Every effort will be made to maximize the response rate, while retaining the voluntary nature of the effort. An advanced notice will be mailed prior to mailing the survey and will include a letter explaining what the survey is about, who is doing it and why, and providing contact information for questions. The second mailing and telephone followup are expected to result in significant increases in response. Every effort to maximize the response rate among Spanish speaking respondents will be made. A Spanish version of the advance notice, the questionnaire, cover letters, and the reminder card, as well as a Spanish version of the telephone transcript have been developed. The cover letters in English include a note in Spanish instructing respondents to call a toll free number if they would like to receive a copy of the survey in Spanish. In addition, participating field sites will ask for information on language preference and/or race/ethnicity of sample patients so that the mailing of the survey can be tailored for Spanishspeakers.

Finally, phone followup to respondents who do not complete the survey by mail will be conducted by bilingual interviewers so that those who want to complete the survey by telephone in either English or Spanish can be accommodated.

Surveys generally do not yield complete responses from every individual sampled from the population. In this analysis, patterns of both unit and item nonresponse will be examined and modeled, and the potential impact of nonresponse bias assessed. A common set of administrative variables (e.g., age, gender, race/ethnicity) will be used to predict unit nonresponse. These variables and others collected on the survey itself will be used as predictors of item nonresponse. Case mix adjustment and nonresponse weights will be used to more accurately reflect consumer experiences with health care in the field test hospitals. Multivariate logistic regression models will be used to analyze the factors associated with unit nonresponse and item nonresponse.

Estimated Annual Respondent Burden

Exhibit 1 shows the estimated annualized burden for the respondents' time to participate in this data collection. The CAHPS Hospital Survey Health Literacy Module will be completed by about 600 persons in total, or an annual average of 400 persons per year for the 18 months of the pretest. The estimated response time of 20 minutes is based on the written length of the survey and AHRQ's experience with previous CAHPS[supreg] surveys of comparable length that were fielded with similar samples. The total annualized burden hours are estimated to be 133 hours.

Exhibit 2 shows the respondents' cost burden associated with their time to participate in this data collection. The total annualized cost burden is estimated to be $2,601.
Exhibit 1Estimated Annualized Burden Hours Number of Form name Number of responses per Hours per Total burden respondents respondent response hours Mail survey with reminder card, mail and phone 400 1 20/60 133 followup mail and phone followup.............

Total....................................... 400 1 na 133 Exhibit 2Estimated Annualized Cost Burden Number of Total burden Average hourly Total cost Form name respondents hours wage rate* burden Mail survey with reminder card, mail and phone.. 400 133 $19.56 $2,601 followup.......................................

Total....................................... 400 133 na 2,601 * Based upon the average wages, ``National Compensation Survey: Occupational Wages in the United States, May 2007,'' U.S. Department of Labor, Bureau of Labor Statistics. Estimated Annual Costs to the Federal Government

The total cost for the contracted service is approximately $245,000 and the cost for AHRQ staff to oversee the project is $50,000, including benefits. The project was initiated in October of 2008 and it is forecasted that it will be completed in 18 months. It is estimated that the total cost of the project is approximately $295,000. The annualized cost of the project is approximately $196,669.
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Exhibit 3Estimated Cost
Annualized Cost component Total cost cost Review of literature.................... $20,000 $13,334 Cognitive interviews.................... 60,000 40,000 Field test.............................. 90,000 60,000 Data analyses........................... 40,000 26,667 Finalize survey......................... 35,000 23,334 AHRQ project management................. 50,000 33,334

Total............................... 295,000 196,669 Request for Comments

In accordance with the abovecited Paperwork Reduction Act legislation, comments on AHRQ's information collection are requested with regard to any of the following: (a) Whether the proposed collection of information is necessary for the proper performance of AHRQ health care research and health care information dissemination functions, including whether the information will have practical utility; (b) the accuracy of AHRQ's estimate of burden (including hours and costs) of the proposed collection(s) of information; (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 upon the respondents, including the use of automated collection techniques or other forms of information technology.

Comments submitted in response to this notice will be summarized and included in the Agency's subsequent request for OMB approval of the proposed information collection. All comments will become a matter of public record.

Dated: May 4, 2009.
Carolyn M. Clancy,
Director.
[FR Doc. E911012 Filed 51209; 8:45 am]
BILLING CODE 416090P

FOR FURTHER INFORMATION CONTACT

Doris Lefkowitz, AHRQ Reports Clearance Officer, (301) 4271477, or by email at
doris.lefkowitz@ahrq.hhs.gov.