Agency Information Collection Activities; Submission for OMB Review; Public Comment Request; Chronic Disease Self-Management Education Program; OMB# 0985-0036
| Citation | 84 FR 56813 |
| Record Number | 2019-23121 |
| Published date | 23 October 2019 |
| Section | Notices |
| Court | Community Living Administration |
Federal Register, Volume 84 Issue 205 (Wednesday, October 23, 2019)
[Federal Register Volume 84, Number 205 (Wednesday, October 23, 2019)]
[Notices]
[Pages 56813-56816]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2019-23121]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Community Living
Agency Information Collection Activities; Submission for OMB
Review; Public Comment Request; Chronic Disease Self-Management
Education Program; OMB# 0985-0036
AGENCY: Administration for Community Living (ACL), HHS.
ACTION: Notice.
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SUMMARY: The Administration for Community Living is announcing that the
proposed collection of information listed above has been submitted to
the Office of Management and Budget (OMB) for review and clearance as
required under the Paperwork Reduction Act of 1995. This 30-Day notice
collects comments on the information collection requirements related to
ACL's Chronic Disease Self-Management Education grant program (Proposed
Extension with Changes of a Currently Approved Collection [ICR Rev]).
DATES: Submit written comments on the collection of information by
November 22, 2019.
ADDRESSES: Submit written comments on the collection of information by:
(a) Email to: [email protected], Attn: OMB Desk Officer
for ACL;
(b) Fax to 202.395.5806, Attn: OMB Desk Officer for ACL; or
(c) By mail to the Office of Information and Regulatory Affairs,
OMB, New Executive Office Bldg., 725 17th St. NW, Rm. 10235,
Washington, DC 20503, Attn: OMB Desk Officer for ACL.
FOR FURTHER INFORMATION CONTACT: Kristie Kulinski
([email protected]) or (202) 795-7379.
SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, ACL has
submitted the following proposed collection of information to OMB for
review and clearance. The ``Empowering Older Adults and Adults with
Disabilities through Chronic Disease Self-Management Education (CDSME)
Programs'' cooperative agreement program has been financed through the
Prevention and Public Health Fund (PPHF). The statutory authority for
cooperative agreements under the most recent program announcement (FY
2019) is contained in the Department of Defense and Labor, Health and
Human Services, and Education Appropriations Act, 2019 and Continuing
Appropriations Act, 2019, Public Law 115-245; Public Health Service
Act, 42 U.S.C. 300u-2 (Community Programs) and 300u-3 (Information
Programs); and the Patient Protection and Affordable Care Act, 42
U.S.C. 300u-11 (Prevention and Public Health Fund). The Empowering
Older Adults and Adults with Disabilities through CDSME Programs
initiative supports a national resource center and awards competitive
grants to deliver and sustain evidence-based CDSME interventions.
OMB approval of the existing set of data collection tools expires
on October 31, 2019 (OMB Control Number 0985-0036). This data
collection continues to be necessary for monitoring program operations
and outcomes. ACL proposes to use the following tools: (1) Semi-annual
program reports to monitor grantee progress; and (2) a set of tools
used to collect information at each program completed by the program
facilitators (Program Information Cover Sheet and Attendance Log) and a
Participant Information Survey completed by each participant to
document their demographic and health characteristics. ACL is not
requesting renewal of Host/Implementation Organization Information
Form. ACL intends to continue using an online data entry system for the
program and participant survey data. In addition to non-substantive
formatting edits, minor changes are being proposed to two of the four
currently approved tools, as indicated below. All changes proposed are
based on feedback from a focus group that included a sub-set of current
grantees, as well as consultation with subject matter experts.
Comments in Response to the 60-Day Federal Register Notice
A notice was published in the Federal Register on July 9, 2019
(Vol. 84, Number 131; pp. 32746-32747). Thirteen emails were received
with comments. Based on the comments, some minor modifications were
made to the proposed survey instruments.
In addition to the public comments, feedback on the current forms
was sought from the following:
[[Page 56814]]
ACL Performance and Evaluation subject matter experts
National Chronic Disease Self-Management Education
Resource Center
One grantee focus group (fewer than nine participants)
Based on this collective feedback, the following modifications to
the currently approved forms are being proposed:
Participant Information Survey
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Topic/issue Comment ACL response
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Participant ID........................ More than one respondent Compared to previous versions, the
indicated that the unique Participant ID is now to be completed
identifier is cumbersome and by onsite staff and/or program leaders.
presents an opportunity for The National CDSME Resource Center will
mistakes due to its length. be providing training and technical
Also a comment that the assistance on the best strategies for
change may make it difficult documenting the Participant ID. The
to evaluate at the individual change is primarily driven by increased
level across years. attention to the application of the
highest standards for safeguarding data
collected by our grantees. After
extensive review of evidence-based
program data collection processes, ACL
and the Resource Center are working to
elevate standards to ensure the privacy
and security of all data collected from
participants. As such, the use of the
existing Participant ID, which includes
components of the participants' names
and year of birth, could potentially
provide clues into the person's
identity, especially if coupled with
other demographic data.
Provider Referral..................... Specific to Question #1 (Did ACL will incorporate this suggested
your health care provider revision.
suggest that you take this
program?), replace the word
``take'' with ``attend.''
Sex/Gender............................ More than one respondent As a federal agency, ACL references the
suggested the incorporation American Community Survey (implemented
of a non-binary response by the Census Bureau) as a benchmark
option, in addition to male/ for demographic questions. To remain
female. consistent with the U.S. Census/
American Community Survey, ACL will
continue to use male/female response
options.
Suggestion to delineate either This wording has been used for the past
sex or gender (question 6 years without issue and preserves
currently reads, ``Are you . data collection continuity.
. . male/female?'')
LGBTQ Identification.................. Suggestion to incorporate a As noted previously, ACL works to align
question to allow individuals our data collection with what is
to self-identify their sexual collected by the U.S. Census around
orientation. demographic information. Census does
not currently collect information on
sexual orientation.
Chronic Conditions List............... Suggestion to add HIV to Collection of HIV/AIDS data requires
chronic conditions list. additional special care in the
collection and sharing of this data
because persons with HIV/AIDS can face
discrimination. In some states, added
protections require providers to
request additional permission from the
patient to share information related to
HIV/AIDS status.
HIV/AIDS has not been asked in prior
iterations of this survey. Centers for
Medicare & Medicaid Services (CMS) data
from 2017 shows that across all
beneficiaries (age 65+), HIV/AIDS
accounted for .1% of cases nationally.
The goal is not to capture an
exhaustive list of chronic conditions;
rather, the most common based the
public data and the experience of
current/prior grantees. This question
also allows participants to select
`Other' (without an open-ended
response).
Social Isolation Multiple comments received, as
detailed below:
Truncate Question #16 (How The item stems from validated tools in
often do you feel lonely or the National Institutes of Health's
isolated from those around PROMIS item bank (v2.0)--Social
you?) to remove ``from those Isolation. The original version is
around you'' at end. written in the first person. Loneliness
was added to improve literacy (reduce
grade level)
Question #16 (and It is also an adaptation from the UCLA
corresponding post-test Loneliness Scale (v3, #14). ``How often
Question #3) adds to the do you feel isolated from others?''
survey length and may (Never to Always), which has been
perceived by some as extensively used for decades (Russell,
intrusive. Additionally, 1996). It continues to be validated
wording may be off-putting with older adults (Ausin et al, 2019;
for participants who are Domenech-Abella, et al, 2017).
expecting a positive,
strengths-based experience.
Specific to post-test Question The item has also been used successfully
#3, comment that item is not by CMS in social screening efforts
likely to show change from (Accountable Health Communities Health-
pre- to post-, especially Related Social Needs Screening), as
given the negative direction. well as Kaiser Permanente.
Suggestion to ask at post-
test only and frame as
``After taking this class,
how much more connected to
others do you feel?'' or
something similar.
[[Page 56815]]
Comment that a single social ACL appreciates the suggestion to
isolation question may not collect more data but has decided in
provide useful information. the interest of balancing data
Suggestion to include sub- collection and burden to not include
questions specific to additional elements on the survey.
companionship, worry about
being alone, shared interests
and ideas, and participation
in social clubs or religious
groups.
Chronic Conditions Language........... Suggestion to replace ACL appreciates that ``ongoing'' may be
``chronic'' health considered synonymous with ``chronic'';
condition(s) with ``ongoing'' however, we will continue to use the
health condition(s). term chronic, as this is the vernacular
generally used within the U.S.
Department of Health and Human Services
(e.g., Centers for Disease Control and
Prevention, Centers for Medicare &
Medicaid Services, etc.).
For Whom Attending Program............ Comment that Question #12 (For ACL agrees with this comment; we will
whom are you attending this remove the question from the survey.
program?) lengthens the
questionnaire without
substantial benefit (purpose
is unclear).
Disability Status..................... Proposed revision to Question The six-item set of questions used in
#15 includes three sub-parts the American Community Survey (ACS) are
to independently assess the minimum standard for disability
various facets of disability survey questions. Questions and answers
status; the current version in this set cannot be changed. The six
combines all three parts into questions define disability from a
a single item. Suggestion to functional perspective and are
keep question as is (single collectively a meaningful measure of
item). disability for data collection and
reporting.
A comment was received that Edits initially proposed by ACL utilize
suggested using the Behavior five of the six BRFSS questions
Risk Factor Surveillance specific to disability status (hearing,
System (BRFSS) questions to vision, mobility, self-care, and
assess disability. independent living). ACL will add the
question related to cognition (Because
of a physical, mental, or emotional
condition, do you have difficulty
concentrating, remembering, or making
decisions?).
Confidence Managing Chronic Conditions Suggestion to revise wording ACL appreciates this comment and
in Question #17 (How proposes revising the language to read,
confident are you that you ``How sure are you that you can manage
can manage your chronic your condition so you can do the things
conditions?) to reference you need and want to do?'' to be
both physical and emotional inclusive of both physical and
concerns. emotional health concerns.
Positive comment received
regarding inclusion of
question at post-test
(Question #2) to assist with
evaluating change over time.
Health Status......................... Specific to post-test Question ACL is interested in utilizing this
#1 (In general, would you say question to assess changes in self-
that your health is), comment rated health at pre/post intervention.
that this question seems If changes are not detected, we will
unnecessary unless the consider removal of this item during
underlying assumption is that the next data collection renewal.
CDSME changes self-perceived
health.
Positive comment received
regarding inclusion of self-
rated health at post-test
(Question #1) to assist with
evaluating change over time.
Satisfaction Question................. Request to add satisfaction A satisfaction question has not been
question back into the post- part of the required data collection
survey. elements, though some grantees choose
to collect this information
voluntarily.
Additional Questions.................. Suggestion to incorporate ACL appreciates the suggestion to
questions specific to: Formal collect more data but has decided in
referral by physician, the interest of balancing data
weight, exercise, collection and burden to not include
medications, and health care additional elements on the survey.
utilization.
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Program Information Cover Sheet
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Topic/issue Comment ACL response
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Funding Source........................ Specific to Question #7, ACL suggests that local program
program facilitators may not coordinators complete this question
know the funding source prior to submitting form for data
(determined by other program entry.
staff).
Another comment was received ACL will incorporate this revision.
suggesting that ACL clarify
that the intent of question
is to capture direct sources
of funding support (vs.
indirect/global support).
Another comment was received ACL will work with the National CDSME
that it would be helpful to Resource Center to develop a brief
have a description of funding overview of the various funding sources
sources. listed. Grantee can distribute this
information to their partners.
[[Page 56816]]
National Resource Center and National Suggestion to use a term other ACL awarded a five-year cooperative
Database Language. than ``chronic disease'', as agreement in 2016 that specifically
there are many programs in designates a National Chronic Disease
the menu of health promotion Self-Management Education (CDSME)
programs. Resource Center. This resource center
houses the National CDSME Database. ACL
may consider modifying the name of the
National CDSME Resource Center if/when
it is re-competed in 2021; however,
such a change is not appropriate at
this time.
Consent to Receive Information from A comment was received that Requesting this consent through a
National CDSME Resources Center. the addition of this question standard data collection form is the
seems unnecessary to have as most direct manner ACL can use to
a standard question, since it ensure that program facilitators can
should only be asked once of opt in to receiving technical
each leader. A suggestion was assistance communications from our
made to ask this question at National CDSME Resource Center. ACL is
leader trainings instead. unable to require grantees to share
information collected via facilitator
trainings.
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Attendance Log
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Topic/issue Comment ACL response
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Format................................ Suggestion to modify format Participant signatures are not required
from portrait to landscape to by ACL with respect to this data
accommodate participant collection effort (and ACL does not
signature. retain the names of CDSME
participants). If other partners/
funders require participant signature,
grantee should modify the format
accordingly.
Program Name.......................... Suggestion to add program name The very top of the form has an editable
to form. field (Your Program Name) that can be
customized by the grantee.
Participant Phone/Email Address....... Suggestion to collect ACL does not collect any personally
participant phone number and identifiable information from
email address for participants. Grantees can
facilitators to use for independently request this information
reminder follow-up. from participants as needed for
programmatic reminders.
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The proposed data collection forms may be found on the ACL website
at https://www.acl.gov/about-acl/public-input.
Estimated Program Burden: ACL estimates the burden of this
collection of information as follows:
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Number of Responses per Hours per Annual burden
Respondent/data collection activity respondents respondent response hours
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Program facilitators (Program 1,350 Once per program........ .33 445.5
Information Cover Sheet, Attendance
Log).
Program participants (Participant 13,500 1....................... .20 2,700
Information Survey).
Data entry staff (Program Information 65 Once per program times .17 229.5
Cover Sheet, Attendance Log, 1,350 programs.
Participant Information Survey).
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Total............................. .............. ........................ .............. 3,375
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Dated: October 16, 2019.
Mary Lazare,
Principal Deputy Administrator.
[FR Doc. 2019-23121 Filed 10-22-19; 8:45 am]
BILLING CODE 4154-01-P
