ATTACHMENT D -- 60 Day Federal Register Notice

Federal Register / Vol. 76, No. 126 / Thursday, June 30, 2011 / Notices
delivery, please call (800) 444–6472 in
advance to schedule delivery.
The Office of Minority Health strongly
encourages commenters to submit
comments via the Federal eRulemaking
Portal. Comments received, including
any personal information, will be posted
without change to the docket at http://
www.regulations.gov as they are
submitted, usually within 1 week after
submission. While the comment period
remains open, individuals may also
provide comments in response to
already submitted comments that have
been posted to the docket.
The submission of comments in
response to this notice should not
exceed 5 pages, not including
appendices and supplemental
documents. Any information you
submit will be made public.
Consequently, do not send proprietary,
commercial, financial, business
confidential, trade secret, or personal
information that you do not wish to be
made public.
FOR FURTHER INFORMATION CONTACT:
Rochelle Rollins, PhD, MPH, Office of
Minority Health, 1101 Wootton
Parkway, Suite 600, Rockville, MD
20852; Phone (800) 444–6472; E-mail
ACASection4302@hhs.gov.
SUPPLEMENTARY INFORMATION:

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Introduction
DHHS reports, dating back to the
landmark 1985 Secretary’s Task Force
on Black and Minority Health, note the
critical importance of rich data systems
and culturally competent research to
understand and reduce health
disparities among population
subgroups. Such disparities reflect the
interactive effects of multiple social,
economic, behavioral, and
environmental determinants of health,
including access to high quality health
care services. Data improvement efforts
enhance the ability of the public health
and healthcare systems to identify and
track disparities in health and health
care, and facilitate greater accountability
for reducing them. Although there have
been government-wide standards for the
collection of race and ethnicity for many
years, the lack of standards related to
data collection on population subgroups
defined by other characteristics—such
as primary language and disability—
remains a challenge for reporting and
tracking data on health disparities.
Overview of Section 4302 of the
Affordable Care Act
The Affordable Care Act includes
multiple provisions aimed at
eliminating health disparities in
America. Section 4302 (Understanding

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health disparities: Data collection and
analysis) of the Affordable Care Act
focuses on the standardization,
collection, analysis, and reporting of
health disparities data. While data alone
will not reduce disparities, it can be
foundational to our efforts to
characterize the disparities, design
effective responses, and evaluate our
progress.
Section 4302 begins by requiring the
Secretary of DHHS to establish data
collection standards for race, ethnicity,
sex, primary language, and disability
status. The law requires that, once
established, these data collection
standards be used, to the extent
practicable, in HHS national population
health surveys. The law also requires
that any DHHS data standards be in
compliance with standards created by
the Office of Management and Budget
(OMB), such as those for race and
ethnicity. As such, OMB’s standards are
not the subject of comment in this
notice.
The focus of this announcement is for
data collection standards related to race,
ethnicity, primary language, sex, and
disability status, as outlined in Section
4302 of the Affordable Care Act. The
law also requires that these data
collection standards be used for the
purposes of measuring quality and
reporting for any federally sponsored,
federally conducted, or supported
health care or public health program,
activity, or survey. Additional
subsections of the law relate to data
collection standards require the
Department to develop data collection
standards for access to care for persons
with disabilities. The law also gives the
Secretary the authority to require that
additional demographic data be
collected on all Departmental surveys
and to develop appropriate data
collection standards. The full text of
Section 4302 of the Affordable Care Act
can be found at minorityhealth.hhs.gov/
section4302.
Implementation of Section 4302 of the
Affordable Care Act
The Department proposed data
collection standards for race, ethnicity,
sex, primary language and disability
status were guided by existing federal
data standards, the results of studies
and public reports, consultation with
statistical agencies and programs, and
the expertise of subject matter experts
who have leadership roles with
collecting and analyzing this type of
data. The focus was to develop data
collection standards for race, ethnicity,
sex, primary language and disability
status that are appropriate for the

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purposes and methods of population
health surveys for self-reported data.
The proposed data collection
standards and rationale are for race,
ethnicity, primary language, sex, and
disability status and pertain only to selfreported data. These proposed data
collection standards represent the first
round of implementation of Section
4302 of the Affordable Care Act related
to race, ethnicity, sex, primary language
and disability status. Implementation
efforts related to additional subsections
of Section 4302 of the Affordable Care
Act continue.
The Department is also in the process
of developing and validating standard
approaches for collecting data about
sexual orientation and gender identity.
With this notice, the Office of
Minority Health requests comment from
the public and interested stakeholders
on the proposed data collection
standards for race, ethnicity, sex,
primary language, and disability status.
The text of the proposed data
standards is available in HTML and PDF
formats through the Office of Minority
Health Web site at
minorityhealth.hhs.gov/section4302 and
the http://www.regulations.gov, docket
ID number HHS–OMH–2011–0013. The
full text of Section 4302 of the
Affordable Care Act can be found at
minorityhealth.hhs.gov/section4302. For
those who may not have Internet access,
a hard copy can be requested from the
point of contact, Rochelle Rollins, PhD,
MPH, Office of the Minority Health,
1101 Wootton Parkway, Suite 600,
Rockville, MD 20852; Phone (800) 444–
6472; E-mail ACASection4302@hhs.gov.
June 24, 2011.
Garth Graham,
Deputy Assistant Secretary for Minority
Health, Office of Assistant Secretary for
Health .
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Agency for Healthcare Research and
Quality
Agency Information Collection
Activities; Proposed Collection;
Comment Request
Agency for Healthcare Research
and Quality, HHS.
ACTION: Notice.
AGENCY:

This notice announces the
intention of the Agency for Healthcare
Research and Quality (AHRQ) to request
that the Office of Management and

SUMMARY:

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Federal Register / Vol. 76, No. 126 / Thursday, June 30, 2011 / Notices

Budget (OMB) approve the proposed
information collection project: ‘‘Medical
Expenditure Panel Survey—Insurance
Component 2012–2013.’’ In accordance
with the Paperwork Reduction Act, 44
U.S.C. 3501–3521, AHRQ invites the
public to comment on this proposed
information collection.
DATES: Comments on this notice must be
received by August 29, 2011.
Written comments should
be submitted to: Doris Lefkowitz,
Reports Clearance Officer, AHRQ, by email at doris.lefkowitz@AHRO.hhs.gov.
Copies of the proposed collection
plans, data collection instruments, and
specific details on the estimated burden
can be obtained from the AHRQ Reports
Clearance Officer.
FOR FURTHER INFORMATION CONTACT:
Doris Lefkowitz, AHRQ Reports
Clearance Officer, (301) 427–1477, or by
e-mail at
doris.lefkowitz@AHRQ.hhs.gov.
ADDRESSES:

SUPPLEMENTARY INFORMATION:

Proposed Project
Medical Expenditure Panel Survey—
Insurance Component 2012–2013
Employer-sponsored health insurance
is the source of coverage for 85 million
current and former workers, plus many
of their family members, and is a
cornerstone of the U.S. health care
system. The Medical Expenditure Panel
Survey—Insurance Component (MEPS–
IC) measures the extent, cost, and
coverage of employer-sponsored health
insurance on an annual basis. These
statistics are produced at the National,
State, and sub-State (metropolitan area)
level for private industry. Statistics are
also produced for State and Local
governments.
This research has the following goals:
(1) To provide data for Federal
policymakers evaluating the effects of
National and State health care reforms;
(2) To provide descriptive data on the
current employer-sponsored health
insurance system and data for modeling

the differential impacts of proposed
health policy initiatives; and
(3) To supply critical State and
National estimates of health insurance
spending for the National Health
Accounts and Gross Domestic Product.
This study is being conducted by
AHRQ through an interagency
agreement with the U.S. Census Bureau
and pursuant to AHRQ’s statutory
authority to conduct surveys to collect
data on the cost, use and quality of
health care, including the types and
costs of private health insurance. 42
U.S.C. 299b–2(a).
Method of Collection
To achieve the goals of this project the
following data collections for both
private sector and state and local
government employers will be
implemented:
(1) Prescreener Questionnaire—The
purpose of the Prescreener
Questionnaire, which is collected via
telephone, varies depending on the
insurance status of the establishment
contacted. (Establishment is defined as
a single, physical location in the private
sector and a governmental unit in state
and local governments.) For
establishments that do not offer health
insurance to their employees, the
prescreener is used to collect basic
information such as number of
employees. Collection is completed for
these establishments through this
telephone call. For establishments that
do offer health insurance, contact name
and address information is collected
that is used for the mailout of the
establishment and plan questionnaires.
Obtaining this contact information helps
ensure that the questionnaires are
directed to the person in the
establishment best equipped to
complete them.
(2) Establishment Questionnaire—The
purpose of the mailed Establishment
Questionnaire is to obtain general
information from employers that
provide health insurance to their

employees. Information such as total
active enrollment in health insurance,
other employee benefits, waiting
periods, and retiree health insurance is
collected through the establishment
questionnaire.
(3) Plan Questionnaire—The purpose
of the mailed Plan Questionnaire is to
collect plan-specific information on
each plan (up to four plans) offered by
establishments that provide health
insurance to their employees. This
questionnaire obtains information on
total premiums, employer and employee
contributions to the premium, and plan
enrollment for each type of coverage
offered—single, employee-plus-one, and
family—within a plan. It also asks for
information on deductibles, copays, and
other plan characteristics. This
information is needed in order to
provide the tools for Federal, State, and
academic researchers to evaluate current
and proposed health policies and to
support the production of important
statistical measures for other Federal
agencies.
Estimated Annual Respondent Burden
Exhibit 1 shows the estimated
annualized burden hours for the
respondent’s time to provide the
requested data. The Prescreener
questionnaire will be completed by
31,552 respondents and takes about 51⁄2
minutes to complete. The Establishment
questionnaire will be completed by
25,839 respondents and takes about 23
minutes to complete. The Plan
questionnaire will be completed by
23,230 respondents and will require an
average of 2.1 responses per respondent.
Each Plan questionnaire takes about 11
minutes to complete. The total
annualized burden hours are estimated
to be 21,440 hours.
Exhibit 2 shows the estimated
annualized cost burden associated with
the respondents’ time to participate in
this data collection. The annualized cost
burden is estimated to be $614,256.

EXHIBIT 1—ESTIMATED ANNUALIZED BURDEN HOURS
Number of
respondents

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Form name

Number of
responses per
respondent

Hours per
response

Total burden
hours

Prescreener Questionnaire ..............................................................................
Establishment Questionnaire ...........................................................................
Plan Questionnaire ..........................................................................................

31,552
25,839
23,230

1
1
2.1

0.09
0.38
0.18

2,840
9,819
8,781

Total ..........................................................................................................

80,621

na

na

21,440

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Federal Register / Vol. 76, No. 126 / Thursday, June 30, 2011 / Notices
EXHIBIT 2—ESTIMATED ANNUALIZED COST BURDEN
Number of
respondents

Form name

Total burden
hours

Average hourly wage rate*

Total cost
burden

Prescreener Questionnaire ..............................................................................
Establishment Questionnaire ...........................................................................
Plan Questionnaire ..........................................................................................

31,552
25,839
23,230

2,840
9,819
8,781

28.65
28.65
28.65

$81,366
281,314
251,576

Total ..........................................................................................................

80,621

21,440

na

$614,256

* Based upon the mean hourly wage for Compensation, Benefits, and Job Analysis Specialists occupation code 13–1141, at http://www.bls.gov/
oes/current/oes_nat.htm#13-0000 (U.S. Department of Labor, Bureau of Labor Statistics.)

Estimated Annual Costs to the Federal
Government

The total cost over the 2 years of this
clearance is $22,954,000.

Exhibit 3 shows the estimated
annualized cost of this data collection.

EXHIBIT 3—ESTIMATED TOTAL AND ANNUALIZED COST
[$ thousands]
Cost component

Total cost

Annualized
cost

Project Development .......................................................................................................................................................
Data Collection Activities .................................................................................................................................................
Data Processing and Analysis .........................................................................................................................................
Project Management ........................................................................................................................................................
Overhead .........................................................................................................................................................................

$3,338
7,789
7,789
2,925
1,113

$1,669
3,895
3,895
1,463
557

Total ..........................................................................................................................................................................

$22,954

$11,477

NOTE: Components may not sum to Total due to rounding.

srobinson on DSK4SPTVN1PROD with NOTICES

Request for Comments
In accordance with the Paperwork
Reduction Act, comments on AHRQ’s
information collection are requested
with regard to any of the following: (a)
Whether the proposed collection of
information is necessary for the proper
performance of AHRQ healthcare
research and healthcare information
dissemination functions, including
whether the information will have
practical utility; (b) the accuracy of
AHRQ’s estimate of burden (including
hours and costs) of the proposed
collection(s) of information; (c) ways to
enhance the quality, utility, and clarity
of the information to be collected; and
(d) ways to minimize the burden of the
collection of information upon the
respondents, including the use of
automated collection techniques or
other forms of information technology.
Comments submitted in response to this
notice will be summarized and included
in the Agency’s subsequent request for
OMB approval of the proposed
information collection. All comments
will become a matter of public record.
Dated: June 17, 2011.
Carolyn M. Clancy,
Director.
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DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[Docket Number CDC–2011–0008]

Assessing the Current Research,
Policy, and Practice Environment in
Public Health Genomics
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice; establishment of docket;
request for comments, data and
information.
AGENCY:

The Centers for Disease
Control and Prevention (CDC), located
within the Department of Health and
Human Services (HHS) is announcing
the opening of a docket to solicit
comments, data, and other information
helpful to assess the current research,
policy, and practice environment in
public health genomics. HHS/CDC is
currently leading a process to assess the
most important steps for public health
genomics in the next five years.
DATES: Electronic or written comments
must be received on or before August 1,
2011.
ADDRESSES: You may submit written
comments to the following address:
SUMMARY:

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Office of Public Health Genomics,
Centers for Disease Control and
Prevention, 1600 Clifton Road, NE.,
MS–E61, Atlanta, Georgia 30333, Attn:
Docket No. CDC–2011–0008.
You may also submit comments
electronically to http://
www.regulations.gov, Docket No. CDC–
2011–0008. Please follow directions at
http://wwww.regulations.gov to submit
comments. All relevant comments
received will be posted publicly without
change, including any personal or
proprietary information provided.
FOR FURTHER INFORMATION CONTACT:
Katherine Kolor, PhD, Office of Public
Health Genomics, Centers for Disease
Control and Prevention, 1600 Clifton
Road, NE., MS–E61, Atlanta, GA 30333,
e-mail genetics@cdc.gov, phone 404–
498–0001.
SUPPLEMENTARY INFORMATION:
I. Background
Since 1997, the Office of Public
Health Genomics (OPHG) of the Centers
for Disease Control and Prevention
(CDC) has worked to integrate genomics
into public health research, policy, and
programs, which could improve
interventions designed to prevent and
control the country’s leading chronic,
infectious, environmental, and
occupational diseases. OPHG’s efforts
focus on conducting population-based

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