Agency Information Collection Activities; Submission for OMB Review; Public Comment Request; Chronic Disease Self-Management Education Program; OMB# 0985-0036, 56813-56816 [2019-23121]
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Federal Register / Vol. 84, No. 205 / Wednesday, October 23, 2019 / Notices
detailed information can be found in
each collection’s supporting statement
and associated materials (see
ADDRESSES).
CMS–10463 Cooperative Agreement
To Support Navigators in FederallyFacilitated Exchanges
Under the PRA (44 U.S.C. 3501–
3520), federal agencies must obtain
approval from the Office of Management
and Budget (OMB) for each collection of
information they conduct or sponsor.
The term ‘‘collection of information’’ is
defined in 44 U.S.C. 3502(3) and 5 CFR
1320.3(c) and includes agency requests
or requirements that members of the
public submit reports, keep records, or
provide information to a third party.
Section 3506(c)(2)(A) of the PRA
requires federal agencies to publish a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each proposed
extension or reinstatement of an existing
collection of information, before
submitting the collection to OMB for
approval. To comply with this
requirement, CMS is publishing this
notice.
Information Collection
1. Type of Information Collection
Request: Revision of a currently
approved collection; Title of
Information Collection: Cooperative
Agreement to Support Navigators in
Federally-facilitated Exchanges; Use:
Section 1311(i) of the PPACA requires
Exchanges to establish a Navigator grant
program under which it awards grants
to eligible individuals and entities (as
described in Section 1311(i)(2) of the
PPACA and 45 CFR 155.210(a) and (c))
applying to serve consumers in States
with a FFE. Navigators assist consumers
by providing education about and
facilitating selection of qualified health
plans (QHPs) within the Exchanges, as
well as other required duties. Entities
and individuals cannot serve as
federally certified Navigators and carry
out the required duties without
receiving federal cooperative agreement
funding.
As a condition of award, Navigator
awardees must agree to cooperate with
any Federal evaluation of the program
and must provide required weekly,
monthly, quarterly, annual, and final (at
the end of the cooperative agreement
period) reports in a form prescribed by
CMS, as well as any additional reports
as required. Form Number: CMS–10463
(OMB control number: 0938–1215);
Frequency: Annually, Monthly,
Quarterly, Weekly; Affected Public:
Private sector; Number of Respondents:
50; Total Annual Responses: 50; Total
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Annual Hours: 20,850. (For questions
regarding this collection contact Gian
Johnson at 301–492–4323.)
Dated: October 17, 2019.
William N. Parham, III,
Director, Paperwork Reduction Staff, Office
of Strategic Operations and Regulatory
Affairs.
[FR Doc. 2019–23075 Filed 10–22–19; 8:45 am]
BILLING CODE 4120–01–P
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
Administration for Community
Living (ACL), HHS.
ACTION: Notice.
AGENCY:
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 SelfManagement Education grant program
(Proposed Extension with Changes of a
Currently Approved Collection [ICR
Rev]).
SUMMARY:
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: OIRA_submission@
omb.eop.gov, 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 (kristie.kulinski@
acl.hhs.gov) 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
DATES:
PO 00000
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56813
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) Semiannual 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:
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Federal Register / Vol. 84, No. 205 / Wednesday, October 23, 2019 / Notices
• ACL Performance and Evaluation
subject matter experts
• National Chronic Disease SelfManagement 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
Topic/issue
Comment
ACL response
Participant ID .................
More than one respondent indicated that the
unique identifier is cumbersome and presents an opportunity for mistakes due to its
length. Also a comment that the change
may make it difficult to evaluate at the individual level across years.
Provider Referral ...........
Specific to Question #1 (Did your health care
provider suggest that you take this program?), replace the word ‘‘take’’ with ‘‘attend.’’
More than one respondent suggested the incorporation of a non-binary response option, in addition to male/female.
Compared to previous versions, the Participant ID is now to be completed by onsite staff and/or program leaders. The National
CDSME Resource Center will be providing training and technical
assistance on the best strategies for documenting the Participant
ID. The change is primarily driven by increased 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.
ACL will incorporate this suggested revision.
Sex/Gender ...................
LGBTQ Identification .....
Chronic Conditions List
Social Isolation
VerDate Sep<11>2014
Suggestion to delineate either sex or gender
(question currently reads, ‘‘Are you . . .
male/female?’’)
Suggestion to incorporate a question to allow
individuals to self-identify their sexual orientation.
Suggestion to add HIV to chronic conditions
list.
Multiple comments received, as detailed
below:
Truncate Question #16 (How often do you
feel lonely or isolated from those around
you?) to remove ‘‘from those around you’’
at end.
Question #16 (and corresponding post-test
Question #3) adds to the survey length and
may perceived by some as intrusive. Additionally, wording may be off-putting for participants who are expecting a positive,
strengths-based experience.
Specific to post-test Question #3, comment
that item is not likely to show change from
pre- to post-, especially given the negative
direction. 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.
18:10 Oct 22, 2019
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As a federal agency, ACL references the American Community Survey (implemented by the Census Bureau) as a benchmark for demographic questions. To remain consistent with the U.S. Census/
American Community Survey, ACL will continue to use male/female response options.
This wording has been used for the past 6 years without issue and
preserves data collection continuity.
As noted previously, ACL works to align our data collection with what
is collected by the U.S. Census around demographic information.
Census does not currently collect information on sexual orientation.
Collection of HIV/AIDS data requires 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 openended response).
The item stems from validated tools in the National Institutes of
Health’s PROMIS item bank (v2.0)—Social Isolation. The original
version is written in the first person. Loneliness was added to improve literacy (reduce grade level)
It is also an adaptation from the UCLA Loneliness Scale (v3, #14).
‘‘How often do you feel isolated from others?’’ (Never to Always),
which has been extensively used for decades (Russell, 1996). It
continues to be validated with older adults (Ausin et al, 2019;
Domenech-Abella, et al, 2017).
The item has also been used successfully by CMS in social screening efforts (Accountable Health Communities Health-Related Social
Needs Screening), as well as Kaiser Permanente.
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56815
PARTICIPANT INFORMATION SURVEY—Continued
Topic/issue
Comment
ACL response
ACL appreciates the suggestion to collect more data but has decided
in the interest of balancing data collection and burden to not include additional elements on the survey.
Chronic Conditions Language.
Comment that a single social isolation question may not provide useful information.
Suggestion to include sub-questions specific to companionship, worry about being
alone, shared interests and ideas, and participation in social clubs or religious groups.
Suggestion to replace ‘‘chronic’’ health condition(s) with ‘‘ongoing’’ health condition(s).
For Whom Attending
Program.
Disability Status .............
Confidence Managing
Chronic Conditions.
Health Status .................
Satisfaction Question ....
Additional Questions .....
Comment that Question #12 (For whom are
you attending this program?) lengthens the
questionnaire without substantial benefit
(purpose is unclear).
Proposed revision to Question #15 includes
three sub-parts to independently assess
various facets of disability status; the current version combines all three parts into a
single item. Suggestion to keep question as
is (single item).
A comment was received that suggested
using the Behavior Risk Factor Surveillance
System (BRFSS) questions to assess disability.
Suggestion to revise wording in Question #17
(How confident are you that you can manage your chronic conditions?) to reference
both physical and emotional concerns.
Positive comment received regarding inclusion of question at post-test (Question #2)
to assist with evaluating change over time.
Specific to post-test Question #1 (In general,
would you say that your health is), comment that this question seems unnecessary
unless the underlying assumption is that
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.
Request to add satisfaction question back into
the post-survey.
Suggestion to incorporate questions specific
to: Formal referral by physician, weight, exercise, medications, and health care utilization.
ACL appreciates that ‘‘ongoing’’ may be considered synonymous with
‘‘chronic’’; however, we will continue to use the 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.).
ACL agrees with this comment; we will remove the question from the
survey.
The six-item set of questions used in the American Community Survey (ACS) are the minimum standard for disability survey questions. Questions and answers in this set cannot be changed. The
six questions define disability from a functional perspective and are
collectively a meaningful measure of disability for data collection
and reporting.
Edits initially proposed by ACL utilize five of the six BRFSS questions specific to disability status (hearing, vision, mobility, self-care,
and 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?).
ACL appreciates this comment and proposes revising the language
to read, ‘‘How sure are you that you can manage your condition so
you can do the things you need and want to do?’’ to be inclusive
of both physical and emotional health concerns.
ACL is interested in utilizing this question to assess changes in selfrated health at pre/post intervention. If changes are not detected,
we will consider removal of this item during the next data collection
renewal.
A satisfaction question has not been part of the required data collection elements, though some grantees choose to collect this information voluntarily.
ACL appreciates the suggestion to collect more data but has decided
in the interest of balancing data collection and burden to not include additional elements on the survey.
PROGRAM INFORMATION COVER SHEET
Topic/issue
Comment
ACL response
Funding Source .............
Specific to Question #7, program facilitators
may not know the funding source (determined by other program staff).
Another comment was received 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 that it would
be helpful to have a description of funding
sources.
ACL suggests that local program coordinators complete this question
prior to submitting form for data entry.
VerDate Sep<11>2014
18:10 Oct 22, 2019
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ACL will incorporate this revision.
ACL will work with the National CDSME Resource Center to develop
a brief overview of the various funding sources listed. Grantee can
distribute this information to their partners.
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Federal Register / Vol. 84, No. 205 / Wednesday, October 23, 2019 / Notices
PROGRAM INFORMATION COVER SHEET—Continued
Topic/issue
Comment
ACL response
National Resource Center and National Database Language.
Suggestion to use a term other than ‘‘chronic
disease’’, as there are many programs in
the menu of health promotion programs.
Consent to Receive Information from National CDSME Resources Center.
A comment was received that the addition of
this question seems unnecessary to have
as a standard question, since it should only
be asked once of each leader. A suggestion was made to ask this question at leader trainings instead.
ACL awarded a five-year cooperative agreement in 2016 that specifically designates a National Chronic Disease Self-Management
Education (CDSME) 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.
Requesting this consent through a standard data collection form is
the most direct manner ACL can use to ensure that program
facilitators can opt in to receiving technical assistance communications from our National CDSME Resource Center. ACL is unable
to require grantees to share information collected via facilitator
trainings.
ATTENDANCE LOG
Topic/issue
Comment
ACL response
Format ...........................
Suggestion to modify format from portrait to
landscape to accommodate participant signature.
Program Name ..............
Suggestion to add program name to form ......
Participant Phone/Email
Address.
Suggestion to collect participant phone number and email address for facilitators to use
for reminder follow-up.
Participant signatures are not required by ACL with respect to this
data collection effort (and ACL does not retain the names of
CDSME participants). If other partners/funders require participant
signature, grantee should modify the format accordingly.
The very top of the form has an editable field (Your Program Name)
that can be customized by the grantee.
ACL does not collect any personally identifiable information from participants. Grantees can independently request this information from
participants as needed for programmatic reminders.
The proposed data collection forms
may be found on the ACL website at
https://www.acl.gov/about-acl/publicinput.
Estimated Program Burden: ACL
estimates the burden of this collection
of information as follows:
Number of
respondents
Hours per
response
Respondent/data collection activity
Program facilitators (Program Information Cover Sheet, Attendance Log).
Program participants (Participant Information Survey) ...........
Data entry staff (Program Information Cover Sheet, Attendance Log, Participant Information Survey).
Total .................................................................................
Dated: October 16, 2019.
Mary Lazare,
Principal Deputy Administrator.
BILLING CODE 4154–01–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
National Institutes of Health
Clinical Center; Notice of Closed
Meeting
Pursuant to section 10(d) of the
Federal Advisory Committee Act, as
amended, notice is hereby given of a
meeting of the Board of Scientific
Counselors of the NIH Clinical Center.
The meeting will be closed to the
public as indicated below in accordance
18:10 Oct 22, 2019
Jkt 250001
Once per program .................
.33
445.5
13,500
65
1 .............................................
Once per program times
1,350 programs.
.20
.17
2,700
229.5
........................
................................................
........................
3,375
Name of Committee: Board of Scientific
Counselors of the NIH Clinical Center.
Date: October 28–29, 2019.
Time: 8:00 a.m. to 12:00 p.m.
Agenda: To review and evaluate grant
applications.
Place: National Institutes of Health, 10
Rockville Pike, Bethesda, MD 20892.
Contact Person: Ronald Neumann, MD,
Deputy Scientific Director, Office of Clinical
PO 00000
Frm 00062
Annual
burden hours
1,350
with the provisions set forth in sections
552b(c)(4) and 552b(c)(6), Title 5 U.S.C.,
as amended for the review, discussion,
and evaluation of individual grant
applications conducted by the
CLINICAL CENTER, including
consideration of personnel
qualifications and performance, and the
competence of individual investigators,
the disclosure of which would
constitute a clearly unwarranted
invasion of personal privacy.
[FR Doc. 2019–23121 Filed 10–22–19; 8:45 am]
VerDate Sep<11>2014
Responses per
respondent
Fmt 4703
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Research, NIH–Clinical Center, 10 Center
Drive, Room 1C453, Bethesda, MD 20892,
301–496–6455.
Any interested person may file
written comments with the committee
by forwarding the statement to the
Contact Person listed on this notice. The
statement should include the name,
address, telephone number and when
applicable, the business or professional
affiliation of the interested person.
This notice is being published less
than 15 days prior to the meeting due
to the timing limitations imposed by the
review and funding cycle.
Dated: October 17, 2019.
Ronald J. Livingston, Jr.,
Program Analyst, Office of Federal Advisory
Committee Policy.
[FR Doc. 2019–23042 Filed 10–22–19; 8:45 am]
BILLING CODE 4140–01–P
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]]>Agencies
[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.
-----------------------------------------------------------------------
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
----------------------------------------------------------------------------------------------------------------
Topic/issue Comment ACL response
----------------------------------------------------------------------------------------------------------------
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.
----------------------------------------------------------------------------------------------------------------
Program Information Cover Sheet
----------------------------------------------------------------------------------------------------------------
Topic/issue Comment ACL response
----------------------------------------------------------------------------------------------------------------
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.
----------------------------------------------------------------------------------------------------------------
Attendance Log
----------------------------------------------------------------------------------------------------------------
Topic/issue Comment ACL response
----------------------------------------------------------------------------------------------------------------
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.
----------------------------------------------------------------------------------------------------------------
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:
----------------------------------------------------------------------------------------------------------------
Number of Responses per Hours per Annual burden
Respondent/data collection activity respondents respondent response hours
----------------------------------------------------------------------------------------------------------------
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
----------------------------------------------------------------------------------------------------------------
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
