Notice2021-26903
Agency Forms Undergoing Paperwork Reduction Act Review
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
December 13, 2021
Issuing agencies
Health and Human Services DepartmentCenters for Disease Control and Prevention
Full Text
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<title>Federal Register, Volume 86 Issue 236 (Monday, December 13, 2021)</title>
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[Federal Register Volume 86, Number 236 (Monday, December 13, 2021)]
[Notices]
[Pages 70841-70842]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-26903]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[30Day-22-0891]
Agency Forms Undergoing Paperwork Reduction Act Review
In accordance with the Paperwork Reduction Act of 1995, the Centers
for Disease Control and Prevention (CDC) has submitted the information
collection request titled ``World Trade Center Health Program
Enrollment, Petitions, Designated Representative/HIPAA Authorization,
and Member Satisfaction'' to the Office of Management and Budget (OMB)
for review and approval. CDC previously published a ``Proposed Data
Collection Submitted for Public Comment and Recommendations'' notice on
July 22, 2021 to obtain comments from the public and affected agencies.
CDC received three comments related to the previous notice but were
unrelated to the package. This notice serves to allow an additional 30
days for public and affected agency comments.
CDC will accept all comments for this proposed information
collection project. The Office of Management and Budget is particularly
interested in comments that:
(a) Evaluate whether the proposed collection of information is
necessary for the proper performance of the functions of the agency,
including whether the information will have practical utility;
(b) Evaluate the accuracy of the agencies estimate of the burden of
the proposed collection of information, including the validity of the
methodology and assumptions used;
(c) Enhance the quality, utility, and clarity of the information to
be collected;
(d) Minimize the burden of the collection of information on those
who are to respond, including, using appropriate automated, electronic,
mechanical, or other technological collection techniques or other forms
of information technology, e.g., permitting electronic submission of
responses; and
(e) Assess information collection costs.
To request additional information on the proposed project or to
obtain a copy of the information collection plan and instruments, call
(404) 639-7570. Comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this information
collection by selecting ``Currently under 30-day Review--Open for
Public Comments'' or by using the search function. Direct written
comments and/or suggestions regarding the items contained in this
notice to the Attention: CDC Desk Officer, Office of Management and
Budget, 725 17th Street NW, Washington, DC 20503 or by fax to (202)
395-5806. Provide written comments within 30 days of notice
publication.
Proposed Project
World Trade Center Health Program Enrollment, Petitions, Designated
Representative/HIPAA Authorization, and Member Satisfaction (OMB
Control No. 0920-0891, Exp. 12/31/2021)--Revision--National Institute
for Occupational Safety and Health (NIOSH), Centers for Disease Control
and Prevention (CDC).
Background and Brief Description
NIOSH seeks to request OMB approval to revise the currently
approved information collection activities that support the World Trade
Center (WTC) Health Program. The James Zadroga 9/11 Health and
Compensation Act of 2010 (Pub. L. 111-347, as amended by Pub. L. 114-
113) created the WTC Health Program to provide medical monitoring and
treatment benefits to eligible firefighters and related personnel, law
enforcement officers, and rescue, recovery, and cleanup workers who
responded to the September 11, 2001, attacks in New York City, at the
Pentagon, and in Shanksville, Pennsylvania (responders), and to
eligible persons who were present in the dust or dust cloud on
September 11, 2001, or who worked, resided, or attended school,
childcare, or adult daycare in the New York City disaster area
(survivors).
Since its inception in 2011, the WTC Health Program has been
approved to collect information from applicants and Program members
concerning enrollment, appointment of a designated representative or
third party, member satisfaction, and petitions regarding adding a new
WTC-related health condition to determine coverage under the Program.
The currently approved total estimated burden is 14,063 hours annually
(see OMB Control No. 0920-0891, Exp. 12/31/2021). The WTC Health
Program has determined that some existing forms need to be updated and
some need to be removed from the burden table.
For this revision, the burden hours on the WTC Health Program
Applications for Enrollment increased due to an expected increase of
application volume. The Program updated the enrollment applications for
plain language and improved processing. We estimate 15,837 individuals
will submit either a FDNY, General Responder, Pentagon/Shanksville
Responder, or WTC Survivor application annually. The burden estimate
for the applications is 7,919 hours. This is an increase from 2018 when
the estimated annualized burden was 2,251. Of the Applications for
Enrollment, we expect to receive per year, we estimate 3,830 of them
are General Responder applications from the NY/NJ area and will have to
select which clinic they would like to visit. It is expected that it
will take the member 0.25 hours to complete the postcard. The burden
hours for the General Responder Clinic Postcard are 958 hours.
The Program finds it necessary to update and add new forms to allow
applicants and Program members to grant permission to share information
with a designated representative or third person about an individual's
application or case. We estimate that 1,300 applicants and members will
submit a Designated Representative Appointment Form and Designated
Representative HIPAA Authorization Form annually. These forms will take
approximately 0.25 hours to complete. The burden estimate for these
forms is 650 hours.
The Program proposes to extend this information collection to
account for adding the WTCHP HIPAA Authorization for Deceased
Individuals, WTCHP General HIPAA Authorization to Third Parties, and
Designated Representative Revocation Form. The WTCHP HIPAA
Authorization for Deceased Individuals was created so a family member
and/or personal representative of a deceased applicant or member can
request program documentation and/or medical records related to the
deceased applicant/member. The WTCHP General HIPAA Authorization to
Third Parties was created for members to give the Program permission to
share information about their case with a third party, such as a
lawyer. The Designated Representative Revocation Form was created for
members who wish to remove or replace a currently appointed designated
representative. We estimate that 30 applicants or members will submit a
[[Page 70842]]
WTCHP HIPAA Authorization for Deceased Individuals, 30 applicants will
submit a WTCHP General HIPAA Authorization to Third Parties form, and
15 applicants or members will submit a Designated Representative
Revocation Form annually. These forms will take no longer than 0.25
hours to complete. The total burden estimate for the WTCHP HIPAA
Authorization for Deceased Individuals form and the WTCHP General HIPAA
Authorization to Third Parties form is eight hours. The total burden
estimate for the Designated Representative Revocation Form is four
hours.
The Program also finds it necessary to add a Member Satisfaction
Survey. This survey is for WTC Health Program members and asks for
feedback about their satisfaction in the Program, at their clinic, and
how they would like to receive Program communications. The survey
should take no longer than 0.5 hours to complete for a burden estimate
of 3,300 burden hours.
The Petition for the addition of a new WTC-Related Health Condition
for Coverage was previously approved in 2018. The burden hours for the
Petition form decreased to 35 as the Program has received less
petitions than anticipated in 2018. The Zadroga Act identified a list
of health conditions for which individuals who are enrolled in the WTC
Health Program may be monitored or treated [Title XXXIII, Sec.
3312(a)(3)]; those conditions are reiterated and expanded in the
associated WTC Health Program regulations at 42 CFR 88.15. Under the
regulations, interested parties may submit a petition to request that a
new health condition be added to the list of conditions specified in
Sec. 88.15. The forms should take no longer than one hour to complete
for a burden estimate of 35 burden hours.
CDC requests OMB approval for an estimated 12,882 burden hours.
There are no costs to respondents other than their time to participate.
Estimated Annualized Burden Hours
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Average
Number of Number of burden per
Type of respondents Form name respondents responses per response
respondent (in hours)
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FDNY Responder........................ WTC Health Program FDNY 140 1 30/60
Responder Eligibility
Application for Enrollment.
General Responder..................... WTC Health Program Responder 6,215 1 30/60
Eligibility Application for
Enrollment (Other than FDNY).
Pentagon/Shanksville Responder........ WTC Health Program Pentagon/ 242 1 30/60
Shanksville Responder
Application for Enrollment.
WTC Survivor.......................... WTC Health Program Survivor 9,240 1 30/60
Eligibility Application for
Enrollment (all languages).
General responder..................... Clinic Selection Postcard for 3,830 1 15/60
new general responders in NY/
NJ to select a clinic.
Interested Party...................... Petition for the addition of 35 1 1
health conditions.
Program Applicants or Members......... Designated Representative 1,300 1 15/60
Appointment Form.
Program Applicants or Members......... Designated Representative 1,300 1 15/60
HIPAA Release Form to allow
the sharing of member
information with a third
party.
Program Members....................... Member Satisfaction Survey... 6,600 1 30/60
General Public........................ WTCHP HIPAA Authorization for 30 1 15/60
Deceased Individuals.
Designated Representative............. WTCHP General HIPAA 30 1 15/60
Authorization to Third
Parties.
Designated (DR) Representative DR form that removes the 15 1 15/60
Revocation Form. members current designated
representative.
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific
Integrity, Office of Science, Centers for Disease Control and
Prevention.
[FR Doc. 2021-26903 Filed 12-10-21; 8:45 am]
BILLING CODE 4163-18-P
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