[Federal Register: December 12, 2002 (Volume 67, Number 239)]
[Notices]
[Page 76411-76412]
From the Federal Register Online via GPO Access [wais.access.gpo.gov]
[DOCID:fr12de02-84]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Indian Health Service
Indian Health Service Medical Staff Credentials and Privileges
Files
AGENCY: Indian Health Service, HHS.
ACTION: Request for public comment: 30-day proposed collection: Indian
Health Service medical staff credentials and privileges files.
-----------------------------------------------------------------------
SUMMARY: The Indian Health Service (IHS), as part of its continuing
effort to reduce paperwork and respondent burden, conducts a pre-
clearance consultation program to provide the general public and
Federal agencies with an opportunity to comment on proposed and/or
continuing collections of information in accordance with the Paperwork
Reduction Act of 1995 (44 U.S.C. 3506(c)(2)(A)). This program helps to
ensure that requested data can be provided in the desired format,
reporting burden (time and financial resources) is minimized,
collection instruments are clearly understood, and the impact of
collection requirements on respondents can be properly assessed. As
required by section 3507(a)(1)(D) of the Act, the proposed information
collection has been submitted to the Office of Management and Budget
(OMB) for review and approval.
The IHS received comments in response to the 60-day Federal
Register notice (67 FR 50892) published on August 6, 2002. The public
comments received in response to the notice and the agency responses
are summarized and addressed below.
Comment: One comment questioned the accuracy of the public burden
estimate for this collection of information by indicating the burden
estimate seemed to be too low.
Agency response: The burden estimate was checked by having
additional clinical staff review and complete the application formats.
This consultation was conducted within the Department of Health and
Human Services with the Federal Credentialing Program, and with several
Department of Defense (DoD) hospital medical staff members. They
confirmed the accuracy of the burden hour estimates for formats used in
this information collection activity and the burden for the Application
to Medical staff was increased accordingly. They made no specific
recommendations to change any of the application formats or process.
Comments: One comment suggested we consider the time burden spent
by agency staff on this activity.
Agency response: The time spent by agency staff to handle and
process this data collection is not considered in the ``public'' burden
estimate. However, the agency is examining methods to reduce the time
it takes agency staff to process this required data.
Comment: One comment suggested IHS centralize or regionalize the
credentialing process and make it a web-based format.
Agency response: Agency staff responsible for oversight of the
medical staff credentials and privileges application process are
currently collaborating with the Veterans Health Administration and DoD
health program staff to make cost-appropriate advances and improvements
in the credentials process and to automated appropriate portions of the
credentials and privileges process. At present, automation of this
process and use of a data repository like the Federal Credentialing
Program or other complex relational databases is prohibitively
expensive for the IHS. It is hoped that the collaboration will result
in the automation and/or centralization/regionalization of some aspects
of the agency's credentialing process and thereby reduce the public
burden to provide the data and the agency staff time needed to process
the data.
Comment: One comment suggested IHS implement a nationwide corporate
credentialing service with staff trained in the credentialing process.
Agency response: The collaboration discussed above will address
this suggestion.
Comment: One comment suggested the credentialing process include a
``criminal background check''.
Agency response: The criminal background check is not a part of the
IHS credentialing process. However, Public Law 101-630, the Indian
Child Protection and Family Violence Protection Act, requires that all
IHS employees, including the medical staff, with potential direct or
unobserved contact with kids be checked for any history of criminal
acts against children. In addition, the Division of Commissioned
Personnel, United States Public Health Service, conducts a criminal
background check as part of its Childcare National Agency Check with
Written Inquiries (CNACI) system on all new appointees.
The purpose of this notice is to allow an additional 30 days for
public comment to be submitted directly to OMB.
Proposed Collection
Title: 09-17-0009, ``Indian Health Service Medical Staff
Credentials and Privileges Files.'' Type of Information Collection
Request: Extension of a currently approved information collection, 09-
17-0009, ``Indian Health Service Medical Staff Credentials and
Privileges Files.'' Form Number: Instructions and information
collection formats are contained in IHS Circular No. 95-16,
``Credentials and Privileges Review Process for the Medical Staff.''
Need and Use of Information Collection: The IHS operates health care
facilitates that provide health care services to American Indians and
Alaska Natives. To provide these services, the IHS employs (directly
and under contract) several categories of health care providers
including: physicians (M.D. and D.O.), dentists, psychologists,
optometrists, podiatrists, audiologists, physician assistants,
certified registered nurse anesthetists, nurse practitioners, and
certified nurse midwives. IHS policy specifically requires physicians
and dentists to be members of the health care facility medical staff
where they practice. Health care providers become medical staff
members, depending on the local health care facility's capabilities and
medical staff bylaws. There are three types of IHS medical staff
applicants: (1) Health care providers applying for direct employment
with IHS (2) contract health care providers who will not seek to become
IHS employees; and (3) employed IHS health care providers who seek to
transfer between IHS health care facilities.
National health care standards developed by the Health Care
Financing Administration and by the Joint Commission on Accreditation
of Healthcare Organizations (JCAHO) require health care facilities to
review, evaluate and verify the credentials, training and experience of
medical staff applicants prior to granting medical staff privileges. To
meet these standards, IHS health care facilities require each medical
staff applicant to provide information concerning their education,
training, licensure, and work experience and any adverse disciplinary
actions taken against them. This information is then verified with
references supplied by the applicant and may include: former employers,
educational institutions, licensure and certification boards, the
American Medical Association, the Federation of State
[[Page 76412]]
Medical Boards, the National Practitioner Data Bank, and the applicants
themselves.
In addition to the initial granting of medical staff membership and
clinical privileges, JCAHO standards require that a review of the
medical staff be conducted not less than every two years. This review
evaluates the current competence of the medical staff and verifies
whether they are maintaining their licensure and the certification
requirements of their specialty.
The medical staff credentials and privileges records are maintained
at the health care facility where the health care provider is a medical
staff member. The establishment of these records at IHS health care
facilities is not optional; such records must be established and
maintained at all health care facilities in the United States that are
accredited by JCAHO. This information collection activity is used to
evaluate individual health care providers applying for medical staff
privileges at Indian Health Service (IHS) health care facilities.
Affected Public: Individuals, Businesses or other for-profit, Not-
for-profit institutions and State, local or Tribal Government.
Type of Respondents: Health care providers requesting medical staff
privileges at IHS health facilities.
The table below provides the following: Types of data collection
instruments, estimated number of respondents, number of responses per
respondent, annual number of responses, average burden hour per
response, and total annual burden hour.
----------------------------------------------------------------------------------------------------------------
Total
Estimated Responses Annual Average burden hour per annual
Data collection instrument number of per number of response* burden
respondents respondent responses hours
----------------------------------------------------------------------------------------------------------------
Application to Medical Staff.. 600 1 600 1.00 (60 mins).............. 600.0
Reference letter.............. 1,800 1 1,800 0.33 (20 mins).............. 600.0
Reappointment request......... 644 1 644 1.00 (60 mins).............. 644.0
Medical Privileges............ 387 1 387 1.00 (60 mins).............. 387.0
Ob-Gyn Privileges............. 25 1 25 1.00 (60 mins).............. 25.0
Surgical Privileges........... 23 1 23 1.00 (60 mins).............. 23.0
Psychiatric Privileges........ 18 1 18 1.00 (60 mins).............. 18.0
Anesthesia Privileges......... 16 1 16 1.00 (60 mins).............. 16.0
Dental Privileges............. 128 1 128 0.33 (20 mins).............. 42.2
Optometric Privileges......... 21 1 21 0.33 (20 mins).............. 6.9
Psychology Privileges......... 23 1 23 0.17 (10 mins).............. 4.0
Audiology Privileges.......... 6 1 6 0.08 (5 mins)............... 0.5
Podiatric Privileges.......... 6 1 6 0.08 (5 mins)............... 0.5
Radiology Privileges.......... 9 1 9 0.33 (20 mins).............. 3.0
Pathology Privileges.......... 3 1 3 0.33 (20 mins).............. 1.0
--------------
Total................... 3,709 ........... ........... ............................ 2,371.0
----------------------------------------------------------------------------------------------------------------
*For ease of understanding, burden hours are also provided in actual minutes.
There are no Capital Cost, Operating Costs and/or Maintenance Costs
to report.
Request for Comments: Your written comments and/or suggestions are
invited on one or more of the following points: (a) Whether the
information collection activity is necessary to carry out an agency
function; (b) whether the agency processes the information collected in
a useful and timely fashion; (c) the accuracy of public burden estimate
(the estimated amount of time needed for individual respondents to
provide the requested information); (d) whether the methodology and
assumptions used to determine the estimate are logical; (e) ways to
enhance the quality, utility, and clarity of the information being
collected; and (f) ways to minimize the public burden through the use
of automated, electronic, mechanical, or other technological collection
techniques or other forms of information technology.
Direct Comments to OMB: Send your written comments and suggestion
regarding the proposed information collection contained in this notice,
especially regarding the estimated public burden and associated
response time, to: Office of Management and Budget, Office of
Regulatory Affairs, New Executive Office Building, Room 10235,
Washington, DC 20503, Attention: Allison Eydt, Desk Officer for IHS.
Send requests for more information on the proposed collection or to
obtain a copy of the data collection instrument(s) and instructions to:
Mr. Lace Hadohkwen, Sr., M.P.H., IHS Reports Clearance Officer, 12300
Twinbrook Parkway, Suite 450, Rockville, MD 20852, 1601, call non-toll
free (301) 443-1116, send via facsimile to (301) 443-2316, or send your
E-mail requests, comments, and return address to: 1hodahkw@hqe.ihs.gov.
FOR FURTHER INFORMATION CONTACT: Directly pertaining to the proposed
data collection instruments and/or the process, please contact
Katherine Ciacco Palatianos, MD, 801 Thompson Avenue, Suite 320,
Rockville, Md 20852-1627, Telephone (303) 443-1479.
Comment Due Date: Your comments regarding this information
collection are best assured of having their full effect if received
within 30-days of the date of this publication.
Dated: December 3, 2002.
Robert G. McSwain,
Acting Interim Director.
[FR Doc. 02-31251 Filed 12-11-02; 8:45 am]
BILLING CODE 4160-16-M