[Federal Register Volume 80, Number 74 (Friday, April 17, 2015)]
[Notices]
[Pages 21245-21246]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2015-08835]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Children and Families


Proposed Information Collection Activity; Comment Request

Proposed Projects

    Title: Initial Medical Exam Form and Initial Dental Exam Form.
    OMB No.: New.

Description

    Pursuant to Exhibit 1, part A.2 of the Flores Settlement Agreement 
(Jenny Lisette Flores, et al., v. Janet Reno, Attorney General of the 
United States, et al., Case No. CV 85-4544-RJK (C.D. Cal. 1996), 
licensed programs, on behalf of the Administration for Children and 
Families' Office of Refugee Resettlement (ORR), shall arrange for 
appropriate routine medical and dental care, family planning services, 
and emergency health care services, including a complete medical 
examination (including screening for infectious disease) within 48 
hours of admission, excluding weekends and holidays, unless the minor 
was recently examined at another facility; appropriate immunizations in 
accordance with the U.S. Public Health Service (PHS), Center for 
Disease Control; administration of prescribed medication and special 
diets; appropriate mental health interventions when necessary for each 
minor in its care.
    The forms are to be used as worksheets for clinicians, medical 
staff, and the health department to compile information that would 
otherwise have been collected during the initial medical or dental 
exam. Once completed, the forms will be given to shelter staff for data 
entry into ORR's electronic data repository known as `The Portal.' Data 
will be used to record UC health on admission and for case management 
of any identified illnesses/conditions.
    Respondents: Clinicians, Health Department staff, Office of Refugee 
Resettlement Grantee staff.

[[Page 21246]]



                                             Annual Burden Estimates
----------------------------------------------------------------------------------------------------------------
                                                                     Number of    Average burden
                   Instrument                        Number of     responses per     hours per     Total burden
                                                    respondents     respondent       response          hours
----------------------------------------------------------------------------------------------------------------
Initial Medical Exam Form (including Appendix A:             206             155             .25          7982.5
 Supplemental TB Screening Form)................
Initial Dental Exam Form........................             116              28             .08           259.8
----------------------------------------------------------------------------------------------------------------

    Estimated Total Annual Burden Hours: 8242.3.
    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: <a href="/cdn-cgi/l/email-protection#caa3a4aca5a9a5a6a6afa9bea3a5a48aaba9ace4a2a2b9e4ada5bc"><span class="__cf_email__" data-cfemail="a9c0c7cfc6cac6c5c5cccaddc0c6c7e9c8cacf87c1c1da87cec6df">[email protected]</span></a>. 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. 2015-08835 Filed 4-16-15; 8:45 am]
 BILLING CODE 4184-01-P


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