Notice2023-07995
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
April 17, 2023
Issuing agencies
Health and Human Services DepartmentCenters for Disease Control and Prevention
Full Text
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<title>Federal Register, Volume 88 Issue 73 (Monday, April 17, 2023)</title>
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[Federal Register Volume 88, Number 73 (Monday, April 17, 2023)]
[Notices]
[Pages 23425-23427]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-07995]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[30Day-23-1294]
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 ``The Maternal Mortality Review Information
Application (MMRIA)'' 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
January 11, 2023 to obtain comments from the public and affected
agencies. CDC received one comment related to the previous notice. 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, through the use of 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 particular
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
The Maternal Mortality Review Information Application (MMRIA) (OMB
Control No. 0920-1294, Exp. 04/30/2023)--Revision--National Center for
Chronic Disease Prevention and Health Promotion (NCCDPHP), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
The Centers for Disease Control and Prevention (CDC) seeks a
Revision to continue to collect information through the Maternal
Mortality Review Information Application (MMRIA) for three additional
years. MMRIA is a standardized data collection system that allows
Maternal Mortality Review Committees (MMRCs) across the country to
abstract relevant data (clinical and non-clinical) from a variety of
sources, document committee decisions, and analyze data in order to
better understand the contributing factors and preventability of
pregnancy-related deaths and thus to develop recommendations for
prevention.
Pregnancy-related deaths are defined as a death as a result of
pregnancy or delivery complications, a chain of events initiated by
pregnancy, or the aggravation of an unrelated condition by the
physiologic effects of pregnancy. Considerable racial disparities
exist, with persons who are non-Hispanic Native Hawaiian or Other
Pacific Islander, non-Hispanic American Indian/Alaska Native and non-
Hispanic
[[Page 23426]]
Black persons more likely to die from pregnancy-related complications
than persons of other race-ethnicity classifications. Findings from
analyses of aggregated MMRC data indicate that about four out of five
pregnancy-related deaths are preventable.
Maternal Mortality Review is a process by which a multidisciplinary
committee at the jurisdiction level identifies and reviews cases of
death that occur during or within one year of end of pregnancy. Members
of MMRCs typically represent public health, obstetrics and gynecology,
maternal-fetal medicine, nursing, midwifery, forensic pathology, mental
and behavioral health, community-based organizations, and other
relevant partners. Through a partnership among the MMRC, state vital
records office, and epidemiologists, deaths among females of
reproductive age are examined to determine if they occurred during
pregnancy or within one year of the end of pregnancy (i.e., pregnancy-
associated deaths). Through this process, potential cases of pregnancy-
related deaths (i.e., death from any cause related to or aggravated by
pregnancy or its management) are then identified. Review committees
access multiple sources of clinical and non-clinical information to
understand the circumstances surrounding a death in order to determine
pregnancy-relatedness and develop recommendations for action to prevent
similar deaths in the future.
MMRIA is a standardized data collection system designed to support
MMRC processes. Data are abstracted and entered into MMRIA from various
sources, including death records, autopsy reports, birth and fetal
death records, prenatal care records, emergency department visit
records, hospitalization records, records from other medical office
visits, medical transport records, social and environmental profiles,
mental health profiles, and informant interviews. Case narratives for
committee reviews are developed from the abstracted data entered into
MMRIA to facilitate committee review, and committee decisions based on
their review are also be entered into MMRIA.
The data collected in MMRIA is used to facilitate an understanding
of the drivers of maternal mortality and complications of pregnancy and
associated disparities and implement data driven recommendations.
The burden estimates presented here are applicable to the 39
jurisdictions with funding support (which support 40 reporting
jurisdictions through the cooperative agreements Preventing Maternal
Deaths: Supporting Maternal Mortality Review Committees (CDC-RFA-DP19-
1908) and Preventing Maternal Mortality: Supporting Maternal Mortality
Review Committees CDC-RFA-DP22-2211) and 13 remaining eligible
jurisdictions that may apply to receive funding in FY23 (CDC-RFA-DP-23-
0066). These jurisdictions are required to compile a defined set of
information about pregnancy-related deaths into MMRIA. It is estimated
that information will be collected for a total of 2,240 pregnancy-
associated deaths on average, annually, among the 53 jurisdictions with
current or potential funding support through CDC-RFA-DP19-1908, CDC-
RFA-DP22-2211, and CDC-RFA-DP-23-0066. For 34 jurisdictions, it is
estimated that on average, 15 hours of data abstraction are required
for each death entered into MMRIA. The other 19 jurisdictions are able
to participate in a process to reduce burden by which CDC uploads vital
records information into MMRIA rather than jurisdiction staff manually
abstracting vital records. For these 19 jurisdictions, the estimated
average is 14 hours of abstraction for each death entered into MMRIA.
For all jurisdictions with current or potential funding support through
CDC-RFA-DP19-1908, CDC-RFA-DP22-2211, and CDC-RFA-DP-23-0066, an
additional 24 minutes on average is needed to enter the committee
decisions into MMRIA.
There are four changes that result in this request for revision,
with the first three having an impact on the estimated burden for this
revision. First, through additional congressional appropriations, an
additional 15 jurisdictions are now funding recipients from the time of
initial OMB PRA approval. An additional 13 jurisdictions are eligible
to apply for FY 23 funding. Overall, this represents an increase from
25 to 53 respondents. Second, CDC estimates a higher number of
pregnancy-associated deaths due to utilizing data from the Pregnancy
Mortality Surveillance System (PMSS) rather than CDC WONDER for these
estimates. PMSS estimates of pregnancy-associated deaths are more
accurate due to more comprehensive and complete identification of these
deaths through multiple case identification methods. Third, CDC has
been working with the National Association for Public Health Statistics
and Information Systems on an initiative that enables CDC to transfer
vital records data associated with CDC identified pregnancy-associated
deaths directly into a jurisdiction's instance of MMRIA, reducing
manual data entry burden for the 19 respondents participating in the
initiative. Fourth, to address user identified needs and increase data
use for analysis by jurisdictions, a total of 60 new optional fields
were added to MMRIA, three fields removed, and two fields combined into
one. None of the added fields are required fields; 50 would only be
relevant for specific causes of death or only when a specific type of
record is available; the majority of new optional fields are drop down
fields with minimal response burden.
The changes resulted in an overall increase of 21,932 burden hours.
CDC requests OMB approval for an estimated annual burden of 33,482
hours. There is no cost for 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 (in
respondent hours)
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Jurisdictions with current or potential MMRIA abstraction form. 34 42 15
funding support through CDC-RFA-DP19-
1908, CDC-RFA-DP22-2211, and CDC-RFA-
DP-23-0066 who manually abstract all
data into MMRIA.
Jurisdictions with current or potential MMRIA abstraction form. 19 42 14
funding support through CDC-RFA-DP19-
1908, CDC-RFA-DP22-2211, and CDC-RFA-
DP-23-0066 for which CDC is uploading
vital records into MMRIA and
jurisdiction staff abstract remaining
data manually into MMRIA.
[[Page 23427]]
All jurisdictions with current or MMRIA committee 53 42 24/60
potential funding support through CDC- decision form.
RFA-DP19-1908, CDC-RFA-DP22-2211, and
CDC-RFA-DP-23-0066.
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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. 2023-07995 Filed 4-14-23; 8:45 am]
BILLING CODE 4163-18-P
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