[Federal Register Volume 68, Number 11 (Thursday, January 16, 2003)]
[Notices]
[Pages 2311-2312]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 03-927]


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DEPARTMENT OF COMMERCE

Census Bureau


2004 National Long-Term Care Survey (NLTCS) and Informal 
Caregivers Survey (ICS)

ACTION: Proposed collection; comment request.

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SUMMARY: The Department of Commerce, as part of its continuing effort 
to reduce paperwork and respondent burden, invites the general public 
and other federal agencies to take this opportunity to comment on 
proposed or continuing information collections, as required by the 
Paperwork Reduction Act of 1995, Pub. L. 104-13 (44 U.S.C. 
3506(c)(2)(A)).

DATES: Written comments must be submitted on or before March 17, 2003.

ADDRESSES: Direct all written comments to Diana Hynek, Departmental 
Paperwork Clearance Officer, Department of Commerce, Room 6086, 14th 
and Constitution Avenue, NW, Washington, DC 20230.

FOR FURTHER INFORMATION CONTACT: Requests for additional information or 
copies of the information collection instrument(s) and instructions 
should be directed to Ronald Dopkowski, Census Bureau, FB 3, Room 3356, 
Mail Stop 8400, Washington, DC 20233-8400, (301) 763-3801.

SUPPLEMENTARY INFORMATION

I. Abstract

    The primary purpose of the NLTCS and the ICS is to obtain 
information on the health and functional status of the elderly 
population in the United States and the people who take care of them in 
a home environment. A secondary purpose of the 2004 NLTCS is to 
identify impaired people and their relatives so the survey sponsor, 
Duke University, can obtain supplemental information from them via 
follow-up contacts not made by the Census Bureau. The Census Bureau 
conducted NLTC surveys in 1982, 1984, 1989, 1994, and 1999 and the IC 
surveys in 1989 and 1999. Beginning with the 1989 NLTCS and ICS, Duke 
University sponsored the surveys using grant funding received from the 
National Institute on Aging (NIA). Duke University and the NIA propose 
the continuation of these two surveys in the spring of 2004. The 
information obtained from the 2004 surveys will be added to the 
information from all previous surveys and then used to inform policy 
decisions relating to the elderly, their care, and the medicare 
program.

Sample Overview

    The 2004 NLTCS sample has a longitudinal component and an aged-in 
component. The longitudinal portion consists of 13,267 people who 
responded to one or more of the previous five surveys. The aged-in 
component consists of 6,600 people: 5,600 who turned 65 years old since 
the 1999 survey and an additional 1,000 people who are 95 years of age 
or older. The total sample size is 19,867 and all are selected from the 
Centers for Medicare and Medicaid Services' (CMS) medicare beneficiary 
file. Approximately 1,800 people are in a part of the sample designated 
as the healthy segment.
    The sample for the ICS is selected during the NLTCS interview and 
consists of approximately 3,275 people who are either not paid or 
members of the NLTCS sample person's family and help or assist the 
NLTCS sample person. We select one caregiver per NLTCS respondent.

Survey Process

    The NLTCS survey consists of a screener interview to determine if a 
person is impaired or currently living in a nursing care facility. If 
the person is impaired and living at home, he/she is administered a 
community interview. If the person is in a nursing care facility, he/
she is administered an institutional interview. If the person is part 
of the healthy segment, he/she is administered a portion of the 
community interview.
    During the community interview, we collect information on people 
who provide help or assistance to the NLTCS respondents. For the ICS 
sample, we select the caregiver, if any, who has provided the most help 
to the NLTCS respondent during the week prior to the interview.
    The Census Bureau stores the survey data on a microdata file and 
delivers a copy of the file to Duke University. The Duke University 
links the NLTCS and the ICS data with previous NLTCS and ICS data and 
appends to this data set the administrative medicare information and 
the data collected from the follow-up contacts with the NLTCS sample 
people. The Duke University analyzes the data and makes its findings 
known to the NIA. The Duke University makes two data sets available for 
research, none of which contain individual identifiers. One data set 
contains the linked NLTCS/ICS/medicare/follow-up survey data. This data 
set is sent to the CMS who controls its subsequent use. The second data 
set contains the linked NLTCS/ICS/follow-up survey data. This data set 
is kept by Duke University who controls its subsequent use.

Summary of Revisions

    The 2004 NLTCS and ICS repeat the 1999 surveys with the following 
exceptions.
    Proxy Respondent Requirements: The selection of eligible proxies 
will follow a hierarchical structure. This structure was not 
established in previous NLTC surveys.
    Respondent Identification: For each section of the questionnaires, 
we will identify whether the sample person or a proxy respondent 
answered the questions. This is important in data assessment. For 
example, the level of help needed that is reported by an individual is 
usually less than the amount of help reported by a caregiver. This 
identification was not done in previous surveys.
    Screener Questionnaire: The activities of daily living (ADL) and 
the instrumental activities of daily living (IADL) will be administered 
to all noninstitutional sample people. Previous NLTC surveys did not 
ask people in the longitudinal sample about disabilities during the 
screener. This created some problems with establishing disability at 
the time of the screener for weighting purposes.
    The screener was expanded to include the new race and ancestry 
questions developed by the Census Bureau for its demographic surveys 
and several other demographic questions like educational attainment and 
marital status. This change consolidates many of the demographic 
variables in the screener and provides demographic statistics more 
consistently across the entire sample.
    Control Card: The format of the control card will change to 
accommodate interviewing in an institutional setting. In addition, the 
control card will collect information on the number of hours worked by 
the sample persons' children and their spouses. These questions were 
asked in

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the 1994 survey but were excluded from the 1999 survey. The caregiver 
research community uses this information to determine the potential 
caregiver universe.
    Community Questionnaire: The length of the community interview will 
be shortened by replacing the lengthy cognitive assessment section used 
in 1999 with the shorter section used in the 1994 survey. In addition 
to this change, questions in other sections were modified or eliminated 
in order to reduce the overall length of the survey.
    Institutional Questionnaire: The institutional interview will be 
changed to allow the sample person to have greater participation than 
in previous years. If the sample person is not capable of participating 
due to physical or mental impairment, the sample person's family will 
be asked to play a larger participatory role. In 1999, most of the 
information was obtained from the nursing home staff resulting in 
incomplete data for many of the cases. Also, the list of medical 
conditions asked in the community interview will be asked in the 
institutional interview.
    ICS: The caregiver selection criteria will be modified. In previous 
caregiver surveys, caregivers were incorrectly excluded from selection 
based on conditions defined in the selection process.

Pretest

    In preparation for the 2004 NLTCS and the ICS, Duke University 
requested the Census Bureau to conduct a complete test in the fall of 
2003 to evaluate the changes made to the 1999 NLTCS and ICS.

II. Method of Collection

    The Census Bureau's field representatives (FRs) conduct the 
screening interviews by telephone or by personal visit if the 
respondent cannot be reached by phone. The FRs conduct all the 
community and institutional interviews primarily through personal-visit 
interviewing. Telephone interviewing is allowed if requested by the 
respondent. The ICS can be conducted either by phone or personal visit 
following the community interview.
    All data are collected using computer-assisted (laptop) 
interviewing. Advance letters are sent to respondents notifying them of 
the upcoming survey.

III. Data

    OMB Number: 0607-0778.
    Form Number: There are no forms. We conduct all interviewing on 
laptop computers.
    Type of Review: Regular.
    Affected Public: Individuals.
    Estimated Number of Respondents:

Pretest
    NLTCS: 465.
    ICS: 35.
Survey
    NLTCS: 18,850.
    ICS: 2,970.
Total: 22,320.

    Estimated Time Per Response (in minutes):

Pretest
    NLTCS: 15.
    ICS: 30.

    Survey
    NLTCS: 15.
    ICS: 30.
    Estimated Total Annual Burden Hours:
Pretest
    NLTCS: 116.
    ICS: 18.
Survey
    NLTCS: 4,713.
    ICS: 1,485.
Total: 6,332.

    Estimated Total Annual Cost: We do not expect respondents to incur 
any cost other than that of their time to respond.
    Respondent's Obligation: Voluntary.

    Legal Authority: Title 42, United States Code, Section 285e-1 
and Title 15, United States Code, Section 1525 authorize this 
survey.

IV. Request for Comments

    Comments are invited on: (a) Whether the proposed collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) The accuracy of the agency's estimate of the burden 
(including hours and cost) of the proposed collection of information; 
(c) Ways to enhance the quality, utility, and clarity of the 
information to be collected; and (d) Ways to minimize the burden of the 
collection of information on respondents, including through the use of 
automated collection techniques or other forms of information 
technology.
    Comments submitted in response to this notice will be summarized or 
included in the request for OMB approval of this information 
collection. They also will become a matter of public record.

    Dated: January 10, 2003.
Madeleine Clayton,
Management Analyst, Office of the Chief information Officer.
[FR Doc. 03-927 Filed 1-15-03; 8:45 am]
BILLING CODE 3510-07-P