22554 Federal Register / Vol. 74, No. 91 / Wednesday, May 13, 2009 / Notices 

of Health and Human Services, is 

publishing the following summary of a 

proposed information collection request 

for public comment. Interested persons 

are invited to send comments regarding 

this burden estimate or any other aspect 

of this collection of information, 

including any of the following subjects: 

(1) The necessity and utility of the 

proposed information collection for the 

proper performance of the agency’s 

functions; (2) the accuracy of the 

estimated burden; (3) ways to enhance 

the quality, utility, and clarity of the 

information to be collected; and (4) the 

use of automated collection techniques 

or other forms of information 

technology to minimize the information 

collection burden. 

To obtain copies of the supporting 

statement and any related forms for the 

proposed paperwork collections 

referenced above, e-mail your request, 

including your address, phone number, 

OMB number, and OS document 

identifier, to 

Sherette.funncoleman@hhs.gov, or call 

the Reports Clearance Office on (202) 

690–6162. Written comments and 

recommendations for the proposed 

information collections must be directed 

to the OS Paperwork Clearance Officer 

at the above email address within 60- 

days. 

Proposed Project: Request for 

Applicant Background Survey—OMB 

No. Extension–0990–0208 Assistant 

Secretary for Administration and 

Management. 

Abstract: 

The Applicant Background Survey 

form will be used for the next three 

years by the Operating Divisions 

(OPDIVs). The major sub-organizations 

within the Department of Health and 

Human Services (HHS), will collect and 

analyze data on race, sex, national 

origin, and disability from applicants for 

employment. Information will be 

collected by each of the personnel 

offices in the Department. The form will 

be used routinely by the OPDIVs when 

recruiting for all positions, including 

senior level positions and for selected 

job series where workforce analysis has 

shown evidence of low representation of 

minorities, women, or persons with 

disabilities. The results of the collection 

will assist the Department to determine 

if present recruitment sources yield 

qualified minority and female 

applicants and applicants with 

disabilities as required by EEOC MD 

715. 

ESTIMATED ANNUALIZED BURDEN TABLE

Type of respondent Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden hours 

per response 

(minutes) 

Total burden 

hours 

Individuals ........................................................................................................ 30,000 1 2 1,000 

Terry Nicolosi, 

Office of the Secretary, Paperwork Reduction 

Act Reports Clearance Officer. 

[FR Doc. E9–11078 Filed 5–12–09; 8:45 am] 

BILLING CODE 4151–17–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: 

‘‘Coordinating Care across Primary Care 

and Specialty Care Practices.’’ 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 March 5th, 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. 

This notice differs from the 60 day 

notice in that the Patient Satisfaction 

Survey has been eliminated. 

DATES: Comments on this notice must be 

received by June 12, 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@ahrg.hhs.gov. 

SUPPLEMENTARY INFORMATION: 

Proposed Project 

‘‘Coordinating Care across Primary 

Care and Specialty Care Practices.’’ 

AHRQ proposes an evaluation of the 

redesign of the transitions of care 

between primary care and specialty care 

services. The purpose of the redesign is 

to remedy inefficiencies in the current 

referral processes that threaten care 

quality and safety, and system 

efficiency. This redesign is being 

implemented at the Boston Medical 

Center (BMC), and two affiliated health 

centers. The evaluation will be 

conducted for AHRQ by its contractor, 

the Boston University School of Public 

Health (BUSPH). 

Care coordination has been identified 

by the Institute of Medicine (IOM) as a 

key strategy with potential to improve 

the effectiveness, safety and efficiency 

of the health care system. At the same 

time, care coordination, particularly in 

transitions among sites of care, is often 

lacking. Research shows that problems 

in coordination of care and common 

failures in patients’ transitioning 

between and among systems typically 

create serious quality concerns in many 

settings. Individuals moving across 

systems of care and between care 

providers are vulnerable to fragmented 

and disjointed care (Coleman et al., 

2004). Uncoordinated and fragmented 

transitions can lead to a wide range of 

costly problems and threats to patient 

safety including greater use of hospital 

and emergency services (Coleman et al., 

2004), ordering and completion of 

redundant tests (Coleman & Berenson, 

2004), prescription and medication 

errors and use of poly-pharmacy by 

multiple providers (Coleman & 

Berenson, 2004). The end result is often 

confusion about conflicting care plans 

and lack of follow-up care. The aim of 

Federal Register / Vol. 74, No. 91 / Wednesday, May 13, 2009 / Notices 22555 

this evaluation is to address this 

confusion and fragmentation by 

expanding knowledge of how to 

improve the experience and outcomes 

for patients in transitions of care 

between primary care and specialty 

practices. The initial focus is on 

referrals between primary care and two 

specialties: gastroenterology (GI) and 

obstetrics (OB). The redesigned referral 

system will be tested by implementing 

it in three participating primary care 

sites and two specialty clinics. We 

expect that the lessons learned from this 

evaluation will provide a model and 

tools that can later easily be tested and 

applied to other sites and specialties in 

the BMC system and provide lessons 

learned to other systems seeking to 

sustainably improve their referral 

systems. 

This project is being conducted 

pursuant to AHRQ’s statutory authority 

to conduct research and evaluations on 

health care and systems for the delivery 

of such care, including activities with 

respect to: The quality, effectiveness, 

efficiency, appropriateness and value of 

health care services; clinical practice, 

including primary care and practiceoriented research; and health care costs, 

productivity, organization, and market 

forces. See 42 U.S.C. 299a(a)(1), (4) and 

(6). 

The overall aims of the evaluation are 

to provide a rigorous assessment of the 

success of the redesigned referral system 

in meeting its improvement goals and to 

gain an understanding of the 

implementation of the redesigned 

system. 

Method of Collection 

This evaluation will include the 

following data collections: 

• Medical record data will be used to 

analyze aspects of the referral process, 

such as percentage of items on referral 

forms filled in, proportion of specialty 

appointments made, time between 

referral and initial specialty 

appointment. Patients’ personal health 

data will not be analyzed. The medical 

record data will be used to measure both 

the fidelity of the redesigned system 

within the practices and success in 

meeting redesign improvement goal 

(outcome) indicators. The medical 

record data will be extracted by project 

staff and will not impose a burden on 

the participating health care sites. 

• Focus groups with providers, 

clinical staff and administrative staff 

will be conducted in each primary care 

site and in each specialty practice. The 

group sessions will pursue three topics: 

The extent to which the new system is 

being used as intended; the perceived 

effectiveness of the new system as 

implemented; and the organization and 

culture of the clinical setting. Themes 

from the focus groups will be used to 

assess fidelity of implementation, 

performance outcomes and factors 

affecting fidelity and outcomes. 

• Implementation logs and meeting 

notes kept by the project team 

throughout the redesign implementation 

will document the implementation 

process, including factors affecting the 

process, challenges encountered, and 

strategies for dealing with the 

challenges. This component of the 

evaluation will not impose a burden on 

the participating health care sites. 

Estimated Annual Respondent Burden 

Exhibit 1 shows the estimated 

annualized burden hours for the 

respondents’ time to participate in this 

two year evaluation. Focus groups will 

be conducted with about 21 clinical 

staff at each of the 3 primary care sites 

and 2 specialty care sites (Exhibit 1 

shows 2.5 sites per year). Each focus 

group session will last about 45 

minutes. The total annualized burden is 

estimated to be 39 hours. 

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS

Form name Number of 

respondents 

Number of 

responses 

per 

respondent 

Hours per 

response 

Total burden 

hours 

Focus groups ................................................................................................... 2.5 21 45/60 39 

Total .......................................................................................................... 2.5 na na 39 

Exhibit 2 shows the estimated 

annualized cost burden associated with 

the respondents’ time to participate in 

this project. The total annualized cost 

burden is estimated to be $1,463. 

EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN

Form name Number of 

respondents 

Total burden 

hours 

Average 

hourly wage 

rate* 

Total cost 

burden 

Focus groups ................................................................................................... 2.5 39 $37.50 $1,463 

Total .......................................................................................................... 2.5 39 na 1,463 

* The hourly wage is based upon the weighted mean of the average wages for physicians ($58.76, n=45), clinical administrative staff ($17.64, 

n=30) and other clinical staff ($25.48, n=30). National Compensation Survey: Occupational Wages in the United States, U.S. Department of 

Labor, Bureau of Labor Statistics. June 2007, Summary 0703, http://www.bls.gov/ncs/ocs/sp/ncblo9 1 0.pdf. Accessed December 10, 2008. 

Estimated Annual Costs to the Federal 

Government 

Exhibit 3 shows the estimated total 

and annualized cost for this two-year 

evaluation. The total cost is $155,110 

and includes $23,267 for project 

development, $32,573 for data 

collection activities, $31,022 for data 

processing and analysis, $15,511 for the 

publication of results, $12,408 for 

project management and $40,329 for 

overhead. 

22556 Federal Register / Vol. 74, No. 91 / Wednesday, May 13, 2009 / Notices 

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST

Cost component Total cost Annualized 

cost 

Project Development ............................................................................................................................................... $23,267 $11,633 

Data Collection Activities ......................................................................................................................................... 32,573 16,287 

Data Processing and Analysis ................................................................................................................................. 31,022 15,511 

Publication of Results .............................................................................................................................................. 15,511 7,756 

Project Management ................................................................................................................................................ 12,408 6,204 

Overhead ................................................................................................................................................................. 40,329 20,164 

Total .................................................................................................................................................................. 155,110 77,555 

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 health care research, quality 

improvement and 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: May 4, 2009. 

Carolyn M. Clancy, 

Director. 

[FR Doc. E9–11009 Filed 5–12–09; 8:45 am] 

BILLING CODE 4160–90–M 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Health Resources and Services 

Administration 

Agency Information Collection 

Activities: Proposed Collection: 

Comment Request 

In compliance with the requirement 

for opportunity for public comment on 

proposed data collection projects 

(section 3506(c)(2)(A) of Title 44, United 

States Code, as amended by the 

Paperwork Reduction Act of 1995, Pub. 

L. 104–13), the Health Resources and 

Services Administration (HRSA) 

publishes periodic summaries of 

proposed projects being developed for 

submission to the Office of Management 

and Budget (OMB) under the Paperwork 

Reduction Act of 1995. To request more 

information on the proposed project or 

to obtain a copy of the data collection 

plans and draft instruments, e-mail 

paperwork@hrsa.gov or call the HRSA 

Reports Clearance Officer on (301) 443– 

1129. 

Comments are invited on: (a) The 

proposed collection of information for 

the proper performance of the functions 

of the agency; (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 Title: Interim 

Evaluation of the Bright Futures for 

Women’s Health and Wellness 

(BFWHW) Initiative, Emotional 

Wellness Consumer Tools—NEW. 

Purpose: The purpose of this project 

is to design and implement a three-year 

interim evaluation to address initial 

outcomes for the BFWHW emotional 

wellness tools targeted at consumers. 

The project is funded by the Health 

Resources and Services Administrations 

(HRSA), Office of Women’s Health 

(OWH). The evaluation will seek to 

determine (1) the acceptability of the 

tools by the target audiences, (2) 

strategies for ensuring their ongoing use, 

and (3) the outcomes associated with 

the use of these tools in three to four 

selected primary care sites. 

The evaluation team will work with 

HRSA OWH and an Expert Committee 

to identify the questions of interest for 

the evaluation plan and methodology. 

There will be two major components— 

a descriptive/process component 

focusing on the design and 

implementation of the program’s 

intervention and an impact component 

focusing on the preliminary outcomes of 

the intervention on the target audiences 

and their behavioral intentions. 

Respondents: 

Female consumers (adolescents 

between the ages of 13 and 17 and 

adults 18 and older) who receive 

services from primary care sites or 

community service organizations will 

receive a written survey on site at the 

time of service. 

Distributors of the Consumer Tools 

(e.g., healthcare providers, program 

staff, and community stakeholders/ 

organizations) from the three to four 

selected HRSA-funded program sites 

will respond to a web-based written 

survey. 

Female consumers (adolescents 

between the ages of 13 and 17 and 

adults 18 and older) who receive 

services from primary care sites or 

community service organizations will be 

invited to participate in a focus group.