[Federal Register Volume 76, Number 176 (Monday, September 12, 2011)]
[Notices]
[Pages 56141-56143]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-23158]
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Notices
Federal Register
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This section of the FEDERAL REGISTER contains documents other than rules
or proposed rules that are applicable to the public. Notices of hearings
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Federal Register / Vol. 76, No. 176 / Monday, September 12, 2011 /
Notices
[[Page 56141]]
DEPARTMENT OF AGRICULTURE
Economic Research Service
Notice of Intent To Request New Information Collection
AGENCY: Economic Research Service, USDA.
ACTION: Notice and request for comments.
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SUMMARY: In accordance with the Paperwork Reduction Act of 1995, this
notice invites the general public and other public agencies to send
comments regarding any aspect of this proposed information collection.
This is a new collection for a Survey on Rural Community Wealth and
Health Care Provision.
DATES: Written comments on this notice must be received on or before
November 14, 2011 to be assured of consideration.
ADDRESSES: Address all comments concerning this notice to John Pender,
Resource and Rural Economics Division, Economic Research Service, U.S.
Department of Agriculture, 1800 M. St., NW., Room N4056, Washington, DC
20036-5801. Comments may also be submitted via fax to the attention of
John Pender at 202-694-5774 or via e-mail to [email protected].
Comments will also be accepted through the Federal eRulemaking Portal.
Go to http://www.regulations.gov, and follow the online instructions
for submitting comments electronically.
FOR FURTHER INFORMATION CONTACT: For further information contact John
Pender at the address in the preamble. Tel. 202-694-5568.
SUPPLEMENTARY INFORMATION: All written comments will be open for public
inspection at the office of the Economic Research Service during
regular business hours (8:30 a.m. to 5 p.m., Monday through Friday) at
1800 M. St., NW., Room N4056, Washington, DC 20036-5801.
All responses to this notice will be summarized and included in the
request for Office of Management and Budget approval. All comments and
replies will be a matter of public record. Comments are invited 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, including the validity of the methodology and assumptions
used; (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 on those who are to respond, including use of
appropriate automated, electronic, mechanical, or other technological
collection techniques or other forms of information technology.
Title: Survey on Rural Community Wealth and Health Care Provision.
OMB Number: 0536-XXXX.
Expiration Date: Three years from the date of approval.
Type of Request: New collection.
Abstract: This survey will collect information on the assets and
investments of rural communities and their influence on recruitment and
retention of rural health care providers, and on the effects of rural
health care provision on economic development of rural communities.
This information will contribute to a better understanding of the roles
that rural communities play in promoting or retarding the development
and provision of health care services, and of how improved health care
provision contributes to development of these communities. Such
understanding is critical to develop effective policies to address the
challenge of inadequate access to health care services in many rural
communities, and to realize the opportunities offered by improved
health care provision to attract and keep residents in rural areas,
provide employment, and improve the quality of life.
Health care services is one of the largest and most rapidly growing
industries in rural America, and adequate provision of health care
services is increasingly critical for achieving economic development
and improved well-being of rural people. In many rural communities,
health care services is the largest employer, and rapid growth in this
sector is occurring and will continue to occur, especially as the Baby-
Boom generation retires. Provision of adequate health care services is
likely to be one of the key factors in attracting retirees and other
migrants to rural areas, helping to stem persistent outmigration from
many of these areas and in some cases, contributing to rural growth and
prosperity. Despite recent growth and potential for continued growth in
this sector, many rural communities suffer from poor access to health
care services, especially because of the limited supply of health care
professionals. Addressing these access problems likely will become
increasingly important as the Patient Protection and Affordable Care
Act is implemented, increasing rural people's access to health
insurance.
Although substantial research has investigated the problems of
attracting and retaining health care providers in rural areas, very
little of this research addresses the issue from the perspective of
rural communities themselves. For example, prior research has
established that physicians who grew up in a rural area, who attended a
medical school with a rural emphasis, or who completed a residency in a
rural hospital are more likely than other physicians to locate their
practice in a rural community. Policies and programs that provide
incentives to physicians to locate in rural areas have also been shown
to increase recruitment of physicians to rural areas, although the
impacts on retention of physicians are more questionable. Much less
research has focused on factors affecting recruitment and retention of
health care providers other than physicians to rural areas, or on the
roles local communities play in affecting these decisions. Of the
research that investigates the roles of local communities, the studies
have been conducted in only a few communities with a small number of
respondents, limiting the ability to draw conclusions applicable to
broader rural regions.
The proposed rural community survey will address this information
gap by collecting information from representatives of 150 rural
communities in three regions of the United States and from health care
providers in the same communities. The
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survey will investigate the perspectives of community leaders and
organizations concerning the need for improved access to health care
services, the local community assets that attract or repel health care
providers, the investments and efforts undertaken or planned to recruit
and retain health care service providers, and the effects of changes in
health care service provision on other aspects of community
development. The survey will also investigate the perspective of health
care providers on the factors affecting their decisions to locate,
continue and change their operations in these rural communities,
including the influence of community assets and investments such as
improvements in local schools, availability of Internet broadband or
other infrastructure, provision of child care services, recreational
opportunities, and other factors.
The three proposed study regions include the lower Mississippi
Delta region (including parts of the States of Mississippi, Louisiana,
Arkansas and Tennessee), the Southern Great Plains region (including
parts of Texas, Oklahoma, Kansas, Nebraska, New Mexico, and Colorado),
and part of the Upper Midwest region (including parts of Missouri,
Iowa, Minnesota, Wisconsin and Illinois). These regions include areas
with high rates of poverty and severe constraints to health care
access--especially in the Delta and Southern Great Plains--while
incomes and health care access are relatively more favorable in the
Upper Midwest region. All three of these regions include rural areas
where growth in health sector employment has been an important
contributor to overall employment growth in recent years, as well as
areas where less growth has occurred. These regions also include
important variations in health status of the populations, presence of
different racial and ethnic groups, social capital, and other key
factors hypothesized to be related to rural health care provision.
The communities (towns and surrounding counties and hospital
service areas (HSAs)) studied in the survey will be selected using a
stratified random sample. Potential respondents for each sampled
community will be identified by accessing public information sources
and by telephone screening. From the town, community leaders such as
the town mayor, council representatives, business leaders or other
stakeholders involved in recruiting and integrating health care
providers to the community will be included on the respondent sample
list. A sample of local health care providers in the selected town--in
most cases limited to primary health care providers such as
administrators of rural clinics, physicians, nurse practitioners, and
dentists--will also be identified. At the county level, the list will
include relevant representatives of the county government--such as the
county executive and officials in the health and economic development
departments--as well as civil society organizations and others involved
at that level in seeking to improve health care provision. At the HSA
level, the sample will include hospital administrators and other
provider representatives. A total of 10 to 15 respondents will be
interviewed in each selected community (including health care providers
and leaders/stakeholders in the town, county and HSA). The interviews
will be conducted by telephone and are expected to require on average
about 20 minutes per respondent, based upon the experience of the
organization that will implement the survey (Survey and Behavioral
Research Services Group, Iowa State University) in implementing
community level surveys of similar scope and size.
The sample for each selected community will be strategically
managed in order to provide the maximum survey response. Advance
letters and a colorful information sheet/brochure will be mailed to
potential respondents. A project Web site will be available with
additional information, and a toll-free number will be provided for
those who have questions or concerns. Confidentiality of responses will
be both assured and ensured. After the advance letters/packets are
sent, all reasonable efforts will be made to contact and interview the
respondents in the sample. Paper or online copies of the survey will be
made available to those who are unable or unwilling to complete a
telephone interview.
All study instruments will be kept as simple and respondent-
friendly as possible. Participation in the survey will be voluntary and
confidential. Survey responses will be used for statistical analysis
and to produce research reports only; not for any other purpose. Data
files from the survey will not be released to the public. Responses
will be linked to secondary data to augment information with no
additional respondent burden. For example, the survey data will be
combined with available county level data from the Census Bureau on
community socioeconomic and demographic characteristics and data from
the Department of Health and Human Services on health care provision
and health status indicators, to analyze factors affecting local
changes in health care provision.
The telephone survey will be conducted within a six month period
during 2012. After the telephone survey and analysis of its results are
completed, a follow up information collection will be conducted in a
sub-sample of the surveyed communities (at most 40), with the goal of
deepening understanding of (i) how and why the community factors that
appear to influence recruitment and retention of health care providers
(as will be identified by the telephone survey) are able to do so, and
(ii) how development of the health care sector contributes to broader
economic development in rural communities. This second phase will use
more qualitative methods, including in depth individual and focus group
interviews, and will be completed in 2013. This notice focuses on the
telephone survey; another notice will be provided before the second
phase begins.
Authority: These data will be collected under the authority of
7 U.S.C. 2204(a) and sec. 501 of the Rural Development Act of 1972
(7 U.S.C. 2661). Individually identifiable data collected under this
authority are governed by 7 U.S.C. 2276, which requires USDA to
afford strict confidentiality to non-aggregated data provided by
respondents. This Notice is submitted in accordance with the
Paperwork Reduction Act of 1995, Pub. L. 104-13 (44 U.S.C. 3501, et
seq.) and Office of Management and Budget regulations at 5 CFR part
1320. ERS also complies with OMB Implementation Guidance,
``Implementation Guidance for Title V of the E-Government Act,
Confidential Information Protection and Statistical Efficiency Act
of 2002 (CIPSEA)'', 72 FR 33362, June 15, 2007.
Affected Public: Respondents will include health care providers,
local government and community leaders, and other stakeholders involved
in recruiting and retaining health care providers in rural communities.
Estimated Number of Respondents and Respondent Burden: The
telephone survey will be completed at one point in time within a six
month period in 2012. The survey will have a complex mixed survey
administration to include telephone screening, pre-notification letter
with Web access, multi-contact telephone interviewing, and follow-up
non-respondent mail questionnaires. The time required for respondents
and non-respondents to read the notification materials, review
instructions, participate in the screening interview, and decide
whether to complete the questionnaire is estimated to average 15
minutes per person. Completion time for each questionnaire respondent
is estimated to average 20 minutes per completed questionnaire. In
addition, the screening interviews used to select
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the sample will involve telephone conversations with knowledgeable
people in each community. We estimate that this may require 15 minute
interviews with up to 8 people per community, or a maximum burden of 2
hours per sample community.
Full Study: The maximum sample size for the full study is 2,812
respondents (15 respondents maximum per community x 150 communities/80%
response rate). The expected overall response rate is 80 percent. The
maximum total estimated response burden for all of those participating
in the study is 1,313 hours (2,250 respondents x 35 minutes per
respondent \1\) and for the non-respondents is 141 hours (562 non-
respondents x 15 minutes per non-respondent \2\). In addition, we
estimate a maximum burden of 300 hours on non-sample interviewees
contacted during the pre-sample screening process for the full study
(150 communities x 8 interviewees/community x 15 minutes per
interviewee).
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\1\ The 35 minutes per respondent includes 15 minutes to review
the materials, participate in the screening interview, and decide
whether to participate, and 20 minutes to complete the
questionnaire.
\2\ The 15 minutes per non-respondent is to review the
materials, participate in the screening interview, and decide
whether to participate.
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Pilot Study: A pilot test of the survey will be done in advance of
the full survey. The purpose of the pilot is to evaluate the survey
protocol, and test instruments and questionnaires. The initial sample
size for this phase of the research is 100 respondents (10 respondents
per community x 10 communities). The expected response rate is 80
percent. The total estimated burden for full respondents in the pilot
testing is 47 hours (100 respondents x 80 percent x 35 minutes per
respondent), and for non-respondents is 5 hours (100 respondents x 20
percent x 15 minutes per non-respondent). In addition, we estimate a
maximum burden of 20 hours on non-sample interviewees contacted during
the pre-sample screening process for the pilot study (10 communities x
8 interviewees/community x 15 minutes per interviewee).
The total respondent burden, including the pilot and full study, is
estimated at 1,826 hours (see table below).
Table--Estimated Respondent Burden for the Survey on Rural Community
Wealth and Health Care Provision
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Item Pilot study Full study Total
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Sample size................... 100 2,812 2,912
Responses
--Number.................. 80 2,250 2,330
--Minutes/response........ 35 35
--Burden hours............ 47 1,313 1,360
Non-responses
--Number.................. 20 562 582
--Minutes/response........ 15 15
--Burden hours............ 5 141 146
Pre-sample screening
interviews
--Number.................. 80 1,200 1,280
--Minutes/interview....... 15 15
--Burden hours............ 20 300 320
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Total burden hours........ 72 1,754 1,826
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Dated: August 31, 2011.
Laurian Unnevehr,
Acting Administrator, Economic Research Service.
[FR Doc. 2011-23158 Filed 9-9-11; 8:45 am]
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