[Federal Register Volume 64, Number 114 (Tuesday, June 15, 1999)]
[Notices]
[Pages 32060-32061]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-15086]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Indian Health Service


Request for Public Comment: 30-Day Proposed Collection: Indian 
Health Service Medical Staff Credentials and Privileges Files

SUMMARY: In compliance with section 3506(c)(2)(A) of the Paperwork 
Reduction Act of 1995, the Indian Health Service (IHS) provided an 
opportunity for public comment on the proposed agency information 
collection project. A notice was previously published in the Federal 
Register on May 1, 1998, (63 FR 24185) and allowed 60 days for public 
comment. No public comment was received in response to the notice. 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 purpose of this notice is to allow 
an additional 30 days for public comment to be submitted directly to 
OMB.

Proposed Collection

    Title: 0917-0009, ``Indian Health Service Medical Staff Credentials 
and Privileges Files''. Type of Information Collection Request: 
Reinstatement, with minor change, of a previously approved information 
collection for which approval expired October 31, 1998. Form Number: 
Instruction and information collection formats are contained in an IHS 
Circular, ``Credentials and Privileges Review Process for the Medical 
Staff.'' Need and Use of Information Collection: The IHS operates 
health care facilities 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, and audiologists; and in some 
States, physician assistants, certified registered nurse anesthetists, 
nurse practitioners, and certified nurse midwives. The 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 the IHS, (2) contract health care 
providers who do 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 or medical malpractice payments 
made on their behalf based on clinical services they performed. 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 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 no 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 speciality.
    The medical staff credentials and privileges records are maintained 
at the heatlh 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 IHS health care facilities. Affected Pubic: Individuals, 
businesses or other for-profit, not-for-profit institutions, and State, 
local or tribal governments. Type of Respondents: Health care providers 
requesting Medical staff privileges at IHS health facilities.

[[Page 32061]]

    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.

                                                                         Table 1
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                                                 Estimated
         Data collection instrument              number of     Responses per   Annual number      Average burden hour per response *       Total annual
                                                respondents     respondent     of responses                                                burden hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
Application to Medical Staff................             600               1             600  0.75 (45 mins)............................           450.0
Reference letter............................            1800               1            1800  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
Optometic Privileges........................              21               1              21  0.33 (20 mins)............................             6.9
Psychology Privileges.......................              23               1              23  0.17 (10 mins)............................             3.9
Audiologic 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)............................            1.01
                                             -----------------------------------------------------------------------------------------------------------
    Total...................................           3,709  ..............           3,709  ..........................................         2,221.0
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* For ease of understanding, burden hours are also provided in actual minutes.

    There are no capital costs, operating costs or maintenance costs to 
report.

Request for Comments

    Your written comments and/or suggestions are invited on one or more 
of the following points: (1) Whether the information collection 
activity is necessary to carry out an agency function; (2) whether the 
IHS processes the information collected in a useful and timely fashion; 
(3) the accuracy of the public burden estimate (this is the amount of 
time needed for individual respondents to provide the requested 
information); (4) whether the methodology and assumptions used to 
determine the estimate are logical; (5) ways to enhance the quality, 
utility, and clarity of the information being collected; and (6) 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 suggestions 
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, D.C. 20503, Attention: Desk Officer for IHS.
    To request more information on the proposed collection or to obtain 
a copy of the data collection instrument(s) and/or instruction(s), 
contact: Mr. Lance Hodahkwen, Sr., M.P.H., IHS Reports Clearance 
Officer, 12300 Twinbrook Parkway, Suite 450, Rockville, MD 20852-1601; 
call non-toll free (301) 443-5938 or send via fax to (301) 443-1522; or 
send your e-mail requests, comments, and return address to: 
[email protected].
    Comment Due Date: Comments regarding this information collection 
are best assured of having their full effect if received on or before 
August 16, 1999.

    Dated: June 7, 1999.
Michael H. Trujillo,
Assistant Surgeon General, Director.
[FR Doc. 99-15086 Filed 6-14-99; 8:45 am]
BILLING CODE 4160-16-M