Federal Register / Vol. 74, No. 49 / Monday, March 16, 2009 / Notices 11109 

similarly revised to include the current 

credit exposure arising from credit 

derivative contracts that represent (a) 

purchased protection that is defined as 

a covered position under the market risk 

capital guidelines and (b) purchased 

protection that is not a covered position 

under the market risk capital guidelines 

and is not recognized as a guarantee for 

risk-based capital purposes. The Federal 

Reserve also proposed to add new 

Memorandum items 3.a and 3.b to 

Schedule HC–R to collect the present 

value of unpaid premiums on sold 

credit protection that is defined as a 

covered position under the market risk 

capital guidelines. Consistent with the 

information currently reported in 

Memorandum item 2.g, the Federal 

Reserve proposed to collect this present 

value information with a breakdown 

between investment grade and 

subinvestment grade for the rating of the 

underlying reference asset and with the 

same three remaining maturity 

breakouts. 

No comments were received on any of 

the proposed reporting revisions 

pertaining to credit derivatives 

described above, except for a comment 

from a bankers’ organization on the 

proposal to collect data on Schedule 

HC–R relating to the present value of 

unpaid premiums on sold credit 

protection that is defined as a covered 

position under the market risk capital 

guidelines. Accordingly, the Federal 

Reserve will implement all of the 

proposed credit derivative reporting 

changes—other than the proposed new 

Schedule HC–R data items for present 

value data—as of June 30, 2009, as 

proposed. With respect to the present 

value data, the bankers’ organization 

requested clarification of the impact of 

this proposed reporting requirement on 

a banking institution’s risk-based capital 

calculations. The Federal Reserve is 

continuing to consider this comment 

and the proposed collection of present 

value data for certain credit derivatives. 

Therefore, the Federal Reserve will not 

add Memorandum items 3.a and 3.b to 

Schedule HC–R to collect this present 

value information effective June 30, 

2009, as proposed. Once deliberations 

on the comment and the proposed 

present value data items have been 

concluded, conclusions will be 

published in a separate Federal Register 

notice. If Memorandum items 3.a and 

3.b are subsequently added to Schedule 

HC–R, this new reporting requirement 

would take effect no earlier than 

December 31, 2009. 

Board of Governors of the Federal Reserve 

System, March 11, 2009. 

Jennifer J. Johnson, 

Secretary of the Board. 

[FR Doc. E9–5584 Filed 3–13–09; 8:45 am] 

BILLING CODE 6210–01–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: 

‘‘Improving Patient Flow and Reducing 

Emergency Department Crowding.’’ In 

accordance with the Paperwork 

Reduction Act of 1995, 44 U.S.C. 

3506(c)(2)(A), AHRQ invites the public 

to comment on this proposed 

information collection. 

This proposed information collection 

was previously published in the Federal 

Register on January 15th, 2009 and 

allowed 60 days for public comment. 

One comment was 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 April 15, 2009. 

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 

e-mail at doris.lefkowitz@ahrq.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

‘‘Improving Patient Flow and 

Reducing Emergency Department 

Crowding’’ AHRQ proposes to study 

implementation of strategies from the 

Urgent Matters (UM) Toolkit for 

improving patient flow in emergency 

departments (ED). UM, a Robert Wood 

Johnson Foundation (RWJF) funded 

initiative, began as a collaborative of 10 

urban, safety net hospitals that 

experimented with a variety of strategies 

(now included in the ‘‘UM Toolkit’’) 

designed to relieve ED crowding. The 

first phase of this initiative 

demonstrated that reductions in ED 

crowding were achievable without 

investment of significant financial 

resources. However, implementation of 

these strategies has not been 

widespread, and questions remain about 

how readily the strategies could be 

implemented in a more diverse group of 

hospitals, and the associated costs and 

outcomes of implementation. This study 

is funded by a grant from RWJF to 

AHRQ. 

Six diverse hospitals have been 

selected for this study of the 

implementation of strategies from the 

UM Toolkit for improving ED patient 

flow. This study poses a common 

outcome goal across all six sites of 

improving patient flow and reducing ED 

crowding, but requires each hospital to 

select strategies that fit its own needs 

and context. This approach rests on 

innovation research showing that 

organizational innovations are more 

successful when they are aligned with 

features of the adopting hospital. 

Participating hospitals will select 

strategies from the UM Toolkit that they 

believe will work best to address the 

particular problems they face. The six 

hospitals have agreed to participate in a 

collaborative run by the UM National 

Program Office (NPO) over the course of 

this study to facilitate the sharing of 

data and experiences while the project 

is underway. 

This study will document the 

experiences of a diverse set of hospital 

EDs as they identify and implement ED 

patient flow improvement strategies. 

The six case study hospitals were 

selected to reflect diversity of size, 

ownership, teaching status, safety net 

status, and types of challenges with ED 

crowding. 

Research methods will include 

observational site visits, in-person and 

telephone interviews, and the analysis 

of cost data. AHRQ’s contractor for this 

study, Health Research & Educational 

Trust (HRET), will perform analysis of 

secondary data on ED performance 

measures; this secondary data will be 

provided to HRET by the Urgent Matters 

NPO. These qualitative and quantitative 

methods will be used to: 

• Study the processes through which 

hospitals decide upon and adopt patient 

flow improvement strategies; 

11110 Federal Register / Vol. 74, No. 49 / Monday, March 16, 2009 / Notices 

• Identify facilitators and barriers to 

the implementation and maintenance of 

these strategies; 

• Document changes in patient flow, 

patient satisfaction, and staff 

satisfaction associated with the 

implementation of strategies and 

processes; 

• Generate estimates of the costs of 

adopting the strategies; 

• Identify issues associated with the 

reporting of ED performance measures; 

and, 

• Develop lessons for hospitals 

considering the adoption of patient flow 

improvement strategies. 

The study will not be used to answer 

questions about causality or degrees of 

effectiveness (e.g., to what degree did a 

given intervention cause an 

improvement in patient flow?). Rather, 

the study seeks to enhance 

understanding of factors affecting 

decision-making and adoption processes 

that facilitate or hinder implementation. 

Insights and lessons learned about 

organizational, technical and resource 

challenges arising from these 

improvement activities may be of 

interest or benefit to others seeking to 

identify and adopt strategies to address 

similar problems in their EDs. 

This study is being conducted 

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: The quality, 

effectiveness, efficiency, 

appropriateness and value of health care 

services; quality measurement and 

improvement; and health care costs, 

productivity, organization, and market 

forces. 42 U.S.C. 299a(a)(1), (2), and (6). 

Method of Collection 

AHRQ seeks approval for the 

following data collection activities: 

In-person interviews will be 

conducted within two months of the 

implementation with up to 12 

individuals at each of the 6 sites during 

two-day site visits to each of the 

hospitals. 

Telephone interviews will be 

conducted approximately 6 months after 

implementation with 12 individuals 

from each of the six hospitals (most or 

all of whom will be the same 

individuals interviewed in person). 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

hospitals’ time to participate in this 

study. In-person interviews will be 

conducted within two months of 

implementation with 12 administrative 

and clinical personnel from each of the 

six participating hospitals and will 

require about one hour. Telephone 

interviews will be conducted 

approximately six months thereafter 

with 12 individuals (administrative and 

clinical) from each hospital and will 

take about 45 minutes. The total 

estimated burden for participation in 

this study is 126 hours. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Data collection Number of 

hospitals 

Number of 

responses per 

hospital 

Hours per 

response 

Total burden 

hours 

In-person interviews ......................................................................................... 6 12 1.0 72 

Telephone interviews ....................................................................................... 6 12 45/60 54 

Total .......................................................................................................... 12 na na 126 

Exhibit 2 shows the estimated 

annualized cost burden for the 

respondents’ time to provide the 

requested data. The total cost burden is 

approximately $4,419. 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Data collection Total burden 

hours 

Average 

hourly wage 

rate * 

Total cost 

burden 

In-person interviews ..................................................................................................................... 72 $35.07 $2,525 

Telephone interviews ................................................................................................................... 54 $35.07 1,894 

Total ...................................................................................................................................... 126 na 4,419 

* For the interviews, the hourly rate of $35.07 is an average of the admini strative personnel hourly wage of $14.53, the physician rate of 

$62.52, and the registered nurse rate of $28.15. National Compensation Survey: Occupational Wages in the United States 2005, U.S. Department of Labor, Bureau of Labor Statistics. 

Estimated Annual Costs to the Federal 

Government 

Exhibit 3 shows the total and 

annualized cost to the government for 

this eighteen-month study. 

EXHIBIT 3—ESTIMATED COST

Cost component Total cost Annualized 

cost 

Project Development ............................................................................................................................................... 52,446 34,964 

Data Collection Activities ......................................................................................................................................... 90,298 60,199 

Federal Register / Vol. 74, No. 49 / Monday, March 16, 2009 / Notices 11111 

EXHIBIT 3—ESTIMATED COST—Continued 

Cost component Total cost Annualized 

cost 

Data Processing and Analysis ................................................................................................................................. 70,569 47,046 

Publication of Results .............................................................................................................................................. 41,420 27,613 

Project Management ................................................................................................................................................ 68,908 45,939 

Overhead ................................................................................................................................................................. 76,320 50,880 

Total .................................................................................................................................................................. $399,961 266,641 

Request for Comments 

In accordance with the above-cited 

Paperwork Reduction Act legislation, 

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’s 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: March 9, 2009. 

Carolyn M. Clancy, 

Director. 

[FR Doc. E9–5581 Filed 3–13–09; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Agency for Healthcare Research and 

Quality 

Meeting of the National Advisory 

Council for Healthcare Research and 

Quality 

AGENCY: Agency for Healthcare Research 

and Quality (AHRQ). 

ACTION: Notice of public meeting. 

SUMMARY: In accordance with section 

10(a) of the Federal Advisory Committee 

Act, 5 U.S.C. app. 2, this notice 

announces a meeting of the National 

Advisory Council for Healthcare 

Research and Quality. 

DATES: The meeting will be held on 

Friday, April 3, 2009, from 9 a.m. to 3 

p.m. 

ADDRESSES: The meeting will be held at 

the Eisenberg Conference Center, 

Agency for Healthcare Research and 

Quality, 540 Gaither Road, Rockville, 

Maryland 20850. 

FOR FURTHER INFORMATION CONTACT: 

Deborah Queenan, Coordinator of the 

Advisory Council, at the Agency for 

Healthcare Research and Quality, 540 

Gaither Road, Rockville, Maryland 

20850, (301) 427–1330. For press-related 

information, please contact Karen 

Migdail at (301) 427–1855. 

If sign language interpretation or other 

reasonable accommodation for a 

disability is needed, please contact Mr. 

Donald L. Inniss, Director, Office of 

Equal Employment Opportunity 

Program, Program Support Center, on 

(301) 443–1144, no later than March 27, 

2009. The agenda, roster, and minutes 

are available from Ms. Bonnie Campbell, 

Committee Management Officer, Agency 

for Healthcare Research and Quality, 

540 Gaither Road, Rockville, Maryland 

20850. Ms. Campbell’s phone number is 

(301) 427–1554. 

SUPPLEMENTARY INFORMATION: 

I. Purpose 

The National Advisory Council for 

Healthcare Research and Quality was 

established in accordance with Section 

921 (now Section 931) of the Public 

Health Service Act, 42 U.S.C. 299c. In 

accordance with its statutory mandate, 

the Council is to advise the Secretary of 

the Department of Health and Human 

Services and the Director, Agency for 

Healthcare Research and Quality 

(AHRQ), on matters related to actions of 

AHRQ to enhance the quality, improve 

the outcomes, and reduce the costs of 

health care services; improve access to 

such services through scientific 

research; and promote improvements in 

clinical practice and in the organization, 

financing, and delivery of health care 

services. 

The Council is composed of members 

of the public, appointed by the 

Secretary, and Federal ex-officio 

members. 

II. Agenda 

On Friday, April 3, the Council 

meeting will convene at 9 a.m., with the 

call to order by the Council Chair and 

approval of previous Council minutes. 

The AHRQ director will present her 

update on current research, programs, 

and initiatives. The agenda will include 

a discussion of AHRQ budget for FY09, 

the comparative effectiveness program, 

and the AHRQ activities under 

American Recovery and Reinvestment 

Act (ARRA). 

The final agenda will be available on 

the AHRQ Web site at http:// 

www.ahrg.gov no later than March 30, 

2009. 

Dated: March 9, 2009. 

Carolyn M. Clancy, 

Alternate Certifying Officer Director. 

[FR Doc. E9–5580 Filed 3–13–09; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

Subcommittee on Procedures 

Reviews, Advisory Board on Radiation 

and Worker Health (ABRWH), National 

Institute for Occupational Safety and 

Health (NIOSH) 

In accordance with section 10(a)(2) of 

the Federal Advisory Committee Act 

(Pub. L. 92–463), CDC announces the 

following meeting for the 

aforementioned subcommittee: 

Time and Date: 10 a.m.–5 p.m., March 24, 

2009. 

Place: Cincinnati Airport Marriott, 2395 

Progress Drive, Hebron, Kentucky 41018. 

Telephone (859) 334–4611, Fax (859) 334– 

4619. 

Status: Open to the public, but without a 

public oral comment period. To access by 

conference call dial the following 

information 1 (866) 659–0537, Participant 

Pass Code 9933701. 

Background: The Advisory Board was 

established under the Energy Employees 

Occupational Illness Compensation Program