View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0985-0022
ICR Reference No:
201612-0985-004
Status:
Historical Active
Previous ICR Reference No:
201309-0985-001
Agency/Subagency:
HHS/ACL
Agency Tracking No:
20468
Title:
Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
06/22/2017
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/30/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2020
36 Months From Approved
06/30/2017
Responses
228
0
94
Time Burden (Hours)
983
0
1,410
Cost Burden (Dollars)
0
0
0
Abstract:
The Alzheimer's Disease Supportive Services Program (ADSSP) was established under Section 398 of the Public Health Service Act (P.L. 78-410; 42 U.S.C. 280c-3). It was amended by the Home Health Care and Alzheimer's Disease Amendments of 1990 (PL 101-557) and by the Health Professions Education Partnerships Act of 1998 (PL 105-392). The ADSSP is administered by the Administration on Aging (AoA) within the U.S. Department of Health and Human Services. The ADSSP program helps states extend supports and services to persons with dementia and their family caregivers, with a focus on underserved populations. The PHS Act requires AoA to "provide for an evaluation of each demonstration project for which a grant is made." In compliance with the PHS Act, AoA developed a new State data collection protocol that will require future ADSSP state grantees (those funded starting in FY 2011) to transmit semi-annual data to AoA. In December 2009, AoA initiated a review of the current ADSSP-Data Reporting Tool (ADSSP-DRT) to ensure the acceptability of these items for evaluating the program and minimizing burden for respondents. This review included experts in the field of Alzheimer's disease and long-term care who are familiar with the program, as well as current ADSSP grantees. Feedback was provided by phone and e-mail over a period of 4 months. The result of this input is the revised ADSSP-DRT and supporting documents. As with the current ADSSP-DRT, AoA will work with ADSSP grantees to ensure easy access to a reporting system and offer regular training in using the tool to ensure minimal burden for program grantees.
Authorizing Statute(s):
PL:
Pub.L. 101 - 557 398 399 399A
Name of Law: Home Health Care and Alzheimer's Disease Amendment of 1990
PL:
Pub.L. 78 - 410 398
Name of Law: Public Health Service Act
PL:
Pub.L. 105 - 392 302
Name of Law: Health Professions Education Partnerships Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
81 FR 57591
08/23/2016
30-day Notice:
Federal Register Citation:
Citation Date:
81 FR 96002
12/29/2016
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection
1
Proposed Alzheimer Disease Prevention Reporting Tool
ICR Summary of Burden
Total Approved
Previously Approved
Change Due to New Statute
Change Due to Agency Discretion
Change Due to Adjustment in Estimate
Change Due to Potential Violation of the PRA
Annual Number of Responses
228
94
0
134
0
0
Annual Time Burden (Hours)
983
1,410
0
-427
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The annual reporting burden hour estimates have decreased from 1176 hours to 983.44. The following reasons account for the change in burden hour estimates: • Although, for data set approved in 2013, it was anticipated that grantee respondents would spend 39 hours reporting annually, the actual number of hours spent (local and state combined), as reported by the current ADSSP and ADI grantees consulted, was 16.54 hours annually per grant • The 39 hours annual burden hour estimate from 2013 was an over-estimate because data provided from grantees were based on the 2010 version. Several items included in the 2010 tool were not included in the 2013 revised tool. The 2016 revision includes fewer items than the 2013 revision. The following reasons account for the change in burden cost estimates: • The new estimates are for 38 grants, rather than the 30 grants from the previous ADSSP-DRT approval. • The pay rates for both local and grantee staff increased between 2013 and 2016. • The annualized cost to the government decreased due to decreased contractor costs through the elimination of maintenance for a data collection web platform.
Annual Cost to Federal Government:
$22,288
Does this IC contain surveys, censuses, or employ statistical methods?
No
Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002?
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Mark Snyderman 202 795-7439
Common Form ICR:
No
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:
(a) It is necessary for the proper performance of agency functions;
(b) It avoids unnecessary duplication;
(c) It reduces burden on small entities;
(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
(f) It indicates the retention periods for recordkeeping requirements;
(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
(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;
(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
(i) It uses effective and efficient statistical survey methodology (if applicable); and
(j) It makes appropriate use of information technology.
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.
Certification Date:
12/30/2016
Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.