25450 Federal Register / Vol. 78, No. 84 / Wednesday, May 1, 2013 / Notices 

Awards may be subject to Federal 

income taxes and HHS will comply with 

IRS withholding and reporting 

requirements, where applicable. 

Payment of the Prize 

Prize will be paid by contractor. 

Basis upon which Phase I finalists 

and Phase II grand prize winner will be 

selected: 

Challenge submissions will be judged 

by a panel selected by ONC and NCI 

with relevant expertise based on the 

following criteria: 

1. The submission is an innovative 

information management tool or 

application deployable on any personal 

computing platform widely available to 

consumers; 

2. The tool or application addresses 

the needs of cancer survivors managing 

their transition from specialty to 

primary care; 

3. Usability and design; 

4. Evidence of co-design with, and 

support from users of proposed tool or 

application (e.g., patients, families, 

primary/specialty caregivers, insurers, 

and/or hospital systems); 

5. Innovation and differentiation from 

existing technologies and products; 

6. Functionality, accuracy, integration 

with electronic care platforms, and use 

of Blue Button+ standards 

(bluebuttonplus.org) and other sources 

of health-related information; and, 

7. Customizability and ability to adapt 

to evolving survivorship care needs 

including primary/specialist care 

interactions. 

In order for an entry to be eligible to 

win this Challenge, it must meet the 

following requirements: 

1. General—Entrants must provide 

continuous access to the application to 

judges during the evaluation period, a 

detailed description of the application, 

instructions on how to install and 

operate the application, and system 

requirements required to run the 

application (collectively, 

‘‘Submission’’). 

2. Acceptable platforms—The tool 

must be designed for use with any 

personal computing platform widely 

available to the average consumer. 

3. No HHS, ONC, NIH, or NCI logos— 

The application must not use HHS’, 

ONC’s, or NCI’s logos or official seals in 

the Submission, and must not claim 

endorsement. 

4. Section 508 Compliance—Entrants 

must acknowledge that they understand 

that, as a pre-requisite to any 

subsequent acquisition by FAR contract 

or other method, they may be required 

to make their proposed solution 

compliant with Section 508 accessibility 

and usability requirements at their own 

expense. Any electronic information 

technology that is ultimately obtained 

by HHS for its use, development, or 

maintenance must meet Section 508 

accessibility and usability standards. 

Past experience has demonstrated that it 

can be costly for solution-providers to 

‘‘retrofit’’ solutions if remediation is 

later needed. The HHS Section 508 

Evaluation Product Assessment 

Template, available at http:// 

www.hhs.gov/web/508/contracting/ 

technology/vendors.html, provides a 

useful roadmap for developers to 

review. It is a simple, web-based 

checklist utilized by HHS officials to 

allow vendors to document how their 

products do or do not meet the various 

Section 508 requirements. 

5. Functionality/Accuracy—A 

Submission may be disqualified if the 

application fails to function as 

expressed in the description provided 

by the user, or if the application 

provides inaccurate or incomplete 

information. 

6. Security—Submissions must be free 

of malware. Entrant agrees that the ONC 

may conduct testing on the application 

to determine whether malware or other 

security threats may be present. ONC 

may disqualify the application if, in 

ONC’s judgment, the application may 

damage government or others’ 

equipment or operating environment. 

Additional Information 

Online Resources 

Blue Button: http://www.healthit.gov/ 

bluebutton 

Blue Button+ Implementation Guide: 

http://bluebuttonplus.org/ 

Follow-up Care After Cancer 

Treatment: http://www.cancer.gov/ 

cancertopics/factsheet/Therapy/ 

followup 

Transitional Care Planning: http:// 

www.cancer.gov/cancertopics/pdq/ 

supportivecare/transitionalcare/ 

Patient/page2 

A Tough Transition: Survivorship 

Care Plans Slow to Take Hold: 

http://www.cancer.gov/ 

ncicancerbulletin/062612/page5 

NCI funding announcement on 

‘‘Examination of Survivorship Care 

Planning Efficacy and Impact’’ 

PA–12–274: http://grants.nih.gov/ 

grants/guide/pa-files/PA-12- 

274.html 

PA–12–275: http://grants.nih.gov/ 

grants/guide/pa-files/PA-12- 

275.html 

Intellectual Property 

Ownership of intellectual property is 

determined by the following: 

• Each entrant retains title and full 

ownership in and to their submission. 

Entrants expressly reserve all 

intellectual property rights not 

expressly granted under the Challenge 

agreement. 

• By participating in the Challenge, 

each entrant hereby irrevocably grants 

to ONC and NCI (Sponsors) and Health 

2.0 (Administrator) a limited, nonexclusive, royalty-free, worldwide 

license and right to reproduce, 

publically perform, publically display, 

and use the Submission to the extent 

necessary to administer the Challenge, 

and to publically perform and 

publically display the Submission, 

including, without limitation, for 

advertising and promotional purposes 

relating to the Challenge. 

General Conditions: ONC and NCI 

reserve the right to cancel, suspend, 

and/or modify non-prize elements of the 

Contest, or any part of it, for any reason, 

at ONC and NCI’s discretion. 

Participation in this Contest constitutes 

an entrant’s full and unconditional 

agreement to abide by the Contest’s 

Official Rules found at 

www.challenge.gov. 

Privacy Policy: ChallengePost collects 

personal information from you when 

you register on Challenge.gov. The 

information collected is subject to the 

ChallengePost privacy policy located at 

www.challengepost.com/privacy 

Authority: 15 U.S.C. 3719. 

Dated: April 24, 2013. 

Farzad Mostashari, 

National Coordinator for Health Information 

Technology. 

[FR Doc. 2013–10192 Filed 4–30–13; 8:45 am] 

BILLING CODE 4150–45–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Agency Information Collection 

Activities; Proposed Collection; 

Comment Request 

AGENCY: Agency for Healthcare Research 

and Quality, HHS. 

ACTION: Notice. 

SUMMARY: This notice announces the 

intention of the Agency for Healthcare 

Research and Quality (AHRQ) to request 

that the Office of Management and 

Budget (OMB) approve the proposed 

information collection project: ‘‘PatientReported Health Information 

Technology and Workflow.’’ In 

accordance with the Paperwork 

Reduction Act, 44 U.S.C. 3501–3521, 

AHRQ invites the public to comment on 

this proposed information collection. 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 84 / Wednesday, May 1, 2013 / Notices 25451 

This proposed information collection 

was previously published in the Federal 

Register on February 13th, 2013 and 

allowed 60 days for public comment. No 

comments were received. The purpose 

of this notice is to allow an additional 

30 days for public comment. 

DATES: Comments on this notice must be 

received by May 31, 2013. 

ADDRESSES: Written comments should 

be submitted to: AHRQ’s OMB Desk 

Officer by fax at (202) 395–6974 

(attention: AHRQ’s desk officer) or by 

email at 

OIRA_submission@omb.eop.gov 

(attention: AHRQ’s desk officer). 

Copies of the proposed collection 

plans, data collection instruments, and 

specific details on the estimated burden 

can be obtained from the AHRQ Reports 

Clearance Officer. 

FOR FURTHER INFORMATION CONTACT: 

Doris Lefkowitz, AHRQ Reports 

Clearance Officer, (301) 427–1477, or by 

email at dorislefkowitz@AHRO.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

Patient-Reported Health Information 

Technology and Workflow. 

Health IT can improve quality of care 

by arraying relevant information, 

displaying clinical guidelines, 

highlighting test values of concern, 

calculating medication doses, and 

supporting clinical decisionmaking in 

many ways (Chaudhry et al., 2006). 

Successful health IT implementation 

requires careful attention to the 

workflow of clinicians and others 

involved in care delivery. However, few 

studies have examined how health IT 

can change workflow in ambulatory 

physician practices. Further, in most 

studies that address health IT in 

ambulatory settings, workflow is not the 

main focus of the research (Unertl, 

Weinger, Johnson et al., 2009, Carayon, 

Karsh, Cartmill et al., 2010a). The health 

IT literature has not focused on 

sociotechnical factors, such as patient or 

provider characteristics, physical 

environment and layout; technical 

training and support; functionality and 

usability of health IT; worker roles, staff 

workload, stress, and job satisfaction; 

and communication flows. Important 

work that does address such factors 

comes mainly from inpatient settings, or 

from other countries where the health 

care system is quite different than in the 

U.S. (Tjora and Scambler, 2009; 

Ammenwerth, filer, and Mahler, 2006; 

Niazkhani, Pirnejad, de Bont et al., 

2008; Niazkhani, Pirnejad, Berg et al., 

2009). Although many of these studies 

have concluded that changes in 

workflow occur when implementing 

different health IT applications, few 

studies have actually examined how 

workflow changes. 

In recent years there has been an 

increase in the use of health IT to 

capture patient reporting of medical 

histories, symptoms, results of selftesting (e.g., blood glucose levels, blood 

pressure), weight questions and 

concerns, over-the-counter medication 

use, and other information that patients 

need to share with their care providers. 

Health IT can elicit such information 

from patients, and help incorporate it 

into the flow of information within a 

physician’s practice so that the 

information is detailed, actionable, 

timely, and can be used to meet 

patients’ treatment goals. Gathering and 

integrating information from patients 

using health IT can include: 

• Patient portals, sometimes referred 

to as (electronic) personal health records 

or PHRs, allow patients to view portions 

of their medical records (e.g., laboratory 

test results), and support other healthrelated tasks such as making 

appointments or requesting medication 

refills. Some patient portal applications 

exist as standalone Web sites; other 

portal applications are integrated into 

an existing electronic health record 

[ERR] system; 

• Secure messaging with patients (use 

of secure email between patients and 

clinicians, typically using the secure 

messaging functionality in the ERR and/ 

or patient portal) (Byrne, Elliott, and 

Firek, 2009; Bergmo, Kummervold, 

Gammon et al., 2005); and 

• E-forms (surveys that are 

administered using computerized media 

[e.g., tablets, laptops] to collect 

information from patients using preformatted forms before or during patient 

visits). 

The use of patient-reported 

information is not yet widely integrated 

into health IT. This project will fill the 

gaps in the current literature by 

exploring the influence of 

sociotechnical factors—for clinicians 

and their office staff, and for patients— 

in capturing and using patient-reported 

information in ambulatory health IT 

systems and associated workflows. The 

goal of the project is to answer the 

following research questions: 

• How does the use of health IT to 

capture and use patient-reported 

information support or hinder the 

workflow from the viewpoints of 

clinicians, office staff, and patients? 

• How does the sociotechnical 

context influence workflow related to 

the capture and use of patient-reported 

information? 

• How do practices redesign their 

workflow to incorporate the capture and 

use of patient-reported information? 

The study will consist of rigorous 

mixed-methods case studies of six 

ambulatory care physician practices 

including three small practices (1–4 

physicians and the other clinicians and 

office staff in their practices) and three 

medium-sized practices (5–10 

physicians, and the other clinicians and 

office staff in their practices). These case 

studies will be conducted during 

multiday (3 to 4 days) site visits to 

collect information for this exploratory 

research. The multiple case study 

research approach of Eisenhardt and 

colleagues (Brown & Eisenhardt, 1997; 

Eisenhardt, 1989) will guide data 

collection and data analysis, to 

elucidate health IT workflows and 

important sociotechnical factors (for 

patients, clinicians, and office staff) in 

the capture and use of patient-reported 

information. 

A focus of the case studies will be to 

identify current workflows related to 

patient-reported information, and 

determine the work system factors that 

influence workflows (barriers and 

facilitators). In particular, data collected 

from the six practices will help identify 

bottlenecks and sources of delay, 

unnecessary steps or duplication, 

rework to correct errors or 

inconsistencies, role ambiguity, missing 

information, and lack of data quality 

controls or reconciliation of 

inconsistencies. The focus is not on the 

content of information reported by 

patients, or how it alters clinicians’ 

diagnostic or treatment decisions. 

Rather, the focus is on the workflows 

required to capture, process, and make 

use of information that patients report to 

their care providers. 

This study is being conducted by 

AHRQ through its contractor, Abt 

Associates Inc., and subcontractors 

University of Wisconsin-Madison and 

University of Alabama-Birmingham, 

pursuant to AHRQ’s statutory authority 

to conduct and support research on 

health care and on systems for the 

delivery of such care, including 

activities with respect to health care 

technologies and the quality, 

effectiveness, efficiency, 

appropriateness and value of health care 

services including quality measurement 

and improvement. 42 U.S.C. 299a(a)(1), 

(2) and (5). 

Method of Collection 

To achieve the goal of this project the 

following activities will be conducted at 

each of six participating ambulatory 

physician practices (referred to herein 

as ‘study sites’): 


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(1) Preliminary Conference Call: The 

Practice Manager (the individual in each 

practice who manages day-to-day 

operations) and the Physician Leader 

(the physician in each practice who is 

most knowledgeable about health IT and 

health IT implementation) will be asked 

to participate in a preliminary 

conference call to learn about the study 

site and what will be expected of their 

practice as a study site. This call will 

last approximately one hour and will be 

completed by up to 2 participants per 

site for a total of up to 12 participants 

across sites. 

(2) Pre-Visit Questionnaire: The 

Practice Manager will be asked to 

complete a brief questionnaire prior to 

the site visit, describing the practice 

size, health IT installed, patient 

population served, and other general 

contextual information about the 

practice and use of health IT. The PreVisit Questionnaire will take 

approximately one hour to complete 

and will be completed by up to one 

respondent per study site. 

(3) Practice Tour: Each of the six site 

visits will begin with a one-hour tour of 

the practice and discussion with the 

Practice Manager to observe the 

physical layout and computer work 

stations, clarify the purpose of the study 

and the site visit, and clarify 

information from the Pre-Visit 

Questionnaire. 

(4) Interviews with Practice Manager 

and Physician Leader: Following the 

tour at each study site, the Practice 

Manager and Physician Leader will be 

asked to participate in a one hour 

interview. The interview with the 

Practice Manager will focus on the 

sociotechnical context of the practice, 

with an emphasis on the social context 

of the practice. The interview with the 

Physician Leader will also focus on the 

sociotechnical context of the practice, 

and, in particular, the technical aspects 

of clinicians using the health IT system. 

The focus will be on the workflow 

across the practice, not the workflow of 

these two individuals. This information 

will be used to create the basic outline 

or structure of a Workflow Process 

Map(s), a diagram that shows the 

temporal sequencing of tasks in relation 

to other work system elements (person, 

organization, environment, and tools 

and technologies). It will also be used to 

begin to identify potential variation or 

flexibility in individuals’ workflows, 

and provide context regarding multiple 

IT systems that may be in use in the 

practice. The information obtained from 

these interviews will be augmented by 

observation of workflows in the practice 

and interviews with others in the 

practice, as described in #5 and #6. 

(5) Observations of Clinicians and 

Office Staff: Researchers will observe 

between 8 to 20 clinicians (including 

physicians, nurse practitioners, 

physician assistants, nurses, medical 

assistants, and ancillary staff) and 

between 3 to 7 office staff (including the 

front desk receptionist, IT staff, clerks, 

and other non-clinical staff) per study 

site, depending on site size for a total of 

up to 84 clinicians and up to 30 office 

staff observations across the study sites. 

Observations will take place as 

clinicians and office staff work to elicit, 

integrate and work with patientreported information. Each clinician 

will be observed for up to two hours and 

each office staff person will be observed 

for up to 30 minutes. These observations 

periods are different because clinicians’ 

work is more complex and varies more 

from one patient to the next, while 

office staff work varies less. 

Observations will focus on processes, 

bottlenecks, facilitators, workarounds, 

and points in the workflow when paper 

information supplements electronic 

information. Observations of both 

clinicians and office staff will be 

recorded on the Observation Form. The 

observations will be used to create a 

detailed Workflow Process Map(s). This 

data collection will not burden the 

clinic staff and is not included in the 

burden estimates in Exhibit 1. 

(6) Interviews with Clinicians and 

Office Staff: Following observations of 

the workflow, each clinician and office 

staff person who was observed will be 

interviewed for up to one hour, for a 

total of up to 84 clinicians and up to 30 

office staff interviews. If there are more 

clinicians or office staff than can be 

interviewed during the site visit, those 

with the most extensive experience with 

patient-reported information will be 

selected for interviews. These 

interviews will include discussion 

about the sociotechnical context, the 

workflow observed (see above), 

facilitators and barriers to capturing and 

using patient-reported information, and 

whether there are uncommon workflow 

patterns that arise occasionally but were 

not observed. Unlike the interviews 

with the Physician Leader and Practice 

Manager, these interviews will focus on 

the workflow of each individual, not the 

workflow across the entire practice. The 

same interview guide will be used for 

both clinician and office staff 

interviews. 

(7) Survey of Clinicians and Office 

Staff: All clinicians and office staff in 

the six study sites will be invited to 

respond to a survey. Although there 

may not be sufficient time on site to 

observe and interview every clinician 

and office staff person in the mediumsized practices, all of them will be asked 

to complete the survey questionnaire. 

Therefore, the number of survey 

respondents is greater than the number 

of observed and interviewed 

individuals. Up to 11 surveys will be 

completed at each small-sized study site 

and up to 35 surveys will be completed 

at each medium-sized study site, for a 

total of up to 138 respondents across the 

six sites. The surveys will be used to 

collect data regarding attitudes about 

and perceptions of the health IT 

workflows staff engage in related to 

patient-reported information and the 

impact of health IT on workload, stress, 

and job satisfaction, because workflow 

can impact workload and job 

satisfaction which have been shown to 

impact quality of care. The survey will 

also be used to collect data on barriers 

and facilitators associated with 

capturing and using patient-reported 

information. 

(8) Patient Interviews: Patients will be 

interviewed to the understand the 

workflow of entering or reporting 

information from the patient’s 

perspective; the extent and adequacy of 

training or instruction patients received 

in using the health IT; attitudes about 

the time it takes to report information; 

and whether there are challenges, 

barriers, facilitators, or workarounds 

commonly used by patients as they 

report information requested by their 

cue providers. Five patients will be 

interviewed at each small practice and 

up to seven at each medium-sized 

practice, for a total of up to 36 across the 

six study sites. More patients will be 

interviewed in the medium-sized 

practices because there are more 

clinicians in these practices, and each 

may have different patterns of 

interacting with their patients. 

Interviewing more patients will enhance 

the ability to capture information about 

variation in the clinician-patient 

information sharing and interaction. 

These interviews will help researchers 

understand the range of patient 

experiences. 

(9) Post-Visit Follow-up to Review the 

Workflow Process Map(s): Following 

each site visit, researchers will complete 

the Workflow Process Map(s) for the 

study-site and send it to the Practice 

Manager and Physician Leader, 

requesting confirmation that the 

understanding of their workflows is 

correct. 

The lessons learned from this research 

may be used in a variety of ways: 

(1) To identify additional workflow 

components that ambulatory practices 

should consider when implementing 

health IT to capture and use patientreported information; 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
Federal Register / Vol. 78, No. 84 / Wednesday, May 1, 2013 / Notices 25453 

(2) To identify issues relevant to best 

practice guidelines for health IT 

implementation; 

(3) To identify issues for 

consideration in the design and 

evaluation of other patient-centered 

health IT tools. 

The study findings will be widely 

disseminated to health IT researchers 

and implementers via AHRQ’s National 

Resource Center for Health IT Web site. 

The study will enhance the existing 

knowledge about sociotechnical factors 

that impact health IT workflow, and 

how small and medium-sized 

ambulatory practices employ health IT 

to capture and use patient-reported 

information as they redesign their 

workflow to deliver patient-centered 

care. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated annual 

burden hours for the respondents’ time 

to participate in this research. The 

Preliminary Conference Call with each 

site will involve two people, the 

Practice Manager and the Physician 

Leader, and will require up to one hour 

per site. A total of 12 people across the 

six study sites will be involved. 

The Pre-Visit Questionnaire and the 

Practice Tour will be completed by the 

Practice Manager at each site and will 

require up to one hour each. The 

Practice Manager and the Physician 

Leader at each site (12 individuals in 

total across the 6 sites) will be 

separately interviewed to gather in 

depth information about the 

sociotechnical context of the practice. 

The interviews will each take up to one 

hour to complete. 

Interviews with Clinicians and Office 

Staff will be completed with a 

maximum of 114 clinicians and office 

staff across the six study sites, and each 

interview will last up to one hour. A 

maximum of 138 clinicians and office 

staff combined (up to 11 for each of 

three small-sized sites and 35 for each 

of 3 medium-sized sites) will be asked 

to complete the clinician and office staff 

survey, which will take approximately 

15 minutes for each respondent to 

complete. 

Up to 36 patients will be interviewed 

(5 in each of the small sites and up to 

7 in each of the medium-sized sites). 

Each interview will take no more than 

30 minutes to complete. A total of 12 

persons (the Practice Manager and the 

Physician Leader at each site) will be 

involved in the Post-Visit Follow-up to 

Review the Workflow Process Map(s), 

which will take one hour. The total 

annual burden hours, is estimated to be 

215 hours. 

Exhibit 2 shows the estimated annual 

cost burden associated with the study 

sites’ time to participate in the research. 

The total annual cost burden is 

estimated to be $10,815. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses 

per 

respondent 

Hours per 

response 

Total burden 

hours 

Preliminary Conference Call ............................................................................ 12 1 1 12 

Pre-Visit Questionnaire .................................................................................... 6 1 1 6 

Practice Tour ................................................................................................... 6 1 1 6 

Interviews with Practice Manager and Physician Leader ................................ 12 1 1 12 

Interviews with Clinicians and Office Staff ...................................................... 114 1 1 114 

Survey of Clinicians and Office Staff ............................................................... 138 1 15/60 35 

Patient Interviews ............................................................................................ 36 1 30/60 18 

Post Visit Follow-up to Review the Workflow Process Map(s) ....................... 12 1 1 12 

Total .......................................................................................................... 336 N/A N/A 215 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly 

wage rate * 

Total cost 

burden 

Preliminary Conference Call ............................................................................ 12 12 a $67.15 $806 

Pre-Visit Questionnaire .................................................................................... 6 6 b 46.17 277 

Practice Tour ................................................................................................... 6 6 b 46.17 277 

Interviews with Practice Manager and Physician Leader ................................ 12 12 a 67.15 806 

Interviews with Clinicians and Office Staff ...................................................... 114 114 c 50.97 5,811 

Survey of Clinicians and Office Staff ............................................................... 138 35 46.89 1,641 

Patient Interviews ............................................................................................ 36 18 e 21.74 391 

Review of the Workflow Process Map(s) ........................................................ 12 12 a 67.15 806 

Total .......................................................................................................... 336 215 N/A 10,815 

*Based upon the mean of the average hourly wages, National Compensation Survey: Occupational wages in the United States May 2011, 

‘‘U.S. Department of Labor, Bureau of Labor Statistics. aThe average wage for Practice Managers ($46.17 per hour) and Physician Leaders ($88.12 per hour) [$88.12 reflects the average for Family 

and General Practitioners ($85.26 per hour) and Internists, General ($90.97 per hour)]. bThe average U.S. wage for Practice Managers is $46.17 per hour. 

cThe weighted average wage for physicians ($88.12 per hour) [$88.12 reflects the average for Family and General Practitioners ($85.26 per 

hour) and Internists, General ($90.97 per hour)], nurse practitioners and physician assistants ($41.63 per hour) [$41.63 reflects the average for 

Physician Assistants ($43.01 per hour) and Health Diagnosing and Treating Practitioners, All ($40.24 per hour)], nurses ($33.23 per hour), and 

Office Staff ($17.94) [reflects the average for Receptionists and Information Clerks ($12.85 per hour), Office and Administration Support Workers, 

All Other ($16.07 per hour), and Computer Support Specialists ($24.91 per hour)]. dThe weighted average wage for physicians ($88.12), nurse practitioners and physician assistants ($41.63), nurses ($33.23) and office staff 

($17.94). eThe average U.S. hourly wage ($21.74). 


wreier-aviles on DSK5TPTVN1PROD with NOTICES
25454 Federal Register / Vol. 78, No. 84 / Wednesday, May 1, 2013 / Notices 

Request for Comments 

In accordance with the Paperwork 

Reduction Act, comments on AHRQ’s 

information collection are requested 

with regard to any of the following: (a) 

Whether the proposed collection of 

information is necessary for the proper 

performance of AHRQ health care 

research and health care information 

dissemination functions, including 

whether the information will have 

practical utility; (b) the accuracy of 

AHRQ’s estimate of burden (including 

hours and costs) of the proposed 

collection(s) 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 upon the 

respondents, including the use of 

automated collection techniques or 

other forms of information technology. 

Comments submitted in response to 

this notice will be summarized and 

included in the Agency’s subsequent 

request for OMB approval of the 

proposed information collection. All 

comments will become a matter of 

public record. 

Dated: April 15, 2013. 

Carolyn M. Clancy, 

Director. 

[FR Doc. 2013–09741 Filed 4–30–13; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[Docket Number NIOSH–161–A] 

Issuance of Final Guidance Publication 

AGENCY: National Institute for 

Occupational Safety and Health 

(NIOSH) of the Centers for Disease 

Control and Prevention (CDC), 

Department of Health and Human 

Services (HHS). 

ACTION: Notice of issuance of final 

guidance publication. 

SUMMARY: The National Institute for 

Occupational Safety and Health 

(NIOSH) of the Centers for Disease 

Control and Prevention (CDC), 

announces the availability of the 

following publication: ‘‘NIOSH Current 

Intelligence Bulletin 65: Occupational 

Exposure to Carbon Nanotubes and 

Nanofibers’’ [2013–145]. 

ADDRESSES: This document may be 

obtained at the following link: Web site: 

http://www.cdc.gov/niosh/docs/2013–

145/. 

FOR FURTHER INFORMATION CONTACT: 

Charles Geraci, NIOSH, Robert A. Taft 

Laboratories, MS–C14, 4676 Columbia 

Parkway, Cincinnati, OH 45226, 

telephone (513) 533–8339. 

Dated: April 25, 2013. 

John Howard, 

Director, National Institute for Occupational 

Safety and Health, Centers for Disease Control 

and Prevention. 

[FR Doc. 2013–10244 Filed 4–30–13; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Administration for Children and 

Families 

Submission for OMB Review; 

Comment Request 

Title: Community Services Block 

Grant (CSBG) Program Model Plan 

Application. 

OMB No.: 0970–0382. 

Description: Sections 676 and 677 of 

the Community Services Block Grant 

Act require States, including the District 

of Columbia and the Commonwealth of 

Puerto Rico, Tribes, Tribal organizations 

and U.S. territories applying for 

Community Services Block Grant 

(CSBG) funds to submit an application 

and plan (Model Application Plan). The 

application plan must meet statutory 

requirements prior to being funded with 

CSBG funds. Applicants have the option 

to submit a detailed application 

annually or biannually. Entities that 

submit a biannual application must 

provide an abbreviated application the 

following year if substantial changes to 

the initial application will occur. OMB 

approval is being sought. 

Respondents: State Governments, 

including the District of Columbia and 

the Commonwealth of Puerto Rico, 

Tribal Governments, Tribal 

Organizations, and U.S. territories. 

ANNUAL BURDEN ESTIMATES

Instrument Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

Total burden 

hours 

Model State CSBG Application ....................................................................... 56 1 10 560 

Model Indian Tribes & Tribal Organizations CSBG Application .................. 30 1 10 300 

Estimated Total Annual Burden 

Hours: 860. 

Additional Information: Copies of the 

proposed collection may be obtained 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. All requests should be 

identified by the title of the information 

collection. Email address: 

infocollection@acf.hhs.gov. 

OMB Comment: OMB is required to 

make a decision concerning the 

collection of information between 30 

and 60 days after publication of this 

document in the Federal Register. 

Therefore, a comment is best assured of 

having its full effect if OMB receives it 

within 30 days of publication. Written 

comments and recommendations for 

the proposed information collection 

should be sent directly to the following: 

Office of Management and Budget, 

Paperwork Reduction Project, Fax: 202– 

395–7285, Email: 

OIRA_SUBMISSION@OMB.EOP.GOV, 

Attn: Desk Officer for the 

Administration for Children and 

Families. 

Robert Sargis, 

Reports Clearance Officer. 

[FR Doc. 2013–10235 Filed 4–30–13; 8:45 am] 

BILLING CODE 4184–01–P 


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