[Federal Register Volume 87, Number 226 (Friday, November 25, 2022)]
[Notices]
[Pages 72488-72491]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-25698]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Community Living


Agency Information Collection Activities; Submission for OMB 
Review; Public Comment Request; Prevention and Public Health Fund 
Evidence-Based Chronic Disease Self-Management Education Program 
Information Collection; OMB# 0985-0036

AGENCY: Administration for Community Living, HHS.

ACTION: Notice.

-----------------------------------------------------------------------

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 requirements related 
to the Prevention and Public Health Fund Evidence-Based Chronic Disease 
Self-Management Education Program Information Collection OMB# 0985-
0036.

DATES: Submit written comments on the collection of information by 
December 27, 2022.

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: Shannon Skowronski 
([email protected]). Administration for Community Living, 
Washington, DC 20201, Attention: Shannon Skowronski.

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 Prevention and Public 
Health Fund Evidence-Based Chronic Disease Self-Management Education 
Program Information Collection OMB# 0985-0036. The Evidence-Based

[[Page 72489]]

Chronic Disease Self-Management Education (CDSME) Grant Program is 
financed through the Prevention and Public Health Fund (PPHF). The 
statutory authority for cooperative agreements under the most recent 
program announcement (FY 2022) is contained in the Older Americans Act, 
Title IV; and the Patient Protection and Affordable Care Act, 42 U.S.C. 
300u-11 (Prevention and Public Health Fund). The CDSME Grant Program 
supports a National CDSME Resource Center that provides technical 
assistance, education, and resources for the national CDSME network of 
partners, and awards competitive grants to implement and promote the 
sustainability of evidence-based CDSME programs that have been proven 
to provide older adults and adults with disabilities with education and 
tools to help them better manage chronic conditions such as diabetes, 
heart disease, arthritis, chronic pain, and depression. OMB approval of 
the existing set of CDSME data collection tools (OMB Control Number, 
0985-0036) expires on 11/30/2022. This data collection continues to be 
necessary for the monitoring of program operations and outcomes. ACL 
currently uses and proposes to continue to use a set of tools to 
collect information for each program including: (1) Program Information 
Cover Sheet and Attendance Log, to be completed by the program leaders; 
and a (2) Participant Information Survey to be completed by 
participants on a voluntary basis before or at the beginning of the 
first program session and at the last session or post program to 
document their demographic and health characteristics. ACL/AoA intends 
to continue using an online data entry system for the program and 
participant survey data.
    ACL collected public comments for analysis, conducted focus groups 
that included a sub-set of current CDSME grantees, as well as consulted 
with subject-matter experts to gather feedback and determine if changes 
to the data collection tools are warranted.

Comments in Response to the 60-Day Federal Register Notice

    A notice published in the Federal Register Vol. 87, No. 137 on July 
19, 2022. Five (5) public comments were received during the 60-day FRN. 
ACL's responses to these comments, along with feedback from grantee 
focus groups, National CDSME Resource Center and ACL's Center for 
Policy and Evaluation, are included below.

                                         Participant Information Survey
----------------------------------------------------------------------------------------------------------------
           Topic/issue                           Comment                              ACL response
----------------------------------------------------------------------------------------------------------------
Survey Purpose...................  Suggestion to add a purpose          ACL will not adopt this suggestion. The
                                    statement to the forms to better     purpose of this data collection is
                                    inform participants of why this      multi-fold--with different benefits and
                                    specific data collection is          potential uses of the data by federal,
                                    pertinent.                           state, and local stakeholders.
Survey Format....................  Multiple comments were received as   (a) ACL will incorporate this suggested
                                    detailed below:                      revision.
                                   (a) Suggestion to change the type    (b) ACL will incorporate this suggested
                                    of bullet used for the response      revision.
                                    options from a circle to a text
                                    box.
                                   (b) Suggestion to group the
                                    disability-related questions and
                                    present in a table/grid format.
Sexual Orientation and Gender      Multiple respondents suggested the   HHS, and ACL as an operating division of
 Identity (SOGI).                   incorporation of inclusive sexual    HHS, recognize the importance of
                                    orientation and gender identity      collecting SOGI data to better assess
                                    question(s).                         diversity and equity in evidence-based
                                                                         program scaling and participation.
                                                                        ACL intends to update this question to
                                                                         incorporate more inclusive questions
                                                                         and responses.
Race/Ethnicity...................  Multiple comments were received as   ACL works to align data collection with
                                    detailed below:                      what is currently collected across the
                                   Suggestion to combine the race and    Federal Government, specifically the
                                    ethnicity questions into one item.   U.S. Census. The questions as presented
                                   Suggestion to ``Include Middle        reflect how race/ethnicity is asked.
                                    Eastern/North African (MENA) as a    ACL will not incorporate the suggestion
                                    response option. This race does      to combine the race and ethnicity
                                    not roll up to the current           questions.
                                    categories (maybe white) and could  Similarly, ACL will not incorporate the
                                    be a cause for not answering the     suggestion to include the MENA group
                                    question''.                          for the reason mentioned above.
                                                                         However, ACL will incorporate the
                                                                         ``some other race'' option to allow for
                                                                         inclusion of additional responses.
Chronic Conditions List..........  Multiple comments were received as   (a) ACL will incorporate these
                                    detailed below:                      conditions based on the growing
                                   (a) Suggestion to expand the list     prevalence of these conditions in the
                                    of conditions to include post-       aging population. For example, an
                                    traumatic stress disorder (PTSD),    estimated 6.5 million older adults are
                                    substance use disorder, urinary      living with Alzheimer's dementia in
                                    incontinence, malnutrition and       2022, 73% of which are 75 years and
                                    Alzheimer's Disease or other         older; 50% of older adults are at risk
                                    dementia.                            for becoming malnourished; and nearly 1
                                   (b) Suggestion to alphabetize the     million adults aged 65 and older live
                                    list to facilitate data entry.       with a substance use disorder.
                                                                        (b) ACL will incorporate this suggested
                                                                         revision.
Social Isolation/Loneliness......  Multiple respondents suggested that  ACL appreciates the suggestion to
                                    this question be revised as it is    collect more data around social
                                    asking about two different           isolation and loneliness but has
                                    constructs--isolation and            decided in the interest of balancing
                                    loneliness. Many respondents         data collection and burden to not
                                    suggested ``replacing the question   include these specific questions in the
                                    with the UCLA loneliness             survey. Instead, the constructs will be
                                    questions''--a three part question.  separated into their own questions in
                                                                         efforts to better analyze and report
                                                                         the information collected.
Participant Outcomes Questions...  (a) Multiple suggestions to add      (a) ACL is interested in assessing
                                    outcomes questions to better         impact of the program as well as
                                    understand the impact of             activities that participants may be
                                    participating in a program and       using to manage their condition as a
                                    what participants might have done    result of their participation. ACL will
                                    since the program to manage their    therefore include a question that will
                                    chronic condition.                   assess what participants have done as
                                   (b) Suggestions to add elements       it relates to talking with their
                                    from the Patient Activation          healthcare provider, reviewing
                                    Measure, Healthy Days Measures and   medications with appreciate healthcare
                                    RAPID3.                              personnel, increasing physical
                                                                         activity, eating healthy foods,
                                                                         participating in other health and
                                                                         wellness programming, and talking to
                                                                         their friends and family about their
                                                                         health.
                                                                        (b) ACL will not incorporate these
                                                                         suggestions at this time as these
                                                                         measures are: too general; lack direct
                                                                         applicability to assessing impact of
                                                                         participating in a CDSME program; or
                                                                         are too specific to particular chronic
                                                                         conditions or symptom.

[[Page 72490]]

 
Satisfaction Question............  Request to add satisfaction          Although a satisfaction question has not
                                    question into the post-survey.       been part of the required data
                                    Summary of respondents               collection elements, ACL agrees with
                                    justification include ``Many         this suggestion and will include a
                                    organizations may be offering        satisfaction question in the survey to
                                    multiple programs, or just getting   assess the extent to which a program is
                                    their programs off the ground.       meeting the needs of the participant,
                                    Measuring participants'              as well as overall program delivery.
                                    satisfaction and overall
                                    experience with the program can
                                    help identify strengths and
                                    challenges across programs and
                                    implementation sites, including
                                    satisfaction with the leaders,
                                    time the program was offered,
                                    location, and other factors that
                                    impact delivery and
                                    sustainability''.
Additional Questions.............  Suggestion to incorporate questions  ACL appreciates the suggestion to
                                    specific to language other than      collect more data but has decided in
                                    English spoken at home, language     the interest of balancing data
                                    preference for reading or speaking   collection and burden to not include
                                    about health/medical information,    these additional elements on the
                                    how well someone speaks English.     survey.
----------------------------------------------------------------------------------------------------------------


                                         Program Information Cover Sheet
----------------------------------------------------------------------------------------------------------------
           Topic/issue                           Comment                              ACL response
----------------------------------------------------------------------------------------------------------------
Size of Implementation Site......  Suggestion to include the question   ACL will not be incorporating this
                                    ``How many older adults does your    element at this time. Being able to
                                    organization serve on an annual      scale and sustain programs depend on a
                                    basis?'' as this would be helpful    variety of factors. The number of older
                                    in analyzing the differences in      adults served is not an adequate
                                    how small and large sites            measure of success in program
                                    implement programs.                  implementation.
Consent to Receive Information     A comment was received that this     Requesting this consent through a
 from National CDSME Resources      question seems unnecessary to have   standard data collection form is the
 Center.                            as a standard question, since it     most direct manner ACL can use to
                                    should only be asked once of each    ensure that program facilitators can
                                    leader.                              opt in to receiving technical
                                                                         assistance communications from our
                                                                         National CDSME Resource Center.
Facilitator Demographics.........  Suggestion to include demographic    ACL agrees and will incorporate this
                                    questions such as age, race/         suggestion by including the same
                                    ethnicity as facilitator             questions as outlined in the
                                    demographics can have a large        participant information survey.
                                    impact on the effectiveness of
                                    program implementation. Knowing
                                    some demographic characteristics
                                    about the leaders could inform
                                    equity, diversity, and inclusion
                                    initiatives and add value to
                                    understanding program adoption and
                                    sustainability.
Facilitator Status...............  Suggestion to include a question to  ACL agrees and will incorporate this
                                    better understand how facilitators   suggestion.
                                    are compensated as organizations
                                    use a mix of paid and volunteer
                                    staff. It would be helpful to
                                    analyze whether a certain model is
                                    used more frequently depending on
                                    the program or whether the
                                    leader's employment status has an
                                    impact on completion of the
                                    workshop.
Program Delivery Format..........  Suggestion to include a question     ACL agrees and will incorporate this
                                    that asks about the delivery         suggestion.
                                    format for a program-- ``With many
                                    programs now offered in multiple
                                    formats, it is important to know
                                    how program format impacts the
                                    demographic of participants who
                                    elect one format vs another,
                                    completion rates, and mapping the
                                    growth of these alternate program
                                    formats''.
Network Status...................  A suggestion was made to ask a       Although Community Care Hubs/Community
                                    question about network status--      Integrated Health Network are
                                    ``Is this workshop implemented as    increasing across the country, ACL will
                                    a part of a centralized,             not incorporate this suggestion at this
                                    coordinated Community-Integrated     time. This may cause undue burden on a
                                    Health Network? Yes/No. If yes,      program facilitator or implementation
                                    provide the name of the Community--  site coordinator and possibly delay the
                                    Integrated Network: (open-ended)''.  return of data.
----------------------------------------------------------------------------------------------------------------


                             Attendance Log
------------------------------------------------------------------------
           Topic/issue                  Comment          ACL response
------------------------------------------------------------------------
Format..........................  Suggestions to:     (a) This form is
                                  (a) Modify format    to be completed
                                   to add the          by the program
                                   following: survey   facilitator who
                                   completion,         should clearly
                                   liability form      print the program
                                   completion,         information and
                                   attendance to       participant IDs.
                                   other programs at   As a part of
                                   site, and an        their training,
                                   example row.        facilitators
                                  (b) Make             should be
                                   participant ID      instructed to not
                                   column smaller so   put participant
                                   participants do     name or other
                                   not write their     identifying
                                   names.              information in
                                                       the participant
                                                       ID column.
                                                      (b) ACL will not
                                                       incorporate this
                                                       suggestion to
                                                       reduce burden on
                                                       the program
                                                       facilitator. If a
                                                       grantee would
                                                       like to collect
                                                       additional
                                                       information, they
                                                       may choose to do
                                                       so independently.
------------------------------------------------------------------------

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

----------------------------------------------------------------------------------------------------------------
                                           Number of                                 Hours per     Annual burden
  Respondent/data collection activity     respondents   Responses per respondent     response          hours
----------------------------------------------------------------------------------------------------------------
Program facilitators (Program                      680  Twice per year (one set              .34          462.40
 Information Cover Sheet, Attendance                     per program).
 Log).
Program participants (Participant               14,000  1.......................             .20        2,800.00
 Information Survey).

[[Page 72491]]

 
Data entry staff (Program Information               70  Once per program times               .20           272.0
 Cover Sheet, Attendance Log,                            1,360 programs.
 Participant Information Survey).
                                       -------------------------------------------------------------------------
    Total Burden Hours................  ..............  ........................  ..............        ** 3,534
----------------------------------------------------------------------------------------------------------------
** Rounded to the nearest hour.


    Dated: November 18, 2022.
Alison Barkoff,
Acting Administrator and Assistant Secretary for Aging.
[FR Doc. 2022-25698 Filed 11-23-22; 8:45 am]
BILLING CODE 4154-01-P