris Buchanan, Director, ODSCT, 

801 Thompson Avenue, Suite 220, 

Rockville, Maryland 20852. 

Telephone: (301) 443–1104. E-Mail: 

Chris.Buchanan@ihs.gov. 

2. Questions on grants management 

and fiscal matters may be directed to: 

Mr. John Hoffman, DGM, Grants 

Management Specialist, 801 

Thompson Avenue, TMP Suite 360, 

Rockville, Maryland 20852. 

Telephone: (301) 443–2116 Fax: (301) 

443–9602. E-Mail: John.Hoffman@

ihs.gov. 

3. Questions on systems matters may 

be directed to: 

Paul Gettys, Grant Systems Coordinator, 

DGM, 801 Thompson Avenue, TMP 

Suite 360, Rockville, MD 20852. 

Phone: 301–443–2114; or the DGM 

main line 301–443–5204. Fax: 301– 

443–9602. E-Mail: Paul.Gettys@

ihs.gov. 

VIII. Other Information 

The Public Health Service strongly 

encourages all cooperative agreement 

and contract recipients to provide a 

smoke-free workplace and promote the 

non-use of all tobacco products. In 

addition, Public Law 103–227, the ProChildren Act of 1994, prohibits smoking 

in certain facilities (or in some cases, 

any portion of the facility) in which 

regular or routine education, library, 

day care, health care, or early childhood 

development services are provided to 

children. This is consistent with the 

HHS mission to protect and advance the 

physical and mental health of the 

American people. 

Dated: March 29, 2015. 

Robert G. McSwain, 

Acting Director, Indian Health Service. 

[FR Doc. 2015–07780 Filed 4–3–15; 8:45 am] 

BILLING CODE 4165–16–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Solicitation of Written Comments on 

the National Vaccine Advisory 

Committee’s Draft Report and Draft 

Recommendations for Consideration 

for Addressing the State of Vaccine 

Confidence in the United States 

AGENCY: Office of the Secretary, Office 

of the Assistant Secretary for Health, 

National Vaccine Program Office, 

Department of Health and Human 

Services 

ACTION: Notice. 

SUMMARY: The National Vaccine 

Advisory Committee (NVAC) was 

established in 1987 to comply with Title 

XXI of the Public Health Service Act 

(Pub. L. 99–660) (§ 2105) (42 U.S. Code 

300aa–5 (PDF–78 KB)). Its purpose is to 

advise and make recommendations to 

the Director of the National Vaccine 

Program on matters related to program 

responsibilities. The Assistant Secretary 

for Health (ASH) has been designated by 

the Secretary of Health and Human 

Services (HHS) as the Director of the 

National Vaccine Program. The National 

Vaccine Program Office (NVPO) is 

located within the Office of the 

Assistant Secretary for Health (OASH), 

Office of the Secretary, U.S. Department 

of Health and Human Services (HHS). 

NVPO provides leadership and fosters 

collaboration among the various federal 

agencies involved in vaccine and 

immunization activities. The NVPO also 

supports the National Vaccine Advisory 

Committee (NVAC). The NVAC advises 

and makes recommendations to the 

ASH in her capacity as the Director of 

National Vaccine Program on matters 

related to vaccine program 

responsibilities. 

Recognizing that immunizations are 

given across the lifespan and there are 

likely to be important differences in 

vaccine acceptance at different stages of 

life, in February of 2013 the National 

Vaccine Advisory Committee accepted 

an initial charge from the Assistant 

Secretary for Health (ASH) to report on 

how confidence in vaccines impacts the 

optimal use of recommended childhood 

vaccines in the United States, including 

reaching Healthy People 2020 

immunization coverage targets. Focus of 

such a report may include 

understanding the determinants of 

vaccination acceptance among parents, 

what HHS should be doing to improve 

parental confidence in vaccine 

recommendations and how to best 

measure confidence in vaccine and 

vaccination to inform and evaluate 

interventions in the future. 

Through a series of teleconferences, 

electronic communications, 

presentations and public discussions 

during the NVAC meetings, a working 

group identified a number of draft 

recommendations to further understand 

and address issues of vaccine 

confidence in the United States. 

On behalf of NVAC, NVPO is 

soliciting public comment on the draft 

report and draft recommendations from 

a variety of stakeholders, including the 

general public, for consideration by the 

NVAC as they develop their final 

recommendations to the ASH. It is 

anticipated that the draft report and 

draft recommendations, as revised with 

consideration given to public comment 

and stakeholder input, will be presented 

to the NVAC for adoption in June 2015 

at the quarterly NVAC meeting. 

DATES: Comments for consideration by 

the NVAC should be received no later 

than 5:00 p.m. EDT on May 6, 2015. 

ADDRESSES: 

(1) The draft report and draft 

recommendations are available on the 

Web at http://www.hhs.gov/nvpo/nvac/

subgroups/nvac-vaccine-confidencewg.html. 

(2) Electronic responses are preferred 

and may be addressed to: vcwg@

hhs.gov. 

(3) Written responses should be 

addressed to: National Vaccine Program 

Office, U.S. Department of Health and 

Human Services, 200 Independence 

Avenue SW., Room 733G, Washington, 

DC 20201. Attn: Vaccine Confidence 

Working Group. 

FOR FURTHER INFORMATION CONTACT: 

National Vaccine Program Office, Office 

of the Assistant Secretary for Health, 


tkelley on DSK4VPTVN1PROD with NOTICES
Federal Register / Vol. 80, No. 65 / Monday, April 6, 2015 / Notices 18425 

Department of Health and Human 

Services; telephone (202) 690–5566; fax 

(202) 690–4631; email: vcwg@hhs.gov. 

SUPPLEMENTARY INFORMATION: 

I. Background 

Vaccination confidence is one of a 

number of factors that affect individual 

and population-level willingness to 

accept a vaccine. Vaccine confidence 

means having confidence in the safety 

and efficacy of a vaccine, having 

confidence in the competence of the 

health professionals who administer the 

vaccine, and having trust in the 

motivations of the policy-makers who 

decide which vaccines are needed and 

when. Vaccine confidence has been 

shown to influence vaccine decision 

making, but to what extent remains 

unclear. This is partly due to a lack of 

consensus on how best to quantify the 

confidence of an individual and a 

population. Gaining this understanding 

along with identifying factors which 

drive public confidence is critical for 

assessing the magnitude of the problem 

in the U.S., as well as designing and 

evaluating potential intervention 

strategies. 

Through their analysis and 

discussion, the NVAC proposes the 

following recommendations: 

Focus Area 1: Measuring and Tracking 

Vaccine Confidence 

1.1 NVAC recommends 

development of an ‘‘index,’’ composed 

of a number of individual and social 

dimensions, to measure vaccine 

confidence. This index should be 

capable of (1) a rapid, reliable and valid 

surveillance of national vaccine 

confidence; (2) detection and 

identification of variations in vaccine 

confidence at the community level; and 

(3) diagnosis of the key dimensions that 

affect vaccine confidence. 

1.2 NVAC recommends continuing 

the use of existing measures for vaccine 

confidence, including systems that 

measure vaccine coverage as well as 

vaccine-related confidence, attitudes 

and beliefs while the science of 

understanding and tracking vaccine 

confidence is being advanced. 

1.3 NVAC recommends the 

development of measures and methods 

to analyze the mass media environment 

and social media conversations to 

identify topics of concern to parents, 

healthcare providers, and members of 

the public. 

1.4 NVAC recommends that existing 

approaches and systems for monitoring 

vaccination coverages and vaccinerelated cognitions, attitudes, and 

behaviors be strengthened and 

enhanced. These include: (1) 

Immunization Information Systems (IIS) 

and Electronic Health Records (EHRs) to 

collect and capture delays and refusals; 

(2) Reliable and valid measures (or 

surveys) of cognitive factors, such as 

adults and parents’ confidence, 

attitudes, and beliefs regarding vaccines 

and recommended vaccinations; (3) 

Surveys of provider attitudes and beliefs 

towards vaccination; and (4) Integration 

of data from all existing systems to track 

trends of vaccination confidence over 

time and to detect variations across time 

and geography. 

Focus Area 2: Communication and 

Community Strategies 

2.1 NVAC recommends healthcare 

providers, immunization programs, and 

those involved in promoting 

recommended vaccinations actively 

reinforce that vaccination according to 

the Advisory Committee on 

Immunization Practices (ACIP) 

recommended schedule is the social 

norm and not the exception. 

Misperceptions that vaccination in line 

with the ACIP recommended schedule 

is not the norm should be appropriately 

addressed. 

2.2 NVAC recommends consistent 

communications assessment and 

feedback pertaining to vaccine 

confidence. These include: 

2.2.1 Creation of a Communication 

Assessment Infrastructure to assess 

vaccine sentiment and provide timely, 

accurate and actionable information 

related to vaccination confidence and 

acceptance to relevant stakeholders. 

This system should have the capability 

to regularly assess vaccine-related 

messaging environment (e.g., to identify 

new or emerging concerns and 

questions) to assess understanding and 

effectiveness of population education 

and information materials and 

resources. 

2.2.2 Identification, evaluation and 

validation of communication resources 

and approaches in terms of their effects 

on enhancing vaccine and vaccination 

confidence so that effective (‘‘evidencebased/evidence-informed’’) 

interventions and best practices can be 

shared and more widely used. 

2.2.3 Creation of a repository of 

evidenced-based best practices for 

informing, educating, and 

communicating with parents and others 

in ways that foster or increase vaccine 

or vaccination confidence. This 

repository would be maintained and 

expanded as future evidence is 

compiled regarding messages, materials, 

and interventions that positively affect 

vaccine or vaccination confidence. 

2.3 NVAC recommends the 

development of systems to support 

parent and community efforts that seek 

to promote vaccine confidence and 

vaccination. 

2.4 NVAC recommends support for a 

community of practice or network of 

stakeholders who are actively taking 

steps to foster or grow vaccine 

confidence and vaccination; such a 

network can foster partnerships and 

encourage sharing of resources and best 

practices. 

Focus Area 3: Healthcare Provider 

Strategies 

3.1 NVAC recommends the 

development and deployment of 

evidence-based materials and toolkits 

for providers to address parent 

questions and concerns. These materials 

and toolkits should continue to be 

revised to incorporate the latest science 

and research. 

3.1.1 A repository of evidence-based 

effective practices for providers should 

be an output of this effort. 

3.2 NVAC recommends curriculum 

and communication training that 

focuses on vaccine confidence (e.g., 

strategies and approaches for 

establishing or building confidence) be 

developed and made available for 

healthcare providers, including doctors, 

nurses, alternative providers, and 

ancillary care providers. 

3.2.1 This training should 

encompass ‘‘providers-in-training,’’ 

such as students, residents, and interns 

as well as currently practicing 

physicians, nurses, and other healthcare 

providers through Continuing Medical 

Education (CMEs). 

3.2.2 Clear and accessible 

information on vaccinations, the 

schedule and any changes to the 

immunization schedule should be 

developed specifically for providers and 

made available to them through 

resources they utilize most. 

3.3 NVAC recommends the 

development of: (i) Provisional billing 

codes for vaccine counseling when 

vaccination is ultimately not given; and 

(ii) Pay for performance initiatives and 

incentives as measured by: (a) 

Establishment of an immunizing 

standard within a practice; and (b) 

Continued improvement in 

immunization coverage rates within a 

provider’s practice. 

Focus Area 4: Policy Strategies 

4.1 NVAC recommends states and 

territories with existing personal belief 

exemption policies should assess their 

policies to assure that exemptions are 

only available after appropriate parent 

education and acknowledgement of the 

associated risks of not vaccinating, to 


tkelley on DSK4VPTVN1PROD with NOTICES
18426 Federal Register / Vol. 80, No. 65 / Monday, April 6, 2015 / Notices 

their child and community. Policies that 

do not do this should be strengthened. 

4.1.1 Increased efforts should be 

made to educate the public and state 

legislatures on the safety and value of 

vaccines, the importance of 

recommended vaccinations and the 

ACIP schedule, and the risks posed by 

low or under-vaccination in 

communities and schools. 

4.2 NVAC recommends information 

on vaccination rates, vaccination 

exemptions, and other preventative 

health measures (e.g., whether a school 

has a school nurse, etc.) for an 

educational institution be made 

available to parents. 

4.2.1 Encourage educational 

institutions and childcare facilities to 

report vaccination rates publicly (e.g., 

via a school health grade or report). 

4.3 NVAC recommends ‘‘on-time 

vaccination’’ should be included as a 

Quality Measure for all health plans, 

public and private, as a first line 

indicator of vaccine confidence. NVAC 

acknowledges that other issues, such as 

access, can also effect on time 

vaccination. 

Final Recommendation 

5.1 The NVAC recommends that the 

National Vaccine Program Office 

(NVPO) should work with federal and 

non-federal partners to develop an 

implementation plan to address vaccine 

confidence, including metrics, and 

report back to NVAC on progress, 

annually. 

II. Request for Comment 

NVPO, on behalf of the NVAC 

Vaccine Confidence Working Group, 

requests input on the draft report and 

draft recommendations. Please limit 

your comments to three (3) pages. 

III. Potential Responders 

HHS invites input from a broad range 

of stakeholders including individuals 

and organizations that have interests in 

immunization efforts and the role of 

HHS in advancing those efforts. 

Examples of potential responders 

include, but are not limited to, the 

following: 

—General public; 

—advocacy groups, non-profit 

organizations, and public interest 

organizations; 

—academics, professional societies, and 

healthcare organizations; 

—public health officials and 

immunization program managers; 

—pediatric provider groups including 

all physician and non-physician 

providers that administer healthcare 

services to children, including 

pharmacists; and 

—representatives from the private 

sector, including those from health 

insurance organizations. 

When responding, please self-identify 

with any of the above or other categories 

(include all that apply) and your name. 

Anonymous submissions will not be 

considered. Written submissions should 

not exceed three to five (3–5) pages. 

Please do not send proprietary, 

commercial, financial, business, 

confidential, trade secret, or personal 

information. 

Dated: March 31, 2015. 

Bruce Gellin, 

Deputy Assistant Secretary for Health, 

Director, National Vaccine Program Office, 

Executive Secretary, National Vaccine 

Advisory Committee. 

[FR Doc. 2015–07778 Filed 4–3–15; 8:45 am] 

BILLING CODE 4150–44–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Substance Abuse and Mental Health 

Services Administration 

Agency Information Collection 

Activities: Proposed Collection; 

Comment Request 

In compliance with section 

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

Reduction Act of 1995 concerning 

opportunity for public comment on 

proposed collections of information, the 

Substance Abuse and Mental Health 

Services Administration (SAMHSA) 

will publish periodic summaries of 

proposed projects. To request more 

information on the proposed projects or 

to obtain a copy of the information 

collection plans, call the SAMHSA 

Reports Clearance Officer on (240) 276– 

1243. 

Comments are invited on: (a) Whether 

the proposed collections of information 

are 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. 

Proposed Project: Notification of Intent 

To Use Schedule III, IV, or V Opioid 

Drugs for the Maintenance and 

Detoxification Treatment of Opiate 

Addiction Under 21 U.S.C. 823(g)(2) 

(OMB No. 0930–0234)—Extension 

The Drug Addiction Treatment Act of 

2000 (‘‘DATA,’’ Pub. L. 106–310) 

amended the Controlled Substances Act 

(21 U.S.C. 823(g)(2)) to permit 

practitioners (physicians) to seek and 

obtain waivers to prescribe certain 

approved narcotic treatment drugs for 

the treatment of opiate addiction. The 

legislation sets eligibility requirements 

and certification requirements as well as 

an interagency notification review 

process for physicians who seek 

waivers. The legislation was amended 

in 2005 to eliminate the patient limit for 

physicians in group practices, and in 

2006, to permit certain physicians to 

treat up to 100 patients. 

To implement these provisions, 

SAMHSA developed a notification form 

(SMA–167) that facilitates the 

submission and review of notifications. 

The form provides the information 

necessary to determine whether 

practitioners (i.e., independent 

physicians) meet the qualifications for 

waivers set forth under the new law. 

Use of this form will enable physicians 

to know they have provided all 

information needed to determine 

whether practitioners are eligible for a 

waiver. 

However, there is no prohibition on 

use of other means to provide requisite 

information. The Secretary will convey 

notification information and 

determinations to the Drug Enforcement 

Administration (DEA), which will 

assign an identification number to 

qualifying practitioners; this number 

will be included in the practitioner’s 

registration under 21 U.S.C. 823(f). 

Practitioners may use the form for 

three types of notification: (a) New, (b) 

immediate, and (c) to notify of their 

intent to treat up to 100 patients. Under 

‘‘new’’ notifications, practitioners may 

make their initial waiver requests to 

SAMHSA. ‘‘Immediate’’ notifications 

inform SAMHSA and the Attorney 

General of a practitioner’s intent to 

prescribe immediately to facilitate the 

treatment of an individual (one) patient 

under 21 U.S.C. 823(g)(2)(E)(ii). Finally, 

the form may be used by physicians 

with waivers to certify their need and 

intent to treat up to 100 patients. 

The form collects data on the 

following items: Practitioner name; state 

medical license number and DEA 

registration number; address of primary 

location, telephone and fax numbers; 

email address; name and address of 


tkelley on DSK4VPTVN1PROD with NOTICES