Notice2024-23293
Agency Information Collection Activities: Submission to OMB for Review and Approval; Public Comment Request; Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access Program and the Screening and Treatment for Maternal Mental Health and Substance Use Disorders Program
Primary source
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Published
October 9, 2024
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
In compliance with the Paperwork Reduction Act of 1995, HRSA 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 89 Issue 196 (Wednesday, October 9, 2024)</title>
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[Federal Register Volume 89, Number 196 (Wednesday, October 9, 2024)]
[Notices]
[Pages 81920-81922]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2024-23293]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Agency Information Collection Activities: Submission to OMB for
Review and Approval; Public Comment Request; Evaluation of the Maternal
and Child Health Bureau Pediatric Mental Health Care Access Program and
the Screening and Treatment for Maternal Mental Health and Substance
Use Disorders Program
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
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 November
8, 2024.
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 Joella Roland, the HRSA
Information Collection Clearance Officer, at <a href="/cdn-cgi/l/email-protection#a8d8c9d8cddadfc7dac3e8c0dadbc986cfc7de"><span class="__cf_email__" data-cfemail="a1d1c0d1c4d3d6ced3cae1c9d3d2c08fc6ced7">[email protected]</span></a> or call
(301) 443-3983.
SUPPLEMENTARY INFORMATION: Information Collection Request Title:
Evaluation of the Maternal and Child Health Bureau Pediatric Mental
Health Care Access Program and the Screening and Treatment for Maternal
Mental Health and Substance Use Disorders Program, OMB No. 0906-xxxx--
New.
Abstract: This notice describes information collection requests for
two of HRSA's Maternal and Child Health Bureau programs: the Pediatric
Mental Health Care Access (PMHCA) program and the Screening and
Treatment for Maternal Mental Health and Substance Use Disorders
(MMHSUD) program. The PMHCA program aims to promote behavioral health
integration into pediatric primary care by developing and supporting
state, regional, and tribal pediatric mental health care
teleconsultation access programs. The MMHSUD program aims to support
maternity care providers and clinical practices by supporting the
development, improvement, and/or maintenance of statewide or regional
behavioral health networks. Both programs support health professionals
(HPs) \1\ in their delivery of high-quality and timely screening,
assessment, treatment, and referrals for their targeted populations
(e.g., children, adolescents, and young adults for PMHCA programs;
pregnant and postpartum people for MMHSUD programs) through the
provision of clinical behavioral health teleconsultation, care
coordination support/navigation (i.e., resource identification and
referrals), and training and education. Additionally, the PMHCA and
MMHSUD programs focus on reducing racial, ethnic, and geographic
disparities in access to care, especially in rural and other
underserved areas.
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\1\ HPs may include, but are not limited to, pediatricians,
family physicians, adult primary care clinicians, obstetrician-
gynecologists, physician assistants, advanced practice nurses/nurse
practitioners, licensed practical nurses, registered nurses, nurse
midwives, counselors, behavioral health clinicians, social workers,
care coordinators, medical assistants, and patient care navigators.
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The information will be collected from PMHCA and MMHSUD award
recipient programs funded in 2021, 2022, or 2023 and from participants
in and stakeholders of those programs:
<bullet> The 2021 and 2022 PMHCA programs are authorized by 42
U.S.C. 254c-19 (sec. 330M of the Public Health Service Act), using
funding provided by Section 2712 of the American Rescue Plan Act of
2021 (Pub. L. 117-2).
<bullet> The 2023 PMHCA programs are authorized by 42 U.S.C. 254c-
19 (sec. 330M of the Public Health Service Act), as amended by Section
11005 of the Bipartisan Safer Communities Act (Pub. L. 117-159).
<bullet> The 2023 MMHSUD programs are authorized by 42 U.S.C. 247b-
13a (sec. 317L-1 of the Public Health Service Act).
To evaluate progress made toward the programs' goals, this data
collection will use the following eight instruments: (1) HP Survey, (2)
Practice-Level Survey, (3) Program Implementation Survey, (4)
Behavioral Health Consultation Provider Semi-Structured Interview
(SSI), (5) Care Coordinator SSI, (6) Champion SSI, (7) Community-Based
and Other Resources SSI, and (8) Program Implementation SSI.
A 60-day notice was published in the Federal Register on May 28,
2024, 89 FR 46143-44. HRSA received two public comments, which included
13 recommendations. All recommendations were considered, as detailed
below, and no changes were made to the current information collection
described in this notice as a result of the recommendations.
Two recommendations focused on defining terms. One recommended use
of the term ``mental and behavioral health'' in place of ``behavioral
health'' and ``infant, child, and adolescent'' in place of ``child and
adolescent'' in any survey language. HRSA selected ``behavioral
health'' as the most concise and accepted term after consideration of
definitions from national associations, federal agencies, and experts
in the field. HRSA noted that the ``child and adolescent'' terminology
is not used in the surveys for the HRSA evaluation of the PMHCA and
MMHSUD programs. Another recommended that HRSA define PMHCA program
training activities. In the Notices of Funding Opportunity that
awardees responded to, HRSA describes various modalities/formats for
training (e.g., Project Extension for Community Health Care Outcomes,
Resource for Advancing Children's Health, learning collaboratives, in
person, synchronous, asynchronous) as well as potential topics for
training (e.g., psychiatric disorders and medications, screening and
treatment protocols, practice transformation processes, trauma-informed
care). Reflective of training-related program requirements, HRSA will
collect data on the number of trainings attended by HPs, modality for
training received, the number of providers trained, the number of
trainings by topic, training methods, and materials used. Training is
defined in the surveys using the survey question response options
(e.g., in-person training event, webinar, self-study with program
resources, video conferencing, learning collaborative [Project
Extension for Community Health Care Outcomes,
[[Page 81921]]
Resource for Advancing Children's Health], and others).
Three recommendations discussed data: the need for data to be
comparable across PMHCA programs while still considering differences
across these programs; ensuring data collection is conducted in a
manner that is clear and relevant for the full range of anticipated
data collection participants (e.g., HPs, program champions, community
resource representatives); and the value of data to inform
understanding of differences in rural, urban, and suburban access to
behavioral health care. No changes will be made to the information
collection forms in response to these recommendations because the data
collection instruments are already responsive to these points. First,
HRSA will record and analyze program differences such as program
structure, funding, history, and size to help inform data findings
across program types. Second, HRSA will collect data about settings in
which patients live, and about practice setting, with response options
including urban, suburban, rural, and frontier. Surveys also collect
the ZIP Code of the primary clinical practice. While specific data on
travel for mental and behavioral health care will not be collected, the
Care Coordinator SSIs will provide qualitative insights on barriers to
referrals, geographic areas of referrals, and strategies to mitigate
barriers, which may include addressing travel time.
One recommendation expressed concerns about HRSA's plan to assess
changes over time in health practitioners' capacity to address
patients' mental and behavioral health and access to mental and
behavioral health care through screening indicating that PMHCA programs
are typically most valuable after the need for mental or behavioral
health interventions has been identified rather than in conducting
initial screenings. For this data collection, HRSA has operationalized
capacity broadly as behavioral health knowledge, skills, practice, and
attitudes. Evaluation questions focus on change in knowledge and
skills; screening, assessment, treatment, and referral; attitudes about
providing behavioral health care; and how change over time differed
based on frequency and modality of program access, treatment location,
demographics, and treatment settings. These questions allow HRSA to
measure changes in these different aspects of provider capacity and
describe how these changes differ across the contexts listed above
(e.g., treatment location, treatment settings).
Four recommendations supported collecting patient-level data and
the use of accessible automated collection techniques and minimally
invasive software and strategies. HRSA disclosed that patient level
data will not be collected under this information collection. All
technology used for the survey administration will meet federal
requirements for Section 508 accessibility. Survey data collection for
the evaluation will be primarily through web-linked survey administered
via email and via survey platform. Qualitative data collection and SSIs
will be conducted virtually (e.g., Microsoft Teams, Zoom).
One recommendation supported the proposed mixed evaluation plan and
approach. HRSA will implement outcome and process evaluations, using a
mixed-methods design, with primary and secondary quantitative and
qualitative data collection activities across all awardees.
One recommendation expressed support of the estimated burden and
asked how grantees will proceed if they do not employ a likely
respondent. HRSA will not require participation in that data collection
activity if an awardee does not employ a likely respondent.
One recommendation suggested that HRSA brand HRSA-MMHSUD
programming in marketing leading up to the evaluation so that providers
can more easily respond to questions. HRSA has developed a promotion
packet of materials with branding guidance and customizable messages
for awardees to use to (1) increase HP and practice engagement with
their programs and (2) encourage participation in evaluation surveys.
Additionally, the surveys will be customized for each program with the
program name and logo, as applicable.
Need and Proposed Use of the Information: HRSA needs this
information to evaluate the PMHCA and MMHSUD programs to guide future
decisions regarding increasing HPs' capacity to address patients'
behavioral health and access to behavioral health services.
Specifically, data collected for the evaluation will be used to study
the efforts of the PMHCA and MMHSUD programs to achieve key outcomes
(e.g., increase in access to behavioral health services; HPs trained;
identification of community-based resources, including counselors or
family service providers) and to measure whether and to what extent
awardee programs are associated with changes in these outcomes. The
evaluation will examine changes over time across PMHCA and MMHSUD
programs, regarding the PMHCA- and MMHSUD-enrolled/participating HPs'
and practices' (1) capacity to address patients' behavioral health and
access to behavioral health care, through screening, assessment,
treatment, and referral for behavioral health conditions; and (2) use
of program services (e.g., consultation, care coordination, training).
Likely Respondents:
<bullet> HP Survey: Pediatricians, family physicians, obstetrician-
gynecologists, physician assistants, advanced practice nurses/nurse
practitioners, licensed practical nurses, registered nurses,
counselors, social workers, medical assistants, and patient care
navigators
<bullet> Practice-Level Survey: Practice managers (e.g., office
managers, office leadership, nurse champions)
<bullet> Program Implementation Survey: Cooperative agreement-
funded project directors/principal investigators
<bullet> Behavioral Health Consultation Provider SSI: PMHCA and
MMHSUD program-level behavioral health consultation providers
<bullet> Care Coordinator SSI: PMHCA and MMHSUD program-level care
coordinators
<bullet> Champion SSI: PMHCA and MMHSUD program champions (e.g.,
HPs, community, and social service specialists)
<bullet> Community-Based and Other Resources SSI: PMHCA and MMHSUD
program-level community resource partner representatives (e.g.,
counselors, social workers, other community and social service
specialists, other HPs/support workers, practice/organization managers)
<bullet> Program Implementation SSI: Cooperative agreement-funded
project directors/principal investigators
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.
The burden estimates below have changed from the estimates of
burden provided in the previous notice (60-day notice published on May
28, 2024, 89
[[Page 81922]]
FR 46143-44). The estimated burden total is slightly higher in this
revised notice because it incorporates estimates for an MMHSUD program
that was funded following submission of the previous notice.
Total Estimated Annualized Burden Hours
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Number of Average burden
Form name Number of responses per Total per response Total burden
respondents respondent responses (in hours) hours
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HP Survey....................... 23,256 1 23,256 0.33 7,674.48
Practice-Level Survey........... 6,172 1 6,172 0.33 2,036.76
Program Implementation Survey... 67 1 67 0.33 22.11
Behavioral Health Consultation 67 1 67 0.75 50.25
Provider SSI...................
Care Coordinator SSI............ 67 1 67 0.75 50.25
Champion SSI.................... 67 1 67 0.50 33.50
Community-Based and Other 50 1 50 0.50 25.00
Resources SSI..................
Program Implementation SSI...... 134 1 134 1.00 134.00
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Total....................... 29,880 .............. 29,880 .............. 10,026.35
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Amy P. McNulty,
Deputy Director, Executive Secretariat.
[FR Doc. 2024-23293 Filed 10-8-24; 8:45 am]
BILLING CODE 4165-15-P
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