[Federal Register Volume 86, Number 61 (Thursday, April 1, 2021)]
[Notices]
[Pages 17153-17156]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-06740]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Community Living

[OMB # 0985-0023]


Agency Information Collection Activities; Submission for OMB 
Review; Public Comment Request; National Survey of Older Americans Act 
Participants

AGENCY: Administration for Community Living, HHS.

ACTION: Notice.

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SUMMARY: The Administration for Community Living is announcing that the 
proposed collection of information listed above has been submitted to 
the Office of Management and Budget (OMB) for review and clearance as 
required under section 506(c)(2)(A) of the Paperwork Reduction Act of 
1995. This 30-Day notice collects comments on the information 
collection requirements related to the information collection 
requirements for consumer assessment surveys used by ACL to measure 
program performance for programs funded under Title III of the Older 
Americans Act. This notice solicits comments on a proposed revision of 
a currently approved collection with the addition of a new rotating 
module to the National Survey of Older Americans Act Participants.

DATES: Submit written comments on the collection of information by May 
3, 2021.

ADDRESSES: Submit written comments and recommendations for the proposed 
information collection within 30 days of publication of this notice to 
www.reginfo.gov/public/do/PRAMain. Find the information collection by 
selecting ``Currently under 30-day Review--Open for Public Comments'' 
or by using the search function. By mail to the Office of Information 
and Regulatory Affairs, OMB, New Executive Office Bldg., 725 17th St. 
NW, Rm. 10235, Washington, DC 20503, Attn: OMB Desk Officer for ACL.

FOR FURTHER INFORMATION CONTACT: Susan Jenkins, Administration for 
Community Living, Washington, DC 20201, by email at 
[email protected] or by telephone at 202-795-7369.

SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, ACL has 
submitted the following proposed collection of information to OMB for 
review and clearance. The Administration for Community Living (ACL) is 
requesting approval to collect data for the National Survey of Older 
Americans Act (OAA) Participants information collection to include 
consumer assessment surveys for the Congregate and Home-delivered meal 
nutrition programs; Case Management, Homemaker, and Transportation 
Services; and the National Family Caregiver Support Program.
    This survey builds on earlier national pilot studies and surveys, 
as well as performance measurement tools developed by ACL grantees in 
the Performance Outcomes Measures Project (POMP). Changes identified as 
a result of these initiatives were incorporated into the last data 
collection package that was approved by OMB and are included in this 
proposed extension of a currently approved collection. This information 
will be used by ACL to track performance outcome measures; support 
budget requests; comply with the GPRA Modernization Act of 2010 (GPRMA) 
reporting requirements; provide national benchmark information; and 
inform program development and management initiatives.
    In addition to the proposed extension of the existing collection of 
information, ACL is requesting approval for a module on COVID-19 to be 
added to the currently approved NSOAAP data collection effort. This 
module supplants the module on Emergency Preparedness that was included 
in the 60-day FRN due to the ongoing health crisis older adults are 
experiencing as a result of COVID-19. The Emergency Preparedness module 
will be added to the 2022 collection instrument.
    As part of a nationwide effort to slow transmission of COVID-19, 
communities have closed locations such as senior centers, adult day 
care centers, and congregate meal facilities where many older adults 
received vital home- and community-based services. In addition, many of 
the in-home services that help older adults to remain in their homes, 
such as home-delivered meals, homemaker services, and respite care have 
been curtailed due to fear of spreading COVID-19. This, combined with 
families and friends unable to assist loved ones due to the fear of 
spreading the virus, have left many older adults isolated and without 
the programs and services they need to remain living safely in the 
community. The purpose of adding questions on COVID-19 to the NSOAAP is 
to measure the effect COVID-19 has had on older adults' access to and 
use of Older Americans Act programs and services during the past year.
    The results of this information collection will be used by ACL/AoA 
to:
     Provide refined national benchmarks for use by states and 
AAAs.
     Provide secondary data for analysis of various Title III 
program evaluations.
     Provide performance information for key demographic 
subgroups, geographical sub regions, and different types of AAAs which 
will enable ACL/AoA to identify variations in performance and examine 
the need for additional targeted technical assistance.
     Provide secondary data for analysis of the effect of 
COVID-19 on access to and use of OAA programs and services among older 
adults that will be shared with states and AAAs to help structure their 
programs and services in response to COVID-related changes.
    The data will be used by the Administrator of the Administration 
for Community Living/Assistant Secretary for Aging in testimony and 
presentations; it will be incorporated into the agency's Annual Report; 
and it will be used by program staff to identify areas that may need 
attention at the national level.
    Descriptions of previous National Surveys of OAA Participants can 
be found under the section on OAA Performance Information on ACL's 
website at: https://acl.gov/programs/performance-older-americans-act-programs. Copies of the survey instruments and data from previous 
National Surveys of OAA Participants can be found and queried using the 
Aging, Independence, and Disability (AGID) Program Data Portal at 
http://www.agid.acl.gov/.

Comments in Response to the 60-Day Federal Register Notice

    A notice published in the Federal Register on Tuesday, November 17, 
2020 in 85 FR No. 222 page 73273. There were thirteen public comments 
received during the 60-day FRN, please see ACLs response to comment 
listed below.

[[Page 17154]]



------------------------------------------------------------------------
         Topic/issue                 Comment            ACL response
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Food insecurity in older      ``We support the      ACL concurs and
 adults.                       inclusion of the      plans to maintain
                               USDA module to        the USDA module and
                               provide national      associated
                               estimates of the      questions for the
                               rate of food          foreseeable future.
                               insecurity among
                               OAA program
                               participants. We
                               recommend this
                               module be
                               continuously
                               included in future
                               administration of
                               this survey.''
Risk of malnutrition........  ``We suggest that     ACL recognizes the
                               ACL consider adding   importance of
                               malnutrition          reducing and
                               screening questions   assessing risk for
                               in addition to the    malnutrition.
                               USDA module's food    However, further
                               insecurity            deliberation is
                               questions, such as:   needed to ensure
                               Do you ever   that we select the
                               eat only one meal     most appropriate
                               daily?''.             and universally
                               Do limits     accepted language.
                               on chewing,           ACL will call upon
                               swallowing or         the expertise of a
                               physical mobility     nutrition workgroup
                               ever prevent you      to make
                               from eating your      recommendations to
                               home-delivered        ACL on selecting
                               meals, even though    the best language
                               you may be            to use. The
                               hungry?''.            workgroup's
                               Do limits     recommendation will
                               on chewing,           inform a redesign
                               swallowing or         of future NSOAAP
                               physical mobility     survey collection
                               ever prevent you      efforts.
                               from getting to
                               your local
                               congregate meal
                               site and eating
                               your meal, even
                               though you may be
                               hungry?''.
Medically-tailored meals for  ``We suggest that     ACL recognizes the
 participants requiring        ACL consider adding   importance of
 special diets.                a question about      capturing data on
                               the need for          the capability of
                               therapeutic diets     OAA nutrition
                               or texture-modified   programs to
                               meals to better       accommodate special
                               understand the        diets. ACL will
                               needs of              call upon nutrition
                               participants as it    experts to make
                               relates to            recommendations and
                               medically tailored    inform a redesign
                               meals.''              of future NSOAAP
                                                     collection efforts.
Ethnic and cultural barriers  ``We suggest that     ACL recognizes that
 to communication and          ACL consider          ethnic and cultural
 nutritional preferences.      including a           barriers may affect
                               question about        participants in the
                               communication         nutrition programs.
                               barriers to both      ACL will call upon
                               the congregate and    nutrition experts
                               home-delivered        to make
                               meals modules, such   recommendations and
                               as:                   inform a redesign
                               Do you have   of future NSOAAP
                               language or           collection efforts.
                               cultural barriers
                               to talking with
                               staff at your
                               congregate meal
                               site/your home
                               delivery staff?.
                              We also suggest that  ACL is considering a
                               ACL consider adding   special topical
                               a question to both    module related to
                               the congregate and    equity and
                               home-delivered        underserved
                               meals modules about   populations.
                               meals meeting
                               cultural
                               preferences.
Nutrition counselor:          ``SVC1(k) asks        ACL recognizes
 Rephrase question to          whether the           ``nutrition
 improve clarity.              respondent has        counselor'' may
                               access to a           offer subjective
                               ``nutrition           responses. However,
                               counselor'' who is    respondents may not
                               providing dietary     know if the
                               advice based on the   qualifications of
                               respondent's          the person
                               condition,            providing dietary
                               medications, and      advice. ACL will
                               related factors. We   call upon nutrition
                               question why the      experts to make
                               survey would not      recommendations and
                               specify ``a           inform a redesign
                               qualified nutrition   of future NSOAAP
                               professional such     collection efforts.
                               as a registered       The use of
                               dietitian'' (or       terminology for
                               registered            this item will be
                               dietitian             tested.
                               nutritionist),
                               since these
                               professionals are
                               the most qualified
                               to answer such
                               questions.
                               Moreover, in 28
                               states, only
                               licensed
                               professionals are
                               legally eligible to
                               provide such
                               advice. The term
                               ``nutrition
                               counselor'' allows
                               for substantial
                               subjective
                               interpretations,
                               and could
                               theoretically
                               include food
                               service staff or
                               other program
                               participants who
                               may be providing
                               such advice against
                               state law.''
Modify item response in       ``We note that the    ACL concurs with
 nutrition modules to          survey asks about     this suggested
 include positive as well as   changes in meals,     change. The
 negative changes.             but almost all        requested change
                               coding options for    has been made to
                               the interviewer are   the survey
                               about reductions or   instrument.
                               negative changes
                               with few
                               opportunities for
                               interviewers to
                               code any positive
                               changes reported by
                               participants. In
                               addition to coding
                               for both reductions
                               and improvements in
                               quality of the
                               food, we recommend
                               adding the
                               corresponding
                               ``positive'' option
                               for all other
                               codes.''
Consistent language in meals  ``Ensure that         ACL recognizes that
 program.                      consistent language   the language used
                               is used to describe   to describe the
                               the program,          meals programs may
                               particularly for      need to be revised
                               congregate or         to be more
                               senior dining         consistent. ACL
                               meals. Some           will call upon
                               questions use the     nutrition experts
                               term ``meals          to make
                               program'' while       recommendations and
                               others use the term   inform a redesign
                               ``lunch program''     of future NSOAAP
                               or, generically,      collection efforts.
                               ``this service'',    The term ``meals
                               including CNR20-23    program'' will be
                               where three           used at this time
                               different terms are   due to the variety
                               used across four      of food services
                               consecutive           during the COVID-19
                               questions. This       pandemic.
                               also applies to
                               SVC1 question in
                               Additional Services
                               module. We
                               recommend using the
                               term ``meals
                               program'' unless
                               exclusively
                               referring to lunch,
                               as some programs
                               serve breakfast or
                               dinner meals rather
                               than lunch meals.''
Living independently........  ``SVC3 asks about     ACL concurs with
                               continuing to         this suggested
                               ``live                change. The
                               independently'' vs.   requested change
                               ``living at home''    has been made to
                               (as they do in        the survey
                               CS15, CNR23, HNR28,   instrument.
                               HC9 and TR20). The
                               terminology
                               ``living
                               independently'' is
                               preferred. Simply
                               continuing to live
                               ``at home'' does
                               not mean that the
                               person is living
                               independently, is
                               living in their own
                               home (vs that of a
                               relative), or has
                               autonomy over where
                               he or she lives.''

[[Page 17155]]

 
Context of ``secure''.......  ``SVC3(b) should be   The question refers
                               more specific with    to how participants
                               regard to the         feel about
                               context of            additional services
                               ``secure.'' We are    that they or their
                               unsure whether the    care recipient
                               context is            receive. ACL
                               financial, food-      recognizes that the
                               based, or related     use of the word
                               to physical           ``secure'' may be
                               safety.''             ambiguous. ACL will
                                                     call upon experts
                                                     in the aging
                                                     network to make
                                                     recommendations to
                                                     inform a redesign
                                                     of future NSOAAP
                                                     collection efforts.
Multiple meals..............  ``HNR5 should be re-  ACL recognizes that
                               phrased to reflect    the question may
                               the fact that many    need to be
                               HDM clients receive   modified. ACL will
                               more than one meal    call upon nutrition
                               and may consume       experts to make
                               multiple HDMs in a    recommendations and
                               day.''                inform a redesign
                                                     of future NSOAAP
                                                     collection efforts.
Care recipients under age 60  The 2020              While ACL recognizes
 with dementia.                reauthorization of    the value of
                               OAA allows            collecting data on
                               ``individuals         care recipients of
                               living with           the NFCSP who are
                               dementia under the    under 60, that is
                               age of 60 to access   not the focus of
                               certain OAA           the NSOAAP. The
                               supports like         focus of the NSOAAP
                               nutritional           is the service
                               services and          recipients, that
                               respite care          is, the caregivers.
                               through the
                               National Family
                               Caregiver Support
                               program. We
                               respectfully
                               request that ACL
                               analyze the data
                               collected on these
                               younger individuals
                               and the services
                               they receive so
                               that those services
                               can be tailored and
                               improved.''
Emergency preparedness......  The advocacy          ACL is not going to
                               organizations         add this module for
                               ``support ACL's       the 2021
                               request to add an     administration but
                               emergency             still plans to use
                               preparedness module   it in the future.
                               to the survey. .
                               .''
Question on participant sex   ``I encourage the     In order to improve
 (gender identity).            modification of the   demographic data
                               questions about       collection related
                               participant sex to    to the LGBT
                               include response      community, ACL is
                               options (which are    supporting the
                               recorded but not      Measuring Sex,
                               verbally offered as   Gender Identity,
                               options) to include   and Sexual
                               ``transgender'' and   Orientation for the
                               or ``other'' with a   National Institutes
                               write-in option.      of Health an ad hoc
                              The questions this     panel of the
                               relates to are: DE1   National Academies
                               (DEGENDR); CGC        of Sciences,
                               (CGPMF); CG83         Engineering, and
                               (CGPMF)--both of      Medicine which will
                               the last have the     review current
                               same variable         measures and the
                               labels and this       methodological
                               should be corrected   issues related to
                               in the survey         measuring sex as a
                               construction.''.      non-binary
                                                     construct, gender
                                                     identity, and
                                                     sexual orientation.
                                                     The panel will
                                                     produce a consensus
                                                     report which is
                                                     expected in
                                                     December 2021. ACL
                                                     will use the report
                                                     as a foundation for
                                                     testing new survey
                                                     questions and
                                                     administrative data
                                                     elements.
                                                    The variable label
                                                     in the survey
                                                     instrument for
                                                     CGPMF was corrected
                                                     to RGENDER.
------------------------------------------------------------------------

Estimated Program Burden

    ACL estimates the burden associated with this collection of 
information as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                        Number of     Responses per                              Annual burden                             Annual burden
Respondent/data collection activity    respondents      respondent       Hours per  response         hours            Cost per hour           (cost)
--------------------------------------------------------------------------------------------------------------------------------------------------------
Area Agency on Aging: Respondent                350                1  4.0.....................           1,400  $44.....................         $61,600
 selection process.
Service Recipients (i.e.,                     4,400                1  .75.....................           3,300  $25.....................          82,500
 Congregate and Home-delivered meal
 nutrition programs; Case
 Management, Homemaker, and
 Transportation Services) +
 Rotating Module.
National Family Caregiver Support             2,200                1  .75.....................           1,650  $25.....................          41,250
 Program Clients + Rotating Module.
                                    --------------------------------------------------------------------------------------------------------------------
    Total..........................           6,950                1  .914 (weighted mean)....           6,350  Varies..................         185,350
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[[Page 17156]]

    Dated: March 26, 2021.
Alison Barkoff,
Acting Administrator and Assistant Secretary for Aging.
[FR Doc. 2021-06740 Filed 3-31-21; 8:45 am]
BILLING CODE 4154-01-P