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:
0985-0036
ICR Reference No:
202211-0985-001
Status:
Active
Previous ICR Reference No:
201908-0985-003
Agency/Subagency:
HHS/ACL
Agency Tracking No:
Title:
Chronic Disease Self-Management Education Program
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
01/03/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/01/2022
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
01/31/2026
36 Months From Approved
12/31/2022
Responses
14,750
0
14,915
Time Burden (Hours)
3,534
0
3,375
Cost Burden (Dollars)
0
0
0
Abstract:
The Administration on Aging (AoA), part of the Administration for Community Living (ACL), will use the proposed set of data collection tools to monitor grantees receiving “Empowering Older Adults and Adults with Disabilities through Chronic Disease Self-Management Education (CDSME)” cooperative agreements.
Authorizing Statute(s):
US Code:
42 USC 301
Name of Law: Public Health Services Act
PL:
Pub.L. 109 - 365 202
Name of Law: functions of the Assistant Secretary for Aging
PL:
Pub.L. 111 - 148 4002
Name of Law: Prevention and Public Health Fund
US Code:
42 USC 1701(a)(3)(A-B), (a)(4)
Name of Law: Public Health Services Act
US Code:
42 USC 1703(a)(4)
Name of Law: Public Health Services Act
US Code:
42 USC 300u-11
Name of Law: Patient Protection and 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:
87 FR 43041
07/19/2022
30-day Notice:
Federal Register Citation:
Citation Date:
87 FR 72488
11/25/2022
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
1
IC Title
Form No.
Form Name
Chronic Disease Self-Management Education Program
N/A, N/A, N/A
Attendance Log
,
Program Information Cover Sheet
,
CDSME Participant Information 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
14,750
14,915
0
-165
0
0
Annual Time Burden (Hours)
3,534
3,375
0
159
0
0
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:
No
Burden Reduction Due to:
Short Statement:
There is a program change increase of 159 annual burden hours and a decrease of -165 respondents. 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 were made to the program information cover sheet and participant information survey. 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. Changes to the collection activities include: • Program Information Cover Sheet: 1. Question #2: Added consent on behalf of the program facilitators to receive program updates/information from the National CDSME Resource Center. 2. Question #5: Additional evidence-based CDSME programs added to the list (reflective of approved programs included in the FY2019 Funding Opportunity Announcement). 3. Question #7: Information regarding funding source(s) requested to assess progress toward developing a sustainable program delivery infrastructure that is not solely reliant on ACL discretionary dollars. • Participant Information Survey: 1. Participant I.D. modified to reduce risk of personally identifiable information exposure. 2. Question #10: Added question regarding veteran status to further describe program participants, as well as to assist with partnerships with veteran-serving organizations. 3. Question #14: Anxiety Disorder and Depression are listed separately (vs. being combined). Also included Yes/No response options for each chronic condition listed to improve data analyses and reporting. 4. Question #15: Response options have been delineated as sub-bullets (vs. being grouped into a single item) to align with the American Community Survey. 5. Question #16: Added question regarding social isolation, a construct that has been demonstrated to have an association with health-related risks for older adults. This question will also be asked upon completion of the last program session. 6. Question #17: This question will be asked at baseline and upon completion of the last program session to measure change.
Annual Cost to Federal Government:
$249,299
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?
No
Agency Contact:
Tomakie Washington 202 795-7336 tomakie.washington@acl.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:
12/01/2022
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