View Information Collection Request (ICR) Package
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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:
0938-1342
ICR Reference No:
202105-0938-002
Status:
Historical Active
Previous ICR Reference No:
201704-0938-003
Agency/Subagency:
HHS/CMS
Agency Tracking No:
OMH
Title:
Evaluating Coverage to Care in Communities (CMS-10632)
Type of Information Collection:
Reinstatement with change of a previously approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
09/01/2022
Retrieve Notice of Action (NOA)
Date Received in OIRA:
05/07/2021
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
09/30/2025
36 Months From Approved
Responses
460
0
0
Time Burden (Hours)
152
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
Achieving better health and reducing health care costs requires individuals to take an active role in their health care and utilize primary and preventive care services. CMS OMH launched C2C in June 2014 to address these needs. To accomplish these goals, C2C offers a variety of consumer-oriented health and health insurance educational materials that have various distribution channels, including print and digital. An evaluation was previously conducted under this OMB number assessing the reach and use of these materials. The current reinstatement proposal seeks to extend this work with a smaller survey of consumers (N=400) and partner organizations (N=60) to compare those who do and do not use C2C materials in three to four geographic areas where there is a high saturation of C2C materials, as well as the health impacts of using these materials.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 .
Name of Law: Affordable Care 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:
86 FR 12192
03/02/2021
30-day Notice:
Federal Register Citation:
Citation Date:
86 FR 24624
05/07/2021
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Case Study: Focus Group
CMS-10632
Case Study: Explanation of Consent, Short Survey, and Focus Group Facilitation Guide
Case Study: Semi-structured Interviews
CMS-10632
Appendix C - Case Study Explanation of Consent and Semi-Structured Interview
Consumer Survey
CMS-10632
Appendix B Consumer Survey: Informed Consent and Survey
Partner Survey
CMS-10632
Appendix A - Partner Survey: Informed Consent and Survey
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
460
0
0
436
-36
60
Annual Time Burden (Hours)
152
0
0
134
-36
54
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
The research activities proposed for reinstatement are a subset of, and similar to, the previously approved activities; however, the proposed activities are smaller in scope. The previously approved activities included two case studies (semi-structured interview and focus group), while the activities proposed for reinstatement only consist of the partner and consumer surveys. Also, a smaller number of survey participants are proposed for the partner (600 vs. 60) and consumer (2800 vs. 400) surveys. The average burden is 20 minutes for all surveys. Following from the proposed activities representing a smaller number of surveys and the same burden hours per survey, survey costs were much higher for the prior partner ($12,117.60 vs. $1001.29) and consumer ($35,610 vs. $4,262.28) surveys.
Annual Cost to Federal Government:
$87,714
Does this IC contain surveys, censuses, or employ statistical methods?
No
Does this ICR request any personally identifiable information (see
OMB Circular No. A-130
for an explanation of this term)? Please consult with your agency's privacy program when making this determination.
No
Does this ICR include a form that requires a Privacy Act Statement (see
5 U.S.C. §552a(e)(3)
)? Please consult with your agency's privacy program when making this determination.
No
Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]?
Yes
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?
Yes
Agency Contact:
Stephan McKenzie 410 786-1943 stephan.mckenzie@cms.hhs.gov
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:
05/07/2021
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