[Federal Register: March 11, 2005 (Volume 70, Number 47)]
[Notices]
[Page 12220-12221]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr11mr05-74]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Medicare & Medicaid Services
[Document Identifier: CMS-R-211, CMS-R-306, CMS-R-185, and CMS-R-238]
Agency Information Collection Activities: Submission for OMB
Review; Comment Request
AGENCY: Centers for Medicare & Medicaid Services, HHS.
In compliance with the requirement of section 3506(c)(2)(A) of the
[[Page 12221]]
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid
Services (CMS), Department of Health and Human Services, is publishing
the following summary of proposed collections 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 function; (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.
1. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Model Application
Template for State Child Health Plan Under Title XXI of the Social
Security Act, State Children's Health Insurance Program, and Model
Application Template and Instructions; Use: States are required to
submit Title XXI plans and amendments for approval by the Secretary
pursuant to Section 2102 of the Social Security Act in order to receive
funds for initiating and expanding health insurance coverage for
uninsured children. The model application template is used to assist
States in submitting a State Child Health Plan and amendments to that
plan; Form Number: CMS-R-211 (OMB: 0938-0707); Frequency:
Quarterly and annually; Affected Public: State, local or tribal
government; Number of Respondents: 40; Total Annual Responses: 40;
Total Annual Hours: 3,200.
2. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Restraint and
Seclusion Standards for Psychiatric Residential Treatment Facilities;
Use: Psychiatric residential treatment facilities are required to
report deaths, serious injuries and attempted suicides to State
Medicaid Agency and Protection and Advocacy Organization. They are also
required to provide residents restraint and seclusion policy in
writing, and to document resident record of all activities involving
use of restraint and seclusion. Form Number: CMS-R-306 (OMB:
0938-0833); Frequency: On occasion; Affected Public: Business or other
for-profit and not-for-profit institutions; Number of Respondents: 500;
Total Annual Responses: 1,199,000; Total Annual Hours: 713,250.
3. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Granting and
Withdrawal of Deeming Authority to Private Nonprofit Accreditation
Organizations and of State Exemption Under State Laboratory Program and
Supporting Regulations in 42 CFR 493.551-493.557; Use: The information
required is necessary to determine whether a private accreditation
organization's or State licensure program's standards and
accreditation/licensure process is equal to or more stringent than
those of CLIA; Form Number: CMS-R-185 (OMB: 0938-0686);
Frequency: As needed; Affected Public: Not-for-profit institutions,
business or other for-profit, and State, local or tribal government;
Number of Respondents: 8; Total Annual Responses: 76; Total Annual
Hours: 768.
4. Type of Information Collection Request: Extension of a currently
approved collection; Title of Information Collection: Inpatient
Psychiatric Services for Individuals Under Age 21 and Supporting
Regulations in 42 CFR 441.151 and 441.152; Use: Certification
requirements in Section 441.152 require that the certification of need
for inpatient psychiatric services include documented clinical evidence
that serves as the basis for the certification of need for inpatient
psychiatric care. Section 1905(h)(1)(B) requires physicians and other
personnel qualified to make determinations, with respect to mental
health conditions and the treatment thereof, certify the need for care
which they have determined to be necessary on an inpatient basis; Form
Number: CMS-R-238 (OMB: 0938-0754); Frequency: Recordkeeping;
Affected Public: State, local or tribal government, not-for-profit
institutions and business or other for-profit; Number of Respondents:
80,000; Total Annual Responses: 80,000; Total Annual Hours: 1.
To obtain copies of the supporting statement and any related forms
for the proposed paperwork collections referenced above, access CMS Web
site address at http://www.cms.hhs.gov/regulations/pra/, or e-mail your
request, including your address, phone number, OMB number, and CMS
document identifier, to Paperwork@cms.hhs.gov, or call the Reports
Clearance Office on (410) 786-1326.
Written comments and recommendations for the proposed information
collections must be mailed within 30 days of this notice directly to
the OMB desk officer: OMB Human Resources and Housing Branch,
Attention: Christopher Martin, New Executive Office Building, Room
10235, Washington, DC 20503.
Dated: March 4, 2005.
John P. Burke, III,
CMS Paperwork Reduction Act Reports Clearance Officer, Office of
Strategic Operations and Regulatory Affairs, Regulations Development
Group.
[FR Doc. 05-4886 Filed 3-10-05; 8:45 am]
BILLING CODE 4120-03-P