Notice2022-12391
Agency Information Collection Activities: Proposed Collection: Public Comment Request; Maternal and Child Health Bureau Performance Measures for Discretionary Grant Information System (DGIS), OMB No. 0915-0298-Revision
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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
June 9, 2022
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
In compliance with the Paperwork Reduction Act of 1995, HRSA has submitted an Information Collection Request (ICR) to the Office of Management and Budget (OMB) for review and approval. Comments submitted during the first public review of this ICR will be provided to OMB. OMB will accept further comments from the public during the review and approval period. OMB may act on HRSA's ICR only after the 30-day comment period for this Notice has closed.
Full Text
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<title>Federal Register, Volume 87 Issue 111 (Thursday, June 9, 2022)</title>
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[Federal Register Volume 87, Number 111 (Thursday, June 9, 2022)]
[Notices]
[Pages 35220-35223]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-12391]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection:
Public Comment Request; Maternal and Child Health Bureau Performance
Measures for Discretionary Grant Information System (DGIS), OMB No.
0915-0298--Revision
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA
has submitted an Information Collection Request (ICR) to the Office of
Management and Budget (OMB) for review and approval. Comments submitted
during the first public review of this ICR will be provided to OMB. OMB
will accept further comments from the public during the review and
approval period. OMB may act on HRSA's ICR only after the 30-day
comment period for this Notice has closed.
DATES: Comments on this ICR should be received no later than July 11,
2022.
ADDRESSES: Written 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 particular
information collection by selecting ``Currently under Review--Open for
Public Comments'' or by using the search function.
FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance
requests submitted to OMB for review, email Samantha Miller, the acting
HRSA Information Collection Clearance Officer at <a href="/cdn-cgi/l/email-protection#a4d4c5d4c1d6d3cbd6cfe4ccd6d7c58ac3cbd2"><span class="__cf_email__" data-cfemail="720213021700051d0019321a0001135c151d04">[email protected]</span></a> or
call (301) 443-9094.
SUPPLEMENTARY INFORMATION:
Information Collection Request Title: Maternal and Child Health
Bureau (MCHB) Performance Measures for Discretionary Grant Information
System (DGIS), OMB No. 0915-0298--Revision.
Abstract: Approval from OMB is sought to implement minor revisions
to the MCHB Performance Measures for DGIS. Most of these measures are
specific to certain types of programs and are not required of all
grantees. The measures are categorized by domain (Adolescent Health,
Capacity Building, Child Health, Children with Special Health Care
Needs, Lifecourse/Crosscutting, Maternal/Women Health, and Perinatal/
Infant Health), in addition to some program-specific measures. Grant
programs are assigned domains based on their activities and individual
grantees respond to only a limited number of performance measures that
are relevant to their specific program.
HRSA intends to change the numbering sequence of the DGIS forms in
an approach different from what was outlined in the Federal Register
notice (87 FR 3313) published on January 21, 2022. The approach
outlined in the January 21, 2022, notice provided for the re-use of
form numbers by reordering the form sequence to accommodate the forms
being removed and added. After further consideration, HRSA intends to
retire the number associated with the six DGIS forms being removed and
give the new DGIS Training form the next number in the numbering
sequence (Training Form 15, which was previously labeled as Training
Form 14 in the January 21, 2022, notice). This streamlined approach
will prevent confusion among grantees and HRSA when referencing the
forms after they are updated in DGIS.
No additional forms are proposed to be added, removed, or revised
beyond what was specified in the January 21, 2022, notice. As noted in
the January 21, 2022, notice, HRSA is making the following changes to
the current information collection for MCHB DGIS to more closely align
data collection forms with the program activities:
Removing the following existing forms: Core 1 (Grant Impact),
Capacity Building 2 (Technical Assistance), Capacity Building 7 (Direct
Annual Access to MCH Data), Training Form 13 (Diverse Adolescent
Involvement (Leadership Education in Adolescent Health Program -
specific)), Financial Form 2 (Project Funding Profile), and Financial
Form 4 (Project Budget and Expenditures);
Adding the following new forms: Training Form 15 (Consultation and
Training for Mental and Behavioral Health) and Leadership, Education,
and Advancement in Undergraduate Pathways Training Program Trainee
Information Form. The title of Training Form 15 was changed from
``Teleconsultation'' to ``Consultation'' to acknowledge that some
programs that report on this form may also have an in-person
consultation component. Therefore, the form was updated to capture both
teleconsults and in-person consults and the title was adjusted to
represent this change;
Revising the following existing forms: F2F (Family to Family Form
1), Financial Form 1 (MCHB Project Budget Details), Financial Form 4
(new name:
[[Page 35221]]
Maternal & Child Health Discretionary Grant Project Abstract), MCH
Training Program Data Forms, Core 3 (Health Equity), Financial Form 3
(Budget Details by Types of Individuals Served), Financial Form 5
(Number of Individuals Served (Unduplicated)), and Financial Form 6
(Project Abstract); and
Moving the following form to a new category: Core 2 (Quality
Improvement) will become Capacity Building 8 (Quality Improvement).
Moving this form out of the Core category and into the Capacity
Building category will allow HRSA to assign this form to only
applicable grantees. Note that in the January 21, 2022, notice, Core 2
was proposed to become Capacity Building 4, however, due to the
decision to change the numbering sequence in the DGIS, the form will
now use the next number in the numbering sequence (following Capacity
Building 7).
Non-substantive revisions also include updates to terminology,
goals, benchmark data sources, and significance sections included in
the measures' detail sheets. A performance measure detail sheet defines
and describes each performance measure. Forms and detail sheets showing
the proposed revisions are available upon request.
In response to the notice published on January 21, 2022, HRSA
received six requests to view the proposed revisions and six public
comments. One comment, with which the Department agrees, conveyed
support for the proposed DGIS form updates and relayed that it will
improve their organization's ability to understand trainees with
relation to gender diversity and decrease the burden of completing DGIS
reporting. Another comment also conveyed support for removing several
forms to alleviate reporting burden, with which the Department agrees.
In addition, this same commenter supported the proposal to align the
age ranges across DGIS measures, specifically between Form 5 and Form
3, with which the Department also agrees. This commenter also relayed
concern over the administrative burden required to count and report
specialty providers by specialty type for trainings and requested
clearer guidance for how to accurately count provider types in Training
Form 15 (referenced as Training Form 14 in the January 21, 2022,
notice). Finally, the commenter relayed concern that requiring
providers to submit data to HRSA (for purposes of Training Form 15)
could preclude providers from participating in the program given their
limited resources. The Department appreciates the challenges of
providers reporting data; however, this information is critical for
HRSA to be able to track program impact.
Similar comments regarding count of providers by specialty type
were received by a third commenter, with a focus on the difficulty to
collect this data related to depression training and additional burden
that is created when the count is required to be de-duplicated by
provider type. The Department acknowledges counting and reporting
specialty providers by specialty type requires more effort than
counting and reporting providers without specialty type. However,
provider specialty type is crucial to HRSA's ability to measure
programmatic reach and impact, which is used to inform programmatic and
policy decision making. To provide better guidance, the form has been
updated to include ``non-specialty'' to the applicable sections of the
tables to assist with reporting and the Department will ensure Training
Form 15 is programmed into DGIS in such a way that it is clearer to the
grantee that any provider type not listed should be counted in an
``Other'' category. Additionally, grantees are not expected to de-
duplicate training counts by provider type. If grantees do not have
information on the type of providers who attended a training, it is
acceptable to place counts under ``Other.''
Additional comments received by a fourth commenter on Training Form
15 included feedback regarding the difficulty for their
teleconsultation line staff to track and report the number of enrolled
providers who may be eligible to call the line; the need for
clarification on how a care coordinator/patient navigator is defined;
the need for clarification on what ``teleconsultation'' specifically
entails and what level of provider needs to provide this service; the
need for clarification around specific terms, including: polysubstance
use, disruptive, impulse-control, conduct disorders as well as co-
occurring mental and substance use disorders; a request for HRSA to
make the individuals served screening-level measure optional for
Maternal Depression and Related Behavioral Disorders (MDRBD) grantees
similar to Pediatric Mental Health Care Access program (PMHCA)
grantees; feedback that depending on the specific modality used to
obtain practice-level screening data, the numerator and denominator
time frame may not fully align with the federal fiscal year; and a
request for clarification regarding reporting the number of referrals
given with a suggestion that HRSA define this measure not as the number
of referrals provided, but rather as the number of referrals services/
supports that could be offered.
In response to these comments, the Department has made the
following updates to Training Form 15: ``if applicable'' has been added
in the first table requesting the number of providers enrolled AND
participating; consultation language has been clarified by changing
``teleconsultation'' to ``consultation,'' which includes both
teleconsultation and in-person consultation. If a call/contact includes
both consultation and care coordination support the contact should be
reported in the ``Both'' category; polysubstance use and co-occurring
mental and substance use disorders have been removed from the list of
condition(s) to report why providers contact the program for
consultation; and the individuals served screening-level measure now
reflects as optional for MDRBD grantees similar to PMHCA grantees.
The Department wishes to clarify that family visitors and doulas
should be reported as Care Coordinators/Patient Navigators if that is
the role they are filling and reporting the number of referrals given
is solely for referral and treatment recommendations for providers who
contact the program. Grantees should be able to collect this
information at the time the provider contacts the program and no
updates have been made to the form regarding this question.
This commenter also provided feedback on the Core Health Equity
Form, Women and Maternal Health (WMH) 1, 2, and 4, and Financial Forms
2, 3, and 5 (now Financial Forms 3, 5, and 7). While the commenter
welcomes the revisions of the Core Health Equity form, they clarified
that specific health equity goals and objectives being pursued may be
overarching and aligned with organizational equity aims, and as such,
progress toward achieving them may be hard to quantify and/or specify
from a programmatic-level.
The Department recognizes there may be some overlap with larger
organizational aims, however, health equity is a focus of MCHB programs
and it is necessary to capture how grantees are advancing health
equity. With regards to WMH 1 and 2, the commenter provided feedback
that it remains difficult to specify/stratify training counts specific
to pregnancy and postpartum care given that most training is specific
to the perinatal period. As a result, grantees whose focus spans the
entirety of the perinatal period like MDRBD grantees would benefit from
[[Page 35222]]
additional reporting instruction on how best to fill out these forms
and whether to include training counts only in Training Form 15 or in
WMH 1 and 2 forms as well. The Department recognizes that some programs
may span pregnancy and postpartum periods, however, there is a need to
capture prenatal care (WMH 1) in the first trimester and timely
postpartum visit (WMH 2) separately to demonstrate each of these
measures are improving.
The Department wishes to clarify that for programs with trainings
that may cover pregnancy and post-partum care, these trainings should
be counted under both WMH 1 and WMH2. These trainings however should
include content on timely prenatal and timely postpartum care.
Finally, the commenter requested HRSA consider making the Tier 4
measure for WMH 4 optional given reporting difficulty and the amount of
time it would take to enact needed electronic medical record
modifications and reporting protocols to obtain treatment/referral
information; any immediate information provided in this area would
require manual tracking. After further consideration, the Tier 4
measure for WMH 4 has been updated to reflect its optional status,
bringing it into alignment with the updates made to Training Form 15.
Additional comments received by a final commenter on Training Form 15
included requested clarification on the definition of ``enrolled
provider,'' guidance for how to classify the reason for provider
contact, requested clarification on how to count the number and types
of providers trained, an example for what constitutes ``treatment
strategies,'' and a specific definition for the term ``treatment.''
As a result of this feedback, the form has been updated to include
a footnote which clarifies that an ``Enrolled'' provider is one who is
currently enrolled in the program even if initial enrollment occurred
prior to the current reporting period. With regards to classifying the
reason for a provider contact, the Department clarifies that the intent
is to not limit responses to specific diagnoses for this question. If a
specific diagnosis can be captured at the time of the call, it should
be captured as such. If it cannot, and the reason(s) for the call are
not included in the provided list, the grantee should capture the
reason for the call under the response option titled, ``Other (please
specify).'' In addition, the form has been updated to state ``Treatment
modality-focused trainings'' instead of ``Treatment strategies-related
trainings.'' Finally, recognizing each grantee may define ``Treatment''
differently, the Department clarifies that ``Treatment'' is broadly
defined for both PMHCA and MDRBD programs as, ``the provision,
coordination, or management of health care and related services among
health care providers.''
Two additional commenters provided feedback on the Family-to-Family
(F2F) Form 1. The first commenter provided the following: a
recommendation that parents of children and youth with special health
care needs be specified in the definition of the numerator as they are
in other related statements in the document; concern about the removal
of the details ``family centered, comprehensive, and coordinated
system'' in the benchmark data sources replaced with ``a system of
care,'' with a recommendation of listing additional other benchmarks
here, such as Healthy People 2030 MICH-19; language that states F2F
services are either one-to-one or through group training and events,
with a recommendation to replace ``one-to-one'' with ``individual total
number of families receiving one-to-one services (including small group
individualized assistance); use of a Likert scale when capturing the
percentage of one-to-one services and trainings provided by topic, as
well as when capturing the percentage of services and trainings to
professionals/providers provided by topic; use of the term ``American
Indian or Alaska Native'' instead of ``tribal organization;'' and
concern about the removal of four subcategories that were previously
used to report the types of services/trainings provided to families,
and removal of references to the six core outcomes in the form.
After considering the feedback, the measure's numerator has been
revised to state: ``The total number of families of children and youth
with special health care needs receiving one-to-one services and
training from Family-To-Family Health Information Centers.'' This
revision reflects how MCHB tracks and reports program impact.
Question 1 has been revised to include the phrase, ``small group
individualized assistance.'' After considering the commenter's use of
Likert scales when capturing the percentage of one-to-one services and
trainings provided by topic, as well as when capturing the percentage
of services and trainings to professionals/providers provided by topic,
these questions have been removed from the form. After further
consideration, the four subcategories that were previously used to
report the types of services/trainings provided to families has been
added back to the form. Finally, the form has been updated to reflect
``American Indian or Alaska Native'' instead of ``tribal
organization.'' This revision aligns all of the selections in table 2c
of the F2F form to be population focused and not a mix of populations
and organization.
With regards to the use of MICH-19 in addition to the benchmark
data source of MICH-20, the Department intends to proceed with the use
of MICH-20, as ``systems of care'' includes having a medical home.
While the title of the objective has changed, the objective of
receiving care in a system of care is still the same. Finally, with
regards to the removal of references to the six core outcomes in the
form: Despite removal from the form, the six core outcomes remain
foundational for all work to improve systems of care. The Department
intends to proceed with removal and would like to reiterate that
grantees can report on the six core outcomes in their annual progress
report.
The second commenter on the F2F form mirrored those of the first
and no additional consideration was necessary.
Need and Proposed Use of the Information: The performance data
collected through the DGIS serves several purposes, including grantee
monitoring, program planning, performance reporting, and the ability to
demonstrate alignment between MCHB discretionary programs and the Title
V MCH Services Block Grant program. This revision will facilitate more
efficient and accurate reporting of information related to Capacity
Building activities, Financial and Demographic data, and Training
activities.
Likely Respondents: The grantees for Maternal and Child Health
Bureau Discretionary Grant Programs.
Burden Statement: Burden in this context means the time expended by
persons to generate, maintain, retain, disclose or provide the
information requested. This includes the time needed to review
instructions; to develop, acquire, install, and utilize technology and
systems for the purpose of collecting, validating, and verifying
information, processing and maintaining information, and disclosing and
providing information; to train personnel and to be able to respond to
a collection of information; to search data sources; to complete and
review the collection of information; and to transmit or otherwise
disclose the information. The total annual burden hours estimated for
this ICR are summarized in the table below.
[[Page 35223]]
Total Estimated Annualized Burden--Hours
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Number of Responses per Total Burden hours Total burden
Form respondents respondent responses per response hours
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Grant Report....................................................... 700 1 700 36 25,200
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HRSA specifically requests comments on (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.
Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2022-12391 Filed 6-8-22; 8:45 am]
BILLING CODE 4165-15-P
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