E9-8141. Agency Information Collection Activities: Submission for OMB Review; Comment Request

Periodically, the Health Resources and Services Administration (HRSA) publishes abstracts of information collection requests under review by the Office of Management and Budget (OMB), in compliance with the Paperwork Reduction Act of 1995 (44 U.S.C. Chapter 35). To request a copy of the clearance requests submitted to OMB for review, e-mail [e-mail] or call the HRSA Reports Clearance Office on [phone].

The following request has been submitted to the Office of Management and Budget for review under the Paperwork Reduction Act of 1995:

Proposed Project: Uncompensated Services Assurance Report (OMB No. 0915-0077)—[Extension]

Under the Hill-Burton Act, the government provides grants and loans for construction or renovation of health care facilities. As a condition of receiving this construction assistance, facilities are required to provide services to persons unable to pay. A condition of receiving this assistance requires facilities to provide assurances periodically that the required level of uncompensated care is being provided, and that certain notification and record keeping procedures are being followed. These requirements are referred to as the uncompensated services assurance.

The annual estimate of burden is as follows:

Instrument	Number of respondents	Responses per respondent	Total responses	Hours per response	Total burden hours
Disclosure Burden (42 CFR)
Published Notices (124.504(c))	86	1	86	0.75	64.5
Individual Notices (124.504(c))	86	1	86	43.6	3,749.6
Determinations of Eligibility (124.507)	86	99	8,514	0.75	6,385.50
Subtotal disclosure burden					10,199.60
Reporting
Uncompensated Services Report—HRSA-710 Form (124.509(a))	10	1	10	11.0	110
Application for Compliance Alternatives:
Public Facilities (124.513)	4	1	4	6.0	24
Small Obligation Facilities (124.514(c))	0
Charitable Facilities (124.516(c))	2	1	2	6.0	12
Annual Certification for Compliance Alternatives:
Public Facilities (124.509(b))	37	1	37	0.5	18.5
Charitable Facilities (124.509(b))	14	1	14	0.5	7
Small Obligation Facilities (124.509(c))	0	1	0	0.5	0
Complaint Information (124.511(a)):
Individuals	10	1	10	0.25	2.5
Facilities	10	1	10	0.5	5
Subtotal reporting burden					179

Recordkeeping	Number of recordkeepers	Hours per year	Total hour burden
Non-alternative Facilities (124.510(a))	86	50	4,300
Subtotal recordkeeping burden			4,300

The total burden for this project is estimated to be 14,678.60 hours. Written comments and recommendations concerning the proposed information collection should be sent within 30 days of this notice to the desk officer for HRSA, either by e-mail to [e-mail] or by fax to [phone]. Please direct all correspondence to the “attention of the desk officer for HRSA.”

Dated: April 3, 2009.

Alexandra Huttinger,

Director, Division of Policy Review and Coordination.