[Federal Register Volume 89, Number 74 (Tuesday, April 16, 2024)]
[Notices]
[Pages 26895-26897]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-08009]


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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 Falls Prevention Program Information Collection; OMB 
Control Number 0985-0039

AGENCY: Administration for Community Living, Department of Health and 
Human Services.

ACTION: Notice.

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SUMMARY: The Administration for Community Living (ACL) 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 the Paperwork Reduction Act of 1995. This 
30-day notice collects comments on the information collection 
requirements related to the proposed extension of this ACL Prevention 
and Public Health Fund Evidence-Based Falls Prevention Program 
Information Collection.

DATES: Comments on the collection of information must be submitted 
electronically by 11:59 p.m. ET or postmarked. May 16, 2024.

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, Attention: OMB Desk Officer for ACL.

FOR FURTHER INFORMATION CONTACT: Donna Bethge, Administration for 
Community Living. Washington, DC 20201, or [email protected], 
(202) 795-7659.

SUPPLEMENTARY INFORMATION: In compliance with the Paperwork Reduction 
Act (44 U.S.C. 3506), the Administration for Community Living (ACL) has 
submitted the following proposed collection of information to OMB for 
review and clearance. The Evidence-Based Falls Prevention 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 2023) is contained in the Older Americans Act, 
title IV; and the Patient Protection and Affordable Care Act, 
(Prevention and Public Health Fund). The Falls Prevention Grant Program 
awards competitive grants to implement and promote the sustainability 
of evidence-based Falls Prevention programs that have been proven to 
provide older adults and adults with disabilities with education and 
tools to help them reduce falls and/or risk of falls and fall-related 
injuries and supports a National Falls Prevention Resource Center that 
provides technical assistance, education, and resources for the 
national Falls Prevention network of partners. OMB approval of the 
existing set of Falls Prevention data collection tools (OMB Control 
Number, 0985-0039) expires on 04/30/2024. This data collection 
continues to be necessary for the monitoring of program operations and 
outcomes. ACL currently uses and proposes to continue to use the 
following tools to collect information for each program:
    (1) a Program Information Cover Sheet and an Attendance Log, 
completed by the program leaders, to record the location of agencies 
that sponsor programs and will allow mapping of the delivery 
infrastructure; and
    (2) a Participant Information Form and a Participant Post Program 
Survey to be completed by participants.
    ACL intends to continue using an online data entry system for the 
program and participant survey data.
    This IC collects demographic data from grantees receiving programs 
and services funded by HHS. ACL will adhere to best practices for 
collection of all demographic information when this information is 
collected for the programs listed in accordance with OMB guidance.
    This includes, but is not limited to, guidance specific to the 
collection of sexual orientation and gender identity (SOGI) items that 
align with Executive Order 13985 on Advancing Racial Equity and Support 
for Underserved Communities Through the Federal Government, Executive 
Order 14075 on Advancing Equality for Lesbian, Gay, Bisexual, 
Transgender, Queer, and Intersex Individuals, and Executive Order 13988 
on Preventing and Combating Discrimination on the Basis of Gender 
Identity and Sexual Orientation. Understanding these disparities can 
and should lead to improved service delivery for ACL's programs and 
populations served.

Comments in Response to the 60-day Federal Register Notice (FRN)

    ACL published a 60-day FRN on December 14, 2023, at 88 FR 86657. 
ACL received fifty-four comments from the public, feedback from four 
focus groups (that included a subset of current and past falls 
prevention grantees and program administrators) and input from subject 
matter experts during the 60-day public comment period. A public 
comment summary table and ACL response is provided below.

[[Page 26896]]



    Participant Information Form and Participant Post Program Survey
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                Comment                              Response
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Several comments suggested               HHS and ACL, as an operating
 incorporating inclusive sexual           division of HHS, recognize the
 orientation and gender identity          importance of collecting
 question(s).                             Sexual Orientation and Gender
                                          Identity (SOGI) data to better
                                          assess diversity and equity in
                                          evidence-based program scaling
                                          and participation.
                                         ACL has incorporated more
                                          inclusive questions and
                                          responses.
Several comments suggested adding a      ACL has adopted this
 question to ask if the participant was   suggestion.
 a caregiver.
Suggestions were received to edit the    ACL reviewed the chronic
 question regarding chronic conditions:   condition question and:
     Include additional              Adopted suggestions
     conditions (e.g., Hearing Loss and      of certain conditions that
     Vision Impairment among others).        most aligned to fall risk
                                             and the growing prevalence
                                             of these conditions in the
                                             aging population.
     Increase possible               Additional
     responses (including length of          responses were not adopted
     diagnosis, don't remember or not        at this time.
     sure).
Several comments received suggested      ACL has adopted the suggestion
 revising the social isolation and        to separate the single
 loneliness question as it combines two   question into two questions in
 different conditions.                    efforts to better analyze and
                                          report the information
                                          collected.
Multiple comments made suggestions for   ACL adopted the following
 the existing question 11 regarding       suggestions:
 falls:
     Change formatting for           Corrected
     clarification.                          formatting.
     Change Primary Care             Changed language
     Physician to Health Care Provider.      from Primary Care Physician
                                             to Health Care Provider.
     Edit and reorder answers        Combined question b
     for 11 b and c. Add `urgent care'       and c to reduce burden and
     and `blank response'.                   added Urgent Care Center as
                                             a response option.
     Distinguish the difference  ...............................
     between telling family/friend
     verse telling a healthcare
     provider.
Some comments suggested changing         ACL adopted these suggestions
 language in the existing question 13:    by adjusting language:
     Make language consistent        Changed ``During
     with existing question 11,              the last 4 weeks'' to ``In
     changing ``During the last 4            the Past 3 months'' for
     weeks'' to ``In the past 3              consistency across the
     months''.                               collection.
     Remove ``to what extent''.      Removed ``to what
                                             extent'' for language
                                             simplification.
     Provide an example such as      Added clarifying
     ``avoiding a friend's home that         example of ``avoiding
     has steps to enter'', ``avoiding        situations with stairs or
     areas with uneven ground,'' etc.''.     uneven ground''.
There were several comments surrounding  ACL adopted the suggestions by
 existing question 14:                    replacing the existing
                                          question 12 and 14 with
                                          questions that rate falls
                                          confidence level surrounding
                                          activities of daily living
                                          (ADLs).
     Rephrase language to        ...............................
     clarify the question and produce
     more useful feedback.
     Replace existing question   ...............................
     14 with a validated outcome
     measure using activities of daily
     living (ADLs) to rate confidence.
     A physical function         ...............................
     question would be a better fit to
     define level of independence more
     clearly.
Many comments received made suggestions  ACL adopted some modifications
 for existing question 15:                to the question:
     Change language to lower        Modified language
     reading level.                          to replicate wording from
                                             the Physical Activity
                                             Guidelines.
     Include descriptions for        Added examples of
     certain terms.                          activity from the Physical
                                             Activity Guidelines.
     Define `vigorously' and     ...............................
     `moderately' more clearly and
     include examples in laymen's terms.
Several comments suggested adding the
 following questions to the forms:
 Reason for taking the class...  ACL did not adopt these
                                          suggestions. These questions
                                          can be added as an optional
                                          question by grantees when
                                          appropriate.
     Collect name, date of       ...............................
     birth, and insurance information.
     How did you hear about      ...............................
     this class?.
    Use of a mobility aid to include     ...............................
     cane, walker, wheelchair,
     crutches, prosthesis, orthosis,
     others.
For Participant Post Program Survey      ACL adopted the suggestions by:
 only.
Many comments suggested changes to the       Reviewing and
 existing question 8 and 9.                  removing the redundancy of
                                             question 8 and 9.
     Remove the redundancy of        Combining the
     question 8 and 9.                       questions to reduce burden.
     Adjust questions to action-
     oriented responses rather than
     feelings or intent.
     Suggest ``I increased my
     activity level'' rather than ``I
     feel more comfortable increasing
     my activity level.''.
     Suggest moving some
     questions under a different
     heading.
     Recategorize ``recommend
     program to friend''.
     Remove questions that are
     not relevant to falls prevention
     programs that have a different
     focus area.
                                             Removing any
                                             questions that were not
                                             core questions that spanned
                                             all program areas. Removed
                                             questions like ``I have
                                             made safety modifications
                                             in my home . . .''. These
                                             can be optional questions
                                             added by grantees when
                                             appropriate.
                                          Language was adjusted
                                          to be action oriented.
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                       Fall Prevention Coversheet
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                Comment                              Response
------------------------------------------------------------------------
A few comments suggested that program    ACL added language to clarify
 leaders do not know the funding source.  that the form should be
                                          adapted by the grantee to only
                                          include applicable funding
                                          sources.
Several comments suggested adding        ACL has adopted 2 of the
 questions to capture:                    suggestions:
     Mode of delivery..........      A question was
                                             added to indicate mode of
                                             delivery.
     Program setting...........      A question was
                                             added clarifying if
                                             facilitators are paid
                                             staff, volunteers or other.
     Whether facilitators are    ...............................
     paid staff, volunteers or other
     Whether the program is an   ACL did not adopt adding a
     adaptation.                          question about adaptation.
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[[Page 26897]]


                     Fall Prevention Attendance Log
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                Comment                              Response
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A suggestion was submitted to add a      ACL adopted the suggestion add
 column for the total number of classes   a column for the total number
 attended and a check box if the          of classes attended.
 participant was considered a completer. ACL did not adopt adding a box
                                          to check if a participant was
                                          a completer due to the
                                          variability of definition of a
                                          completer across programs.
A suggestion was submitted to add space  ACL did not adopt this
 for the date of each session and names   suggestion. The form can be
 of leaders/coaches.                      modified by the grantee.
Some comments suggested that for ease    ACL acknowledges these
 of data entry, the participant           comments.
 identification number is too long.
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                     Comments Relevant To All Forms
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                Comment                              Response
------------------------------------------------------------------------
Some commenters suggested changes to     ACL will provide the documents
 the collection of data, i.e.,            in Word format. If resources
 prefilled forms and positive remarks     allow, we will provide
 to prevent falls.                        fillable PDFs for grantee use.
One respondent commented that the        ACL acknowledges the comment.
 burden of data entry falls on the
 program coordinators taking hours to
 enter different forms.
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    Estimated Program Burden:
    ACL estimates the burden of this collection of information as 
follows:

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    Respondent/data collection                                 Responses per         Hours per     Annual burden
             activity               Number of respondents        respondent          response          hours
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Program leaders (Program            480 leaders..........  Twice a year (one set             .50             480
 Information Cover Sheet,                                   per program).
 Attendance Log).
Data entry staff (Program           48 data entry staff..  Once per program x                .50             469
 Information Cover Sheet,                                   938 programs.
 Attendance Log, Participant
 Information Survey, Participant
 Post Program Survey).
Program participants (Participant   12,265...............  1....................             .10           1,226
 Information Survey).
Program participants (Participant   7,359................  1....................             .10             735
 Post Program Survey).
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    Total Burden Hours............  .....................  .....................  ..............           2,910
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    Dated: April 10, 2024.
Alison Barkoff,
Principal Deputy Administrator for the Administration for Community 
Living, performing the delegable duties of the Administrator and the 
Assistant Secretary for Aging.
[FR Doc. 2024-08009 Filed 4-15-24; 8:45 am]
BILLING CODE 4154-01-P