[Federal Register: August 5, 1999 (Volume 64, Number 150)]
[Notices]               
[Page 42702-42703]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr05au99-101]                         

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Care Financing Administration
[Document Identifier: HCFA-R-291]

 
Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Health Care Financing Administration.

ACTION: Comment request; notice.

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    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Health Care Financing 
Administration (HCFA), Department of Health and Human Services, is 
publishing the following summary of proposed collections for public 
comment. Interested persons are invited to send comments regarding this 
burden estimate or any other aspect of this collection of information, 
including any of the following subjects: (1) The necessity and utility 
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.
    Type of Information Collection Request: New Collection;
    Title of Information Collection: Multi-State Evaluation of Dual 
Eligibles Demonstrations: Wisconsin Partnership Program;
    Form No.: HCFA-R-291 (OMB# 0938-NEW);
    Use: This survey provides information needed to evaluate dual 
eligible demonstrations on issues of satisfaction and gathers health 
and functional status to be used in other analyses. Dual eligible 
demonstrations are designed to create alternative delivery services for 
acute and long-term care services to elderly and disabled persons which 
provide increased coordination, improve access to quality services and 
control or more appropriately allocate future costs. Respondents to the 
survey

[[Page 42703]]

include demonstration enrollees both living in the community and in 
institutions, their families, disenrollees and corresponding comparison 
groups. Information collected will pertain to description of the 
person, information regarding enrollment/disenrollment, quality of 
life, satisfaction, general health, functional status, access to 
services, and informal care giving. This data will be combined with 
secondary data on utilization of services to analyze the coordination 
of care, utilization, outcomes, and cost of providing services.;
    Frequency: Other: One-time;
    Affected Public: Individuals or Households;
    Number of Respondents: 5,945;
    Total Annual Responses: 5,945;
    Total Annual Hours: 3,830.
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access HCFA's 
Web Site address at http://www.hcfa.gov/regs/prdact95.htm, or E-mail 
your request, including your address, phone number, OMB number, and 
HCFA document identifier, to Paperwork@hcfa.gov, or call the Reports 
Clearance Office on (410) 786-1326. Written comments and 
recommendations for the proposed information collections must be mailed 
within 60 days of this notice directly to the HCFA Paperwork Clearance 
Officer designated at the following address: HCFA, Office of 
Information Services, Security and Standards Group, Division of HCFA 
Enterprise Standards, Attention: Dawn Willinghan, Room N2-14-26, 7500 
Security Boulevard, Baltimore, Maryland 21244-1850.

    Dated: July 29, 1999.
John P. Burke III,
HCFA Reports Clearance Officer, HCFA Office of Information Services, 
Security and Standards Group, Division of HCFA Enterprise Standards.
[FR Doc. 99-20100 Filed 8-4-99; 8:45 am]
BILLING CODE 4120-03-P