Attachment G - 60-Day Federal Register Notice

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Federal Register / Vol. 83, No. 222 / Friday, November 16, 2018 / Notices

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III. Provisions of the Proposed Notice
On June 15, 2018, we published a
proposed notice (83 FR 27992) in the
Federal Register announcing CHAP’s
request for continued approval of its
Medicare hospice accreditation
program. In the June 15, 2018 proposed
notice, we detailed our evaluation
criteria. Under section 1865(a)(2) of the
Act and in our regulations at § 488.5, we
conducted a review of CHAP’s Medicare
hospice accreditation application in
accordance with the criteria specified by
our regulations, which include, but are
not limited to, the following:
• An onsite administrative review of
CHAP’s: (1) Corporate policies; (2)
financial and human resources available
to accomplish the proposed surveys; (3)
procedures for training, monitoring, and
evaluation of its hospice surveyors; (4)
ability to investigate and respond
appropriately to complaints against
accredited hospices; and (5) survey
review and decision-making process for
accreditation.
• A comparison of CHAP’s Medicare
hospice accreditation program standards
to our current Medicare hospice
Conditions of Participation (CoPs).
• A documentation review of CHAP’s
survey process to:
++ Determine the composition of the
survey team, surveyor qualifications,
and CHAP’s ability to provide
continuing surveyor training.
++ Compare CHAP’s processes to
those we require of state survey
agencies, including periodic resurvey
and the ability to investigate and
respond appropriately to complaints
against accredited hospices.
++ Evaluate CHAP’s procedures for
monitoring hospices found to be out of
compliance with CHAP’s program
requirements. This pertains only to
monitoring procedures when CHAP
identifies non-compliance. If
noncompliance is identified by a state
survey agency through a validation
survey, the state survey agency monitors
corrections as specified at § 488.9(c).
++ Assess CHAP’s ability to report
deficiencies to the surveyed hospice and
respond to the hospice’s plan of
correction in a timely manner.
++ Establish CHAP’s ability to
provide CMS with electronic data and
reports necessary for effective validation
and assessment of the organization’s
survey process.
++ Determine the adequacy of
CHAP’s staff and other resources.
++ Confirm CHAP’s ability to provide
adequate funding for the completion of
required surveys.
++ Confirm CHAP’s policies to
surveys being unannounced.

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++ Obtain CHAP’s agreement to
provide CMS with a copy of the most
current accreditation survey together
with any other information related to
the survey as we may require, including
corrective action plans.
In accordance with section
1865(a)(3)(A) of the Act, the June 15,
2018 proposed notice also solicited
public comments regarding whether
CHAP’s requirements met or exceeded
the Medicare CoPs for hospices. No
comments were received in response to
our proposed notice.
IV. Provisions of the Final Notice
A. Differences Between CHAP’s
Standards and Requirements for
Accreditation and Medicare Conditions
and Survey Requirements
We compared CHAP’s hospice
accreditation requirements and survey
process with the Medicare CoPs of part
418, and the survey and certification
process requirements of parts 488 and
489. Our review and evaluation of
CHAP’s hospice application, which
were conducted as described in section
III of this final notice, yielded the
following areas where, as of the date of
this notice, CHAP has completed
revising its standards and certification
processes in order to ensure that
hospices accredited by CHAP meet the
requirements at:
• § 418.64(d)(2), to ensure the dietary
needs of patients are met.
• § 418.76(b)(1), to ensure training is
conducted by a registered nurse, or a
licensed practical nurse under the
supervision of a registered nurse.
• § 418.76(b)(3)(xiii), to ensure that
any other task that the hospice may
choose to have an aide perform must be
included in the content of the hospice
aide classroom and supervised practical
training.
• § 418.76(d)(1), to ensure that inservice training is supervised by a
registered nurse.
• § 418.76(h)(3)(iv) and (v), to address
the requirement that the supervising
nurse must assess an aide’s ability to
demonstrate initial and continued
satisfactory performance in meeting
outcome criteria for the hospice’s
infection control policy and procedures
and for reporting changes in the
patient’s conditions.
• § 418.76(k)(3), to address the
requirement for homemakers to report
concerns to the member of the
interdisciplinary group who is
responsible for coordinating homemaker
services.
• § 418.104, to address the
requirement allowing medical records to
be maintained electronically.

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• § 418.110(d)(3), to address the
requirement that provisions of the
adopted edition of the Life Safety Code
do not apply in a state if CMS finds that
a fire and safety code imposed by state
law adequately protects patients in
hospices.
• § 418.113, to ensure compliance
with all applicable federal, state, and
local emergency preparedness
requirements.
• § 488.5(a)(7) through (9), to ensure
that new surveyors receive the required
initial orientation training, and that all
new surveyors receive an evaluation of
performance, in accordance with CHAP
policies.
• § 488.5(a)(12), to ensure that
complaint surveys are conducted in a
manner that meets or exceeds the
processes and investigation practices of
CMS; that the rationale for the decision
whether to conduct an onsite survey or
not, is clearly documented in the
complaint file, according to CHAP
policy; and, to ensure that complaints
are closed out properly with appropriate
notification to complainants.
B. Term of Approval
Based on our review and observations
described in section III of this final
notice, we approve CHAP as a national
accreditation organization for hospices
that request participation in the
Medicare program, effective November
20, 2018 through November 20, 2024.
V. Collection of Information
Requirements
This document does not impose
information collection requirements,
that is, reporting recordkeeping or thirdparty disclosure requirements.
Consequently, there is no need for
review by the Office of Management and
Budget under the authority of the
Paperwork Reduction Act of 1995 (44
U.S.C. 3501 et seq).
Dated: November 7, 2018.
Seema Verma,
Administrator, Centers for Medicare &
Medicaid Services.
[FR Doc. 2018–25066 Filed 11–15–18; 8:45 am]
BILLING CODE 4120–01–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Title: National Evaluation of the
Sexual Risk Avoidance Education

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57729

Federal Register / Vol. 83, No. 222 / Friday, November 16, 2018 / Notices
(SRAE) Program—National Descriptive
Study
OMB NO.: [NEW]
Description: The Administration for
Children and Families (ACF) proposes a
data collection effort related to the
National Evaluation of the Sexual Risk
Avoidance Education (SRAE) Program—
National Descriptive Study.
The National Descriptive Study (of
the National Evaluation of the SRAE
Program) has multiple components.
This information collection request only
pertains to the Early Implementation
Study, which will provide an early
catalogue of SRAE programs’

implementation. ACF seeks approval to
collect the following information:
—Survey for Use with SRAE grantees.
The purpose of this collection effort is
to conduct surveys with
administrators/program directors in
each of the states/organizations that
received SRAE grants to better
understand what key decisions states/
organizations made regarding the
design of their SRAE-funded
programs and why they made those
decisions.
Interview Guide for Use with SRAE
grantees. The purpose of this collection

effort is to conduct semi-structured
interviews, that follow-on the surveys,
with administrators/program directors
in each of the states/organizations that
received SRAE grants: The interviews
will offer long-answer, qualitative
responses to key questions, to better
understand what key decisions states/
organizations made regarding the
design of their SRAE-funded programs
and why they made those decisions.
Respondents: State level
administrators; Agency administrators;
Organization heads; Project directors

ANNUAL BURDEN ESTIMATES
Total
number of
respondents

Instrument

Survey for SRAE Grantees ..................................................
Interview Guide for SRAE Grantees ....................................

Estimated Total Annual Burden
Hours: 250 hours.
In compliance with the requirements
of Section 3506(c)(2)(A) of the
Paperwork Reduction Act of 1995, the
Administration for Children and
Families is soliciting public comment
on the specific aspects of the
information collection described above.
Copies of the proposed collection of
information can be obtained and
comments may be forwarded by writing
to the Administration for Children and
Families, Office of Planning, Research,
and Evaluation, 330 C Street SW,
Washington, DC 20201, Attn: OPRE
Reports Clearance Officer. Email
address: OPREinfocollection@
acf.hhs.gov. All requests should be
identified by the title of the information
collection. 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

Annual
number of
respondents

125
125

Number of
responses per
respondent
1
1

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.
Emily Jabbour,
ACF/OPRE Certifying Officer.
[FR Doc. 2018–24997 Filed 11–15–18; 8:45 am]
BILLING CODE 4184–01–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Submission for OMB Review;
Comment Request
Title: National Youth in Transition
Database (NYTD) and Youth Outcomes
Survey.
OMB No.: 0970–0340.
Description: The Foster Care
Independence Act of 1999 (42 U.S.C.
1305 et seq.) as amended by Public Law
106–169 requires State child welfare
agencies to collect and report to the
Administration on Children and

1
1

Average
burden
hours per
response

Annual
burden
hours
1
1

125
125

Families (ACF) data on the
characteristics of youth receiving
independent living services and
information regarding their outcomes.
The regulation implementing the
National Youth in Transition Database,
listed in 45 CFR 1356.80, contains
standard data collection and reporting
requirements for States to meet the law’s
requirements. Additionally, the Family
First Prevention Services Act of 2017
(H.R. 253) further outlines the
expectation of the collection and
reporting of data and outcomes
regarding youth who are in receipt of
independent living services. ACF will
use the information collected under the
regulation to track independent living
services, assess the collective outcomes
of youth, and potentially to evaluate
State performance with regard to those
outcomes consistent with the law’s
mandate.
Respondents: State agencies that
administer the John H. Chafee Foster
Care Independence Program. The U.S.
Virgin Islands have been included in
this request as they are expected to
begin participating in NYTD data
collection efforts during this approval
period.

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ANNUAL BURDEN ESTIMATES
Number of
respondents

Instrument
Data file ............................................................................................................
Youth Outcomes Survey ..................................................................................

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Number of
responses per
respondent

53
16,333

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2
1

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Average
burden hours
per response
1,430
.50

Total burden
hours
151,580
8,167