Notice2023-11626
Proposed Information Collection Activity; Medical Assessment Form and Dental Assessment Form (Office of Management and Budget 0970-0466)
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
June 1, 2023
Issuing agencies
Health and Human Services DepartmentChildren and Families Administration
Abstract
The Administration for Children and Families (ACF) is requesting a 3-year extension of the forms Medical Assessment Form (formerly, the Initial Medical Exam (IME) Form and Supplemental Tuberculosis (TB) Screening Form) and Dental Assessment Form (formerly, the Dental Exam Form) (Office of Management and Budget (OMB) #0970- 0466, expiration December 31, 2023). Changes are proposed to the currently approved forms.
Full Text
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<title>Federal Register, Volume 88 Issue 105 (Thursday, June 1, 2023)</title>
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[Federal Register Volume 88, Number 105 (Thursday, June 1, 2023)]
[Notices]
[Pages 35883-35884]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-11626]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Proposed Information Collection Activity; Medical Assessment Form
and Dental Assessment Form (Office of Management and Budget 0970-0466)
AGENCY: Office of Refugee Resettlement, Administration for Children and
Families, United States Department of Health and Human Services.
ACTION: Request for public comments.
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SUMMARY: The Administration for Children and Families (ACF) is
requesting a 3-year extension of the forms Medical Assessment Form
(formerly, the Initial Medical Exam (IME) Form and Supplemental
Tuberculosis (TB) Screening Form) and Dental Assessment Form (formerly,
the Dental Exam Form) (Office of Management and Budget (OMB) #0970-
0466, expiration December 31, 2023). Changes are proposed to the
currently approved forms.
DATES: Comments due within 60 days of publication. In compliance with
the requirements of the Paperwork Reduction Act of 1995, ACF is
soliciting public comment on the specific aspects of the information
collection described above.
ADDRESSES: You can obtain copies of the proposed collection of
information and submit comments by emailing <a href="/cdn-cgi/l/email-protection#afc6c1c9c0ccc0c3c3caccdbc6c0c1efceccc981c7c7dc81c8c0d9"><span class="__cf_email__" data-cfemail="cea7a0a8a1ada1a2a2abadbaa7a1a08eafada8e0a6a6bde0a9a1b8">[email protected]</span></a>.
Identify all requests by the title of the information collection.
SUPPLEMENTARY INFORMATION:
Description: The ACF Office of Refugee Resettlement (ORR) places
unaccompanied children in their custody in care provider facilities
until unification with a qualified sponsor. Care provider facilities
are required to provide children with services such as mental health
services and health care. Each child must receive an IME within 2
business days of admission to an ORR care provider program or temporary
influx care facility. The IME satisfies Flores requirements which
require a ``complete medical examination, including a screening for
infectious disease. The purposes of the IME are to assess general
health, administer vaccinations in keeping with U.S. standards (also
required by Flores), identify health conditions that require further
attention, and detect contagious diseases of public health importance,
such as influenza or TB. The IME is performed by a licensed health care
provider and comprised of a complete medical history and physical exam,
risk, and age-based laboratory screenings, TB screenings and
immunizations. In addition, children may be referred to a medical
specialist by their healthcare provider for acute or chronic conditions
that require additional evaluation. Children who are in ORR care for an
extended length of time may require routine well-child evaluations.
The forms are to be used as worksheets for generalist healthcare
providers and pediatric and other medical specialty healthcare
providers to compile information that would otherwise have been
collected during the health evaluation. Once completed, the forms will
be given to care provider program staff for data entry into ORR's
secure, electronic data repository. Data will be used to monitor the
health of unaccompanied children while in ORR care, for case management
of any identified illnesses/conditions and ensure care provider program
compliance with ORR requirements.
ORR has merged the former IME Form and Supplemental TB Screening
Form into one form, the Medical Assessment Form which will be used
during all medical evaluations with a mid-level or higher medical
professional. ORR has incorporated other changes to the forms to
streamline the flow of data collection, clarify the intent of certain
fields, improve data quality, and ensure alignment with ORR program
guidance. In addition, ORR has written instructional letters for the
Medical Assessment Form and Dental Assessment Form to explain the
[[Page 35884]]
purpose of the forms and provide general guidance on completion.
Respondents: Healthcare providers (pediatricians, medical
specialists, and dentists), Care Provider Program Staff
Annual Burden Estimates
Estimated Opportunity Time for Respondents
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Total number Average burden
Instrument Respondent Total number of responses hours per Total burden Annual burden
of respondents per respondent response hours hours
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Medical Assessment Form................... Pediatricians, General...... 300 840 0.22 166,320 55,440
Medical specialist, General. 750 22 0.22 10,890 3,630
Dental Assessment Form.................... Dentists.................... 250 64 0.12 5,760 1,920
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Estimated Total Annual Burden Hours: 60,990.
Estimated Recordkeeping Time
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Total number Average burden
Instrument Respondent Total number of responses hours per Total burden Annual burden
of respondents per respondent response hours hours
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Medical Assessment Form completed by a Care Provider Program Staff. 500 537 0.33 265,815 88,605
medical professional.
Medical Assessment form not completed by a 500 100 0.17 25,500 8,500
medical professional (information
obtained via health records).
Dental Assessment Form.................... 500 32 0.17 8,160 2,720
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Estimated Total Annual Burden Hours: 99,825.
Comments: The Department specifically requests comments on (a)
whether the proposed collection of information is necessary for the
proper performance of the functions of the agency, including whether
the information shall have practical utility; (b) the accuracy of the
agency's estimate of the burden of the proposed collection of
information; (c) the quality, utility, and clarity of the information
to be collected; and (d) ways to minimize the burden of the collection
of information on respondents, including through the use of automated
collection techniques or other forms of information technology.
Consideration will be given to comments and suggestions submitted
within 60 days of this publication.
Authority: 6 U.S.C. 279: Exhibit 1, part A.2 of the Flores
Settlement Agreement (Jenny Lisette Flores, et al., v. Janet Reno,
Attorney General of the United States, et al., Case No. CV 85-4544-RJK
[C.D. Cal. 1996])
Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2023-11626 Filed 5-31-23; 8:45 am]
BILLING CODE 4184-45-P
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