[Federal Register Volume 79, Number 42 (Tuesday, March 4, 2014)]
[Notices]
[Pages 12200-12201]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2014-04755]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary

[Document Identifier: HHS-OS-20883-30D]


Agency Information Collection Activities; Submission to OMB for 
Review and Approval; Public Comment Request

AGENCY: Office of the Secretary, HHS.

ACTION: Notice.

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SUMMARY: In compliance with section 3507(a)(1)(D) of the Paperwork 
Reduction Act of 1995, the Office of the Secretary (OS), Department of 
Health and Human Services, has submitted an Information Collection 
Request (ICR), described below, to the Office of Management and Budget 
(OMB) for review and approval. The ICR is for a new collection. 
Comments submitted during the first public review of this ICR will be 
provided to OMB. OMB will accept further comments from the public on 
this ICR during the review and approval period.

DATES: Comments on the ICR must be received on or before April 3, 2014.

ADDRESSES: Submit your comments to [email protected] or via 
facsimile to (202) 395-5806.

FOR FURTHER INFORMATION CONTACT: Information Collection Clearance 
staff, [email protected] or (202) 690-6162.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the Information Collection Request Title 
and document identifier HHS-OS-20883-30D for reference.
    Information Collection Request Title: Support and Services at Home 
(SASH) Participant Survey
    Abstract: The Office of the Assistant Secretary for Planning and 
Evaluation (ASPE) is requesting approval from the Office of Management 
and Budget (OMB) to conduct a survey of Support And Services at Home 
(SASH) participants to assess the impact of the SASH program on health 
outcomes. Information collected includes general health status, 
functional status, quality of life, medication problems and dietary 
issues. The SASH program operates in Vermont and links staff based in 
housing properties with a team of community-based health and supportive 
services providers to help older adults coordinate and manage their 
care needs. SASH services include: Assessment by a multidisciplinary 
team, creation of an individualized care plan, on-site nursing and care 
coordination with team members and other local partners, and community 
activities to support health and wellness. SASH is anchored in 
affordable senior housing properties, serving residents in the property 
and seniors living in the surrounding community.
    The goal of this project is to conduct a comprehensive evaluation 
of the SASH program. The evaluation will assess whether the SASH model 
of coordinated health and supportive services in affordable housing 
improves quality of life, health and functional status of participants. 
The evaluation has been designed to comprehensively address the 
research questions while minimizing the burden placed on the SASH 
program staff, their partners (e.g., service providers), and Medicare 
and dually eligible Medicare and Medicaid beneficiaries. The mail 
survey is designed to collect outcomes that

[[Page 12201]]

cannot be measured from claims data or other sources. We will use 
brief, standardized scales with demonstrated reliability and validity 
in older adults. Information collected in the survey is not of a 
sensitive nature. Questions in the beneficiary survey are confined to 
health outcomes. RTI International will conduct and analyze the survey. 
RTI has experience doing similar work for ASPE and other government 
clients.
    Need and Proposed Use of the Information: To determine the impact 
of the SASH program on quality of life, health and functional status of 
participants. Care has been taken to ensure that there is no overlap 
between other ongoing state evaluations. Through discussions with SASH 
program staff and other state officials in Vermont, we determined that 
the information we seek to collect is not already being collected from 
our proposed sample, nor can it be measured from claims data. As a 
result of these efforts, the information collected through the survey 
will not duplicate any other effort and is not obtainable from any 
other source.
    Likely Respondents: The target population for the survey is 
Medicare beneficiaries participating in the Support and Services at 
Home (SASH) demonstration. SASH provides integrated, home-based 
services to beneficiaries in selected housing properties throughout 
Vermont. At this point, 1,685 intervention beneficiaries have been 
identified in 37 SASH sites.
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose or provide the 
information requested. This includes the time needed to review 
instructions, to develop, acquire, install and utilize technology and 
systems for the purpose of collecting, validating and verifying 
information, processing and maintaining information, and disclosing and 
providing information, to train personnel and to be able to respond to 
a collection of information, to search data sources, to complete and 
review the collection of information, and to transmit or otherwise 
disclose the information. The total annual burden hours estimated for 
this ICR are summarized in the table below.

                                    Total Estimated Annualized Burden--Hours
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                                                                                      Average
                                                     Number of       Number of      burden per     Total burden
                    Form name                       respondents    responses per   response (in        hours
                                                                    respondent        hours)
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SASH Participant Survey.........................             669               1           20/60             223
    Total.......................................             669               1           20/60             223
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Darius Taylor,
Deputy, Information Collection Clearance Officer.
[FR Doc. 2014-04755 Filed 3-3-14; 8:45 am]
BILLING CODE 4150-05-P