Notice2022-28621
Agency Information Collection Activities: Proposed Collection: Public Comment Request; Information Collection Request Title: Health Resources and Services Administration Uniform Data System, OMB No. 0915-0193-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
January 5, 2023
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
In compliance with the requirement for opportunity for public comment on proposed data collection projects of the Paperwork Reduction Act of 1995, HRSA announces plans to submit an Information Collection Request (ICR), described below, to the Office of Management and Budget (OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the public regarding the burden estimate, below, or any other aspect of the ICR.
Full Text
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<title>Federal Register, Volume 88 Issue 3 (Thursday, January 5, 2023)</title>
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[Federal Register Volume 88, Number 3 (Thursday, January 5, 2023)]
[Notices]
[Pages 874-876]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-28621]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Proposed Collection:
Public Comment Request; Information Collection Request Title: Health
Resources and Services Administration Uniform Data System, OMB No.
0915-0193--Revision
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: In compliance with the requirement for opportunity for public
comment on proposed data collection projects of the Paperwork Reduction
Act of 1995, HRSA announces plans to submit an Information Collection
Request (ICR), described below, to the Office of Management and Budget
(OMB). Prior to submitting the ICR to OMB, HRSA seeks comments from the
public regarding the burden estimate, below, or any other aspect of the
ICR.
DATES: Comments on this ICR must be received no later than February 6,
2023.
ADDRESSES: Submit your comments to <a href="/cdn-cgi/l/email-protection#522233223720253d2039123a2021337c353d24"><span class="__cf_email__" data-cfemail="91e1f0e1f4e3e6fee3fad1f9e3e2f0bff6fee7">[email protected]</span></a> or mail the HRSA
Information Collection Clearance Officer, Room 14N39, 5600 Fishers
Lane, Rockville, MD 20857.
FOR FURTHER INFORMATION CONTACT: To request more information on the
proposed project or to obtain a copy of the data collection plans and
draft instruments, email <a href="/cdn-cgi/l/email-protection#592938293c2b2e362b3219312b2a38773e362f"><span class="__cf_email__" data-cfemail="f08091809582879f829bb098828391de979f86">[email protected]</span></a> or call the HRSA OMB PRA
Officer, Samantha Miller, at (301) 443-1984.
SUPPLEMENTARY INFORMATION: When submitting comments or requesting
information, please include the information request collection title
for reference.
Information Collection Request Title: HRSA Uniform Data System
(UDS) OMB No. 0915-0193--Revision.
Abstract: The Health Center Program, administered by HRSA, is
authorized under section 330 of the Public Health Service (PHS) Act (42
U.S.C. 254b). Health centers are community-based and patient-directed
organizations that deliver affordable, accessible, quality, and cost-
effective primary health care services to patients regardless of their
ability to pay. Nearly 1,400 health centers operate approximately
12,000 service delivery sites that provide primary health care to more
than 30 million people in every U.S. state, the District of Columbia,
Puerto Rico, the U.S. Virgin Islands, and the Pacific Basin. HRSA uses
the UDS \1\ for annual reporting by Health Center Program awardees
(those funded under section 330 of the PHS Act), Health Center Program
look-alikes, and Nurse Education, Practice, Quality and Retention \2\
(NEPQR) Program awardees (specifically those funded under the practice
priority areas of section 831(b) of the PHS Act). Look-alikes do not
routinely receive Federal funding under section 330 of the PHS Act, but
meet the Health Center Program requirements for designation under the
program (42 U.S.C. 1395x(aa)(4)(A)(ii) and 42 U.S.C.
1396d(l)(2)(B)(ii)).
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\1\ <a href="https://www.cms.gov/files/document/sgm-clearinghouse-uds.pdf">https://www.cms.gov/files/document/sgm-clearinghouse-uds.pdf</a>.
\2\ <a href="https://www.hrsa.gov/grants/find-funding/hrsa-20-012">https://www.hrsa.gov/grants/find-funding/hrsa-20-012</a>.
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Need and Proposed Use of the Information: UDS data collection
updates must be completed in a timely manner in order for health
centers to fulfill Health Center Program requirements. Approval of
these
[[Page 875]]
changes is needed by February 1, 2023, to implement the changes in the
data collection system and to provide adequate information on UDS
reporting guidance to health centers, partners, and key stakeholders.
HRSA plans to make the following updates for the performance year 2023
UDS data collection:
<bullet> Table 3B (Demographic Characteristics), will be updated to
include additional subpopulations selection options to better reflect
the diversity of patients served by health centers. Race/ethnicity
categories will be updated to align with U.S. Department of Health and
Human Services (HHS) data standards.\3\ In accordance with section 4302
within the Office of the Assistant Secretary for Planning and
Evaluation (ASPE) \4\ Implementation Guidance on Data Standards for
Race, Ethnicity, Sex, Primary Language, and Disability Status, the UDS
will be updated to include subpopulations categories for: Asian, Native
Hawaiian, Other Pacific Islanders as well as a broader selection for
Hispanic ethnicity.
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\3\ <a href="https://aspe.hhs.gov/reports/hhs-implementation-guidance-data-collection-standards-race-ethnicity-sex-primary-language-disability-0">https://aspe.hhs.gov/reports/hhs-implementation-guidance-data-collection-standards-race-ethnicity-sex-primary-language-disability-0</a>.
\4\ https://aspe.hhs.gov/reports/hhs-implementation-guidance-
data-collection-standards-race-ethnicity-sex-primary-language-
disability-
0#:~:text=Section%204302%20requires%20the%20Secretary,all%20national%
20population%20health%20surveys.
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The 2011 HHS race and ethnicity categories maintains alignment with
the 1997 OMB \5\ minimum categories for race and ethnicity allow for a
better understanding of the cultural diversity of patients served by
health centers.
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\5\ <a href="https://obamawhitehouse.archives.gov/omb/fedreg_1997standards">https://obamawhitehouse.archives.gov/omb/fedreg_1997standards</a>.
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<bullet> Table 5 (Staffing and Utilization), will be updated to
include four distinct lines for reporting Pharmacy Personnel
categorized by Pharmacists, Clinical Pharmacist, Pharmacy Technicians,
and Other Pharmacy Personnel. Health center personnel are critical to
the functioning of health centers, collecting inclusive information
about the health center workforce, will allow HRSA's Bureau of Primary
Health Care to better understand workforce composition as well as
improve the ability to articulate the role that pharmacy personnel play
in an integrated primary care.
<bullet> Table 6A (Selected Diagnoses and Services Rendered), will
be updated to include a diagnostic measure representing long COVID.
This measure is labeled Post COVID-19 condition, unspecified, within
the Selected Infectious and Parasitic Diseases grouping of measures.
With this measure, health centers are able to report both number of
patients with this diagnosis as well as the number of patient visits
related to the diagnosis.\6\ The Centers for Disease Control and
Prevention classifies long COVID, also known as post-COVID, conditions
as a wide range of new, returning, or ongoing health problems people
can experience four or more weeks after first being infected with the
virus that causes COVID-19.\7\ Data on this measure will lead to better
understanding the impact of COVID-19 post-acute infection on health
center patients.
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\6\ <a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html</a>.
\7\ <a href="https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html">https://www.cdc.gov/coronavirus/2019-ncov/long-term-effects/index.html</a>.
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<bullet> Table 6A (Selected Diagnoses and Services Rendered), will
be updated to include a measure that tracks the number of patients who
receive pediatric developmental screening and evaluation services. The
2023 UDS will include developmental screening, behavioral screening/
testing, and administrative assessment International Classification of
Diseases diagnostic and Current Procedural Terminology billing codes
for use to track the changes in the number of children who receive
developmental screening and evaluation services. Early childhood is a
critical period for physical, cognitive, and social development, laying
the foundation for life-long health and well-being.\8\ Children who
experience poverty, particularly during early life are at risk of
adverse health and developmental outcomes.
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\8\ <a href="https://www.hrsa.gov/grants/find-funding/hrsa-22-091">https://www.hrsa.gov/grants/find-funding/hrsa-22-091</a>.
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<bullet> Table 6B (Quality of Care Measures), and Table 7 (Health
Outcomes and Disparities), collected UDS clinical quality measures \9\
(CQMs) where applicable. Collected UDS CQMs will be updated in
alignment with specifications of the issued performance year 2023
electronic-specified clinical quality measures, released by the Centers
for Medicare and Medicaid Services for use by eligible providers.
Clinical performance measure alignment across national programs
promotes data standardization, quality, and transparency, and decreases
reporting burden for providers and organizations participating in
multiple Federal programs.
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\9\ <a href="https://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/downloads/guidetocqms_remediated_2011.pdf">https://www.cms.gov/regulations-and-guidance/legislation/ehrincentiveprograms/downloads/guidetocqms_remediated_2011.pdf</a>.
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<bullet> Appendix D: (Health Center Health Information Technology
{HIT{time} Capabilities Form), will be updated with a question asking
health centers to provide the total number of patients that were
screened for social risk factors, using a standardized screener, during
the calendar year. This question provides a more accurate view of the
impact of social risk on the health center patient population and
continues to reinforce Social Determinates of Health as a priority area
intrinsically linked with health equity.
<bullet> Beginning with the 2023 UDS, health centers will be able
to submit patient-level data in fulfillment of data elements on Tables:
[cir] Table PBZC (Patients by Zip Code)
[cir] Table 3A (Patients by Age and Sex Assigned at Birth)
[cir] Table 3B (Demographic Characteristics)
[cir] Table 4 (Selected Characteristics)
[cir] Table 6A (Selected Diagnoses and Services Rendered)
[cir] Table 6B (Quality of Care Measures)
[cir] Table 7 (Health Outcomes and Disparities
UDS+ Patent Level Reporting leverages a methodological shift in the
process by which health centers submit their annual UDS report, while
maintaining historic UDS measures. High-quality accessible data are
critical to strategically meeting the needs of patients and identifying
opportunities for clinical process improvement. The growth in health
information technology coupled with the increased adoption of
electronic health records has transformed patient care delivery and
underscored the need for secure and rapid exchange of health data
between disparate systems. Health Level Seven International \10\
developed Fast Healthcare Interoperability Resources \11\ (FHIR) to
standardize the electronic exchange of patient data across systems.
FHIR, which is the current gold standard, has the flexibility to
support a variety of user needs and enhances interoperability by
transmitting health data rapidly and more securely than ever before. It
is important for the collection of UDS data to align with
interoperability standards and reporting requirements across HHS and
the healthcare industry. Leveraging FHIR to collect UDS patient-level
data will improve data granularity, allow for the development of robust
patient management programs, and improve equitable access to high-
quality, cost-effective primary care services.
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\10\ <a href="https://www.hl7.org/">https://www.hl7.org/</a>.
\11\ <a href="https://ecqi.healthit.gov/fhir">https://ecqi.healthit.gov/fhir</a>.
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This electronic reporting mechanism will reduce reliance on manual
data entry to populate the annual UDS report, in turn yielding a
reduction in reporting effort burden, and will greatly
[[Page 876]]
increase the analytical value of UDS data for informing policy and
Program decision-making.
Likely Respondents: Likely respondents will include Health Center
Program award recipients, Health Center Program look-alikes, and Nurse
Education, Practice, Quality and Retention Program awardees funded
under the practice priority areas of section 831(b) of the PHS Act.
Burden Statement: Burden includes 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 use technology and systems for the
purpose of collecting, validating, and verifying information,
processing, and maintaining information, disclosing, and providing
information. FHIR standards align with the Centers for Medicare and
Medicaid Services electronic clinical quality measures, allow for
standardization of data, and reduce the potential for misinterpretation
of measures or calculation errors. FHIR also accounts for time to train
personnel, respond to a collection of information, search data sources,
complete and review the collection of information, and transmit or
otherwise disclose the information. FHIR will also include testing
information necessary to support the UDS Test Cooperative. No more than
three tests will be conducted each calendar year and no more than one
hundred health centers will participate in one test. Participation is
voluntary and will not affect their funding status. The total annual
burden hours estimated for this Information Collection Request are
summarized in the forthcoming table.
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Estimated
Estimated number of number of Average burden Estimated
Form name respondents responses per per response total burden
respondent (in hours) hours
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Universal Report...................... Total: 1,505............ 1.00 238 358,190
H80s: 1,370.............
LALs: 117...............
BHW: 18.................
Grant Report.......................... Total: 438.............. 1.24 30 16,294
438 Health Centers
submitted 1 or more
Grant Reports..
1: 346..................
2: 80...................
3: 12...................
UTC Tests............................. 35...................... 3.00 8 840
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Total............................. 1,978................... 5.24 .............. 375,324
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HRSA specifically requests comments on: (1) the necessity and
feasibility 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. 2022-28621 Filed 1-4-23; 8:45 am]
BILLING CODE 4165-15-P
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