25552 Federal Register / Vol. 74, No. 101 / Thursday, May 28, 2009 / Notices 

region; the Medicare Quality 

Improvement Organization(s)(QIO(s) 

serving providers that the proposed 

regional center aims to serve; state and 

tribal government entities in the center’s 

geographic service area including, but 

not limited to, public health agencies; 

libraries and information centers with 

health professional and community 

outreach programs; and consumer/ 

patient organizations. 

• As noted below, we propose to give 

preference to applicants identifying 

viable sources of matching funds. Viable 

sources could include grants from 

states, non-profit foundations, and 

payment for services from providers 

able to make such payment. For 

example, Medicaid providers could 

choose to contract with a regional center 

in lieu of a corporate vendor for 

implementation and meaningful use 

support services, for which costs are 

reimbursable under Section 1903 of the 

Social Security Act, as amended by the 

HITECH Act. A regional center could 

also, theoretically, seek to establish 

itself as a first-choice source of 

assistance that would realize net 

retained earnings on service to nonprioritized providers and use those 

retained earnings as a source of 

matching funds for its grant-funded 

activities. 

B. Maximum Support Levels Expected 

To Be Available to Centers Under the 

Program 

Given current national economic 

conditions, we propose to exercise the 

option in the HITECH Act to not require 

matching funds for awards made in FY 

2010. We will encourage use of 

matching funds and the coordination of 

existing resources to strengthen 

proposals for regional centers and 

potentially expand the number of 

providers that can be assisted. Review 

criteria may be established that give 

preference to proposals including 

matching funds but that do not 

automatically preclude otherwise 

technically meritorious proposals that 

do not include matching funds. 

We propose using ARRA funding for 

two-year awards made in FY2010 and 

furnishing providers in awardees’ areas 

with robust support. While we expect 

the actual ARRA funding awarded per 

center will vary based on the number 

and types of providers proposed to be 

served, and the amount of matching 

funds proposed by each regional center, 

we anticipate an average award value on 

the order of $1 million to $2 million per 

center. The maximum award value we 

anticipate making available to any one 

regional center is $10 million. Funding 

may also be approximately allocated to 

the regional centers in relative 

proportion to the numbers of prioritized 

direct assistance recipients identified in 

the HITECH Act. 

C. Procedures To Be Followed by the 

Applicants 

Timelines 

This notice makes public and invites 

comments on the draft description of 

the regional centers program and is not 

a solicitation of proposals to serve as 

extension centers under this program. 

The Federal Government will award 

funding for the regional centers through 

a solicitation of proposals, after 

considering the comments obtained 

through this notice. The availability of 

this solicitation will be broadly 

announced through appropriate and 

familiar means, including publication in 

the Federal Register of a Notice of the 

solicitation’s availability. This 

announcement of the solicitation will 

provide further details on the finalized 

requirements and application process 

for regional centers, pursuant to and in 

compliance with all applicable statutes 

and regulations, including but not 

limited to the Paperwork Reduction Act 

(44 U.S.C. 3501 et seq.). 

Applicants well prepared to provide 

robust extension services will likely 

need at least two months to provide 

high quality proposals. It is expected, 

however, that other potential applicants 

will need more time to prepare 

proposals. 

We propose to make initial awards for 

regional centers as early as the first 

quarter of FY2010 and continuing 

through the fourth quarter of FY2010. 

Multiple, closely spaced proposal 

submission dates will be established to 

allow each geographic area to begin 

receiving benefit of a regional center as 

soon as possible. We believe this 

approach is necessary to allow areas 

with well prepared applicants to begin 

work sooner, without excluding from 

consideration those areas where the best 

applicants require more time to convene 

a multi-stakeholder collaboration to 

develop a robust proposal that includes 

a viable organizational plan and 

implementation strategy. We solicit 

comment on our phased approach to 

proposal submission dates and issuance 

of awards. 

The target timeframe for awards is 

intended to enable regional centers to 

begin supporting provider adoption in 

time for providers to receive incentive 

payments with respect to Fiscal Year 

(hospitals) or Calendar Year 

(physicians) 2011 and 2012, when 

potential Medicare incentives are 

greatest. 

D. Comments on Draft Description 

ONC requests comments on this draft 

description of the regional centers 

within the Extension Program. Please 

send comments to the address, for 

receipt by the due date, specified at the 

beginning of this notice. 

Dated: May 22, 2009. 

Charles P. Friedman, 

Deputy National Coordinator for Health 

Information Technology. 

[FR Doc. E9–12419 Filed 5–27–09; 8:45 am] 

BILLING CODE 4150–45–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[60Day–0923–09BR] 

Proposed Data Collections Submitted 

for Public Comment and 

Recommendations 

In compliance with the requirement 

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

Paperwork Reduction Act of 1995 for 

opportunity for public comment on 

proposed data collection projects, the 

Centers for Disease Control and 

Prevention (CDC) will publish periodic 

summaries of proposed projects. To 

request more information on the 

proposed projects or to obtain a copy of 

the data collection plans and 

instruments, call 404–639–5960 and 

send comments to Maryam I. Daneshvar, 

CDC Acting Reports Clearance Officer, 

1600 Clifton Road, MS–D74, Atlanta, 

GA 30333 or send an e-mail to 

omb@cdc.gov. 

Comments are invited 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) 

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. Written comments should 

be received within 60 days of this 

notice. 

Proposed Project 

Registration of individuals with 

Amyotrophic Lateral Sclerosis (ALS) in 

the National ALS Registry—New— 

Agency for Toxic Substances and 

Disease Registry (ATSDR), Coordinating 

Federal Register / Vol. 74, No. 101 / Thursday, May 28, 2009 / Notices 25553 

Center for Environmental Health and 

Injury Prevention (CCEHIP), Centers for 

Disease Control and Prevention (CDC). 

Background and Brief Description 

On October 10, 2008, President Bush 

signed S. 1382: ALS Registry Act which 

amended the Public Health Service Act 

to provide for the establishment of an 

Amyotrophic Lateral Sclerosis (ALS) 

Registry. The activities described are 

part of the effort to create the National 

ALS Registry. The purpose of the 

registry is to: (1) Better describe the 

incidence and prevalence of ALS in the 

United States; (2) examine appropriate 

factors, such as environmental and 

occupational, that might be associated 

with the disease; (3) better outline key 

demographic factors (such as age, race 

or ethnicity, gender, and family history) 

associated with the disease; and (4) 

better examine the connection between 

ALS and other motor neuron disorders 

that can be confused with ALS, 

misdiagnosed as ALS, and in some cases 

progress to ALS. The registry will 

collect personal health information that 

may provide a basis for further scientific 

studies of potential risks for developing 

ALS. 

During a workshop held by The 

Agency for Toxic Substances and 

Disease Registry (ATSDR) in March 

2006 to discuss surveillance of selected 

autoimmune and neurological diseases, 

it was decided to develop a proposal to 

build on work that had already been 

done and coordinate existing datasets to 

create a larger database, rather than to 

start from scratch with medical records 

review and physician reporting. Four 

pilot projects were funded to evaluate 

the accuracy and reliability of existing 

data from the Center for Medicare and 

Medicaid Services (CMS) and various 

datasets from the Veterans 

Administration. Preliminary results 

indicate that additional ways to identify 

cases of ALS will be necessary to 

increase completeness of the registry. 

Therefore, ATSDR developed a Web site 

where individuals will register and will 

also have the opportunity to provide 

additional information on such things as 

occupation, military service, and family 

history of ALS, which is not available in 

existing records. 

The registration portion of the data 

collection will be limited to information 

that can be used to identify an 

individual to assure that there are not 

duplicate records for an individual. 

Avoiding duplication of registrants due 

to obtaining records from multiple 

sources is imperative to get accurate 

estimates of incidence and prevalence, 

as well as accurate information on 

demographic characteristics of the cases 

of ALS. 

In addition to questions required for 

registration, there will be a series of 

short surveys to collect information on 

such things as military history, 

occupations, and family history that 

would not likely be available from other 

sources. 

This project proposes to collect 

information on individuals with ALS 

which can be combined with 

information obtained from existing 

sources of information. This combined 

data will become the National ALS 

Registry and will be used to provide 

more accurate estimates of the incidence 

and prevalence of disease as well as the 

demographic characteristics of the 

cases. Information obtained from the 

surveys will be used to better 

characterize potential risk factors for 

ALS which will lead to further in-depth 

studies. 

The existence of the Web site will be 

advertised by ATSDR and advocacy 

groups such as the Amyotrophic Lateral 

Sclerosis Association (ALSA) and the 

Muscular Dystrophy Association 

(MDA). 

There will be approximately 30,000 

individuals living with ALS when the 

National ALS Registry is initiated, and 

it is estimated that approximately 25% 

of those individuals will also 

participate. In addition, approximately 

6,000 people are diagnosed with ALS 

each year and we expect about one-third 

of them will participate in the registry. 

Because an advantage to registration is 

participating in the surveys, we expect 

the one time surveys, and the twice 

yearly survey participation rate will be 

50%. 

There are no costs to the respondents 

other than their time. 

ESTIMATED ANNUALIZED BURDEN HOURS

Data collection instruments/respondents Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Total burden 

(in hours) 

Validation questions (Screener) for suspected ALS cases ............................. 6,000 1 2/60 200 

Registration Form of ALS cases ...................................................................... 4,667 1 7/60 544 

Cases of ALS completing 1-time surveys ....................................................... 2,334 6 5/60 1167 

Cases of ALS completing twice yearly surveys .............................................. 2,334 2 5/60 389 

Total ................................................................................................................. ........................ ........................ ........................ 2300 

Dated: May 20, 2009. 

Maryam I. Daneshvar, 

Acting Reports Clearance Officer, Centers for 

Disease Control and Prevention. 

[FR Doc. E9–12397 Filed 5–27–09; 8:45 am] 

BILLING CODE P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[60Day–09–0214] 

Proposed Data Collections Submitted 

for Public Comment and 

Recommendations 

In compliance with the requirement 

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

Paperwork Reduction Act of 1995 for 

opportunity for public comment on 

proposed data collection projects, the 

Centers for Disease Control and 

Prevention (CDC) will publish periodic 

summaries of proposed projects. To 

request more information on the 

proposed project or to obtain a copy of 

data collection plans and instruments, 

call the CDC Reports Clearance Officer 

on 404–639–5960 or send comments to 

CDC Assistant Reports Clearance 

Officer, 1600 Clifton Road, MS D–74, 

Atlanta, GA 30333 or send an e-mail to 

omb@cdc.gov. 

Comments are invited on: (a) Whether 

the proposed collection of information