66470 Federal Register / Vol. 77, No. 214 / Monday, November 5, 2012 / Notices

Administrator, HRSA, regarding and Budget for review under the care setting, while providing activities related to prevention and Paperwork Reduction Act of 1995: monthly reporting on measurements. control of HIV/AIDS and other STDs, The proposed QI Data Collection and Proposed Project: the support of services to reporting system is an integral Treatment Demonstration Program— component of this model. persons living with HIV/AIDS, and Quality Improvement Data Collection education of health professionals and for the Hemoglobinopathy Learning Purpose: The purpose of this QI Data the public about HIV/AIDS and other Collaborative (OMB No. 0915–xxxx)– Collection strategy is to implement a STDs. [NEW] system to monitor the progress of Matters To Be Discussed: Agenda MCHB-funded activities in improving items include: (1) Treatment Cascade— Background: In response to the care and health outcomes for Linkage to Care/Retention in Care— growing need for resources devoted to individuals living with sickle cell Treatment as Prevention; (2) Ryan White sickle cell disease and other disease/trait and meeting the goals of HIV/AIDS Program Client Level Data hemoglobinopathies, the the SCDTDP. Each improvement team Update; (3) Viral Hepatitis Action Plan Congress, under Section 712 of the will be asked to report on a core set of and Implementation Update; (4) Update American Jobs Creation Act of 2004 measures related to quality on Translation of International HIV/ (Pub. L. 108–357), authorized a improvement for hemoglobinopathies. demonstration program for the AIDS Work Domestically; and (5) CHAC Through an evidence-based process, a prevention and treatment of sickle cell Workgroups Update. bank of QI measures has been developed disease (SCD) to be administered to assess health care utilization of the Agenda items are subject to change as through the Bureau of Primary Health priorities dictate. SCD population as well as several Care and the Maternal and Child Health aspects of the system of care. Contact Person for More Information: Bureau (MCHB) of the Health Resources The QI Data Collection strategy will Margie Scott-Cseh, National Center for and Services Administration (HRSA) in provide an effective and efficient HIV/AIDS, Viral Hepatitis, STD, and TB the U.S. Department of Health and mechanism to do the following: (1) Prevention, CDC, 1600 Clifton Road NE., Human Services. The program is known Assess the services provided by grantees Mailstop E–07, Atlanta, Georgia 30333, as the Sickle Cell Disease Treatment under the SCDTDP and monitor and Telephone: (404) 639–8317. Demonstration Program (SCDTDP). The drive improvement on quality measures; The Director, Management Analysis SCDTDP is designed to improve access (2) collect, coordinate, and distribute and Services Office, has been delegated to services for individuals with sickle data, best practices, and findings from the authority to sign Federal Register cell disease, improve and expand network sites; (3) refine a common Notices pertaining to announcements of patient and provider education, and meetings and other committee improve and expand the continuity and model protocol regarding the prevention management activities, for both the CDC coordination of service delivery for and treatment of sickle cell disease; (4) and the Agency for Toxic Substances individuals with sickle cell disease and examine/address barriers that and Disease Registry. sickle cell trait. individuals and families living with sickle cell disease face when accessing Dated: October 22, 2012. In 2006, the MCHB Genetic Services Branch (GSB) awarded funding to a quality health care and health Elaine L. Baker, National Coordinating Center (NCC). education; (5) evaluate the grantees’ Director, Management Analysis and Services The NCC was established to: (1) Collect, performance in meeting the objectives of Office, Centers for Disease Control and the SCDTDP; and, (6) provide HRSA/ Prevention. coordinate, monitor, and report on best practices and findings regarding the Congress information on the overall [FR Doc. 2012–26478 Filed 11–2–12; 8:45 am] activities of the demonstration program; progress of the program. BILLING CODE 4163–18–P (2) identify a model protocol for eligible The proposed data collection and entities with respect to the prevention entry forms are as follows: (1) and treatment of Sickle Cell Disease; (3) Participant Profile Form, (2) Acute Care DEPARTMENT OF HEALTH AND Visit Form, and (3) HUMAN SERVICES identify educational materials regarding the prevention and treatment of Sickle Visit Form. Health Resources and Services Cell Disease; and, (4) prepare a final Respondents: Grantees funded by Administration report on the efficacy of the HRSA under the SCDTDP will be the demonstration program based on respondents for this data collection Agency Information Collection evaluation and quality improvement activity. Each month, SCDTDP teams Activities: Submission for OMB (QI) findings. will complete up to three data collection Review; Comment Request To achieve the goals/objectives of the and entry forms for 20 patients with NCC, the National Initiative for SCD or sickle cell trait who were seen Periodically, the Health Resources Children’s Healthcare Quality (NICHQ) in their network that month. The and Services Administration (HRSA) and partners are facilitating the Participant Profile form will collect publishes abstracts of information Hemoglobinopathy Learning demographic and basic health collection requests under review by the Collaborative (HLC). The HLC includes information. The Acute Care Visit and Office of Management and Budget grantee teams funded from the SCDTDP Ambulatory Care Visit forms will assess (OMB), in compliance with the and the Sickle Cell Disease for Newborn care in acute and ambulatory care Paperwork Reduction Act of 1995 (44 Screening Program (SCDNBSP). The settings, respectively. U.S.C. Chapter 35). To request a copy of HLC uses a process known as the Model All information will be collected via the clearance requests submitted to for Improvement, which is a widely medical chart review. Data will be OMB for review, email used approach to QI in health care entered directly into a secure web-based [email protected] or call the HRSA settings. The Model for Improvement data collection tool, Research Electronic Reports Clearance Office on (301) 443– utilizes a structured process that asks Data Capture (REDCap). The data 1984. grantee teams, who hereafter will be entered into REDCap will be analyzed The following request has been referred to as improvement teams, to via a custom measurement generator submitted to the Office of Management build on small tests of change in their that will calculate and export the QI

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measures for viewing by improvement The annual estimate of burden is as teams, the NCC, and HRSA. follows:

Responses Instrument Number of per Total Hours per Total burden respondents respondent* responses response hours

Participant Profile Form ...... 9 12 108 5.0 540 Acute Care Visit Form ...... 9 12 108 10.0 1080 Ambulatory Care Visit Form ...... 9 12 108 10.0 1080

Total ...... 27 ...... 324 ...... 2700 * This burden table has been revised from the one published in the 60-day notice to reflect the accurate count of responses per respondent. The number 12 reflects the number of times a respondent will be approached for data collection annually, not the total number of data collection forms completed as was previously reported.

Written comments and methodologies and definitions that best www.ers.usda.gov/data-products/rural- recommendations concerning the suit their program requirements. urban-commuting-area-codes.aspx). proposed information collection should DATES: The public is encouraged to Using data from the Census Bureau, be sent within 30 days of this notice to submit written comments on the every census tract in the United States the desk officer for HRSA, either by proposed FAR methodology no later is assigned a RUCA code. Codes range email to than January 4, 2013. All public from 1 through 10, with 23 sub codes, [email protected] or by comments received will be available for with code 1 representing the most fax to (202) 395–6974. Please direct all public inspection at HRSA’s ORHP on densely populated urban areas and code correspondence to the ‘‘attention of the weekdays between 8:30 a.m. and 5:00 10 representing rural areas with primary desk officer for HRSA.’’ p.m. commuting to a tract outside an Dated: October 25, 2012. Urbanized Area or Cluster. HRSA ADDRESSES: Comments may be believes that the use of RUCAs allows Bahar Niakan, submitted via email to more accurate targeting of resources Director, Division of Policy and Information [email protected]; mail to Office of Rural intended for the rural population. Both Coordination. Health Policy, Health Resources and ORHP and the Centers for Medicare & [FR Doc. 2012–26935 Filed 11–2–12; 8:45 am] Services Administration, 5600 Fishers Medicaid Services have been using BILLING CODE 4165–15–P Lane, Parklawn Building, 5A–05, RUCAs for several years to determine Rockville, MD 20857; or fax to (301) programmatic eligibility for rural areas 443–2803. inside of metropolitan counties. DEPARTMENT OF HEALTH AND FOR FURTHER INFORMATION CONTACT: ORHP currently considers all census HUMAN SERVICES Questions about this request for public tracts with RUCA codes 4 through 10 to comment can be directed to Steven be rural. While use of the RUCA codes Health Resources and Services Hirsch using the contact information has allowed identification of rural Administration listed above. census tracts in metropolitan counties, Methodology for Designation of SUPPLEMENTARY INFORMATION: among the more than 60,000 tracts in Frontier and Remote Areas the U.S., there are some that are Background extremely large and where use of RUCA AGENCY: Health Resources and Services ORHP was authorized by Congress in codes alone fails to account for distance Administration, HHS. December of 1987 by Section 711 of the to services and sparse population. In Social Security Act [42 U.S.C. 912], and response to these concerns, ORHP has ACTION: Request for public comment on charged with informing and advising designated 132 large area census tracts methodology for designation of frontier HHS on matters affecting rural hospitals with RUCA codes 2 or 3 as rural. These and remote areas. and health care and coordinating tracts are at least 400 square miles in activities within the Department that area with a population density of no SUMMARY: This notice announces a relate to rural health care. more than 35 people per square mile. request for public comment on a Definition of ‘‘rural.’’ ORHP considers There is also a ZIP code-based version methodology derived from the Frontier all nonmetropolitan (nonmetro) of the RUCA codes that is often used for and Remote (FAR) system for counties to be ‘‘rural’’ for the purposes policy analysis, research, and other designating U.S. frontier areas. This of eligibility for its grant programs. Over purposes (see: http:// methodology was developed in a the years, ORHP has funded depts.washington.edu/uwruca/). collaborative project between the Office development of a rational, data-driven Need for definition of ‘‘frontier and of Rural Health Policy (ORHP) in the method to designate rural areas inside of remote.’’ Rural experts, researchers, and Health Resources and Services metropolitan counties. The Rural-Urban others have been calling for an Administration (HRSA); and the Commuting Area (RUCA) codes are used improved way to identify frontier and Economic Research Service (ERS) in the for determining grant eligibility. The remote areas. The most commonly used U.S. Department of Agriculture (USDA). RUCAs, which were developed by standard to date has been to identify While other agencies of the Department Richard Morrill and Gary Hart of the frontier areas as those counties with six of Health and Human Services (HHS) University of Washington and John or fewer people per square mile. and the ERS may in the future choose Cromartie of the USDA’s ERS, are based Researchers and policy experts have to use the FAR methodology to on a sub-county unit, the census tract, noted the shortcomings of this approach demarcate the frontier areas of the U.S., permitting a delineation of what since it relies solely on population there is no requirement that they do so, constitutes rural areas inside density and uses counties as the unit of and they may choose other, alternate metropolitan areas (see: http:// measure despite the great disparity in

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