This is a request for an extension without a revision of a previously approved collection which is due to expire April 30, 2016. This collection of information is made necessary by the Department of Health and Human Services Rule entitled Standards for Privacy of Individually Identifiable Health Information (A Privacy Rule) (45 CFR Parts 160 and 164). The Privacy Rule implements the privacy requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996 and creates national standards that protect patient health information and gives our patients access to their health information.
PL:
Pub.L. 104 - 191 264
Name of Law: Health Insurance Portability and Accountability Act
There are no program changes or adjustments. There was a change in IHS-810 Form to include an option for the respondents to release information to Health Information Exchanges. This change is due to the technology solution to share patient information electronically in order to meet Meaningful Use Stage 2 with the IHSâs certified electronic health record, as required by 42 C.F.R. Parts 412, 413, and 495.
The program also made a discretionary change in the burden hours; decreasing the burden hours on two forms, the IHS-810 and IHS-917, from 20 minutes to 10 minutes to more accurately reflect the actual time it takes to complete the form(s). Additionally, the number of respondents were decreased for all five forms to reflect actual baseline numbers collected and provided by the Area Health Information Managers (HIMs). Also, in the table under 12B., âestimated annual costs to respondents for this collection,â the hourly wage rate for respondents was changed from $19 per hour to $17 per hour to more accurately reflect the actual wages of American Indians and Alaska Natives (AIAN). The average annual income of American Indians was $36,252 and the poverty rate was 29%, in 2014 (United States Census Bureau, 2015) (See US Census webpage, âFacts for Features: American Indian and Alaska Native Heritage Month: November 2014â at http://www.census.gov/newsroom/facts-for-features/2014/cb14-ff26.html). Further, the average annual income for AIANs may even be lower as the United States Bureau of Labor Statistics (BLS) reported a 54% population-employment ratio for AIANs, with an 11.3% average unemployment rate. (See BLS report âLabor Force Statistics by Race and Ethnicity, 2014â at http://www.bls.gov/opub/reports/cps/labor-force-characteristics-by-race-and-ethnicity-2014.pdf).
On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control number;
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Form IHS 810 IHS-810, Authorization for Use or Disclosure of Protected Health Information
FINAL OMB_No _0917-0030_Supporting_Statement_Final TClay 3-22-2016_OMBcomments.docx
IHS Privacy Act system notice 09 17 0001, IHS Medical, Health and Billing Records.pdf
IHS-810, Authorization for Use or Disclosure of Protected Health Information