Evaluation of the Oregon Medicaid Reform Demonstration: Adult Interview, Child Interview, Pediatric Asthma Interview, Insulin- Dependent Diabetes Interview, Low Back Pain Interview Medical....

ICR 199709-0938-014

OMB: 0938-0710

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
ICR Details
0938-0710 199709-0938-014
Historical Active
HHS/CMS
Evaluation of the Oregon Medicaid Reform Demonstration: Adult Interview, Child Interview, Pediatric Asthma Interview, Insulin- Dependent Diabetes Interview, Low Back Pain Interview Medical....
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 11/26/1997
Retrieve Notice of Action (NOA) 09/30/1997
This information collection is approved through 11-2000 under the following conditions: HCFA will immediately add questions to determine the effect of a Medicaid expansion on existing coverage. Specifically, this survey should establish what percentage of the new eligibles replaced existing employer-based coverage with Medicaid; and whether area employers of low-income individuals "dropping" insurance coverage becasue of the increased availability of Medicaid. As discussed with HCFA, the previously cleared baseline (0938-0681) may not be used as part of the quantitative analysis of of the Demonstration's impacts, but may be used qualitatively to reference health and insurance status of individuals surveyed in early 1996.
  Inventory as of this Action Requested Previously Approved
11/30/2000 11/30/2000
5,533 0 0
2,242 0 0
0 0 0

The survey instruments listed above are for use in the evaluation of the Oregon Medicaid Reform Demonstration. The adult and child interviews are designed to collect information on health status, access to care, satisfaction with care, and past health insurance status for adult and child members of the Oregon Health Plan (OHP), as well as a comparison group of individuals who are not OHP members. The pediatric asthma interview, insulin-dependent diabetes interview, and low back pain interview collect information on quality of care, utilization of care, satisfaction with care, and health status.

None
None


No

  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 5,533 0 0 5,533 0 0
Annual Time Burden (Hours) 2,242 0 0 2,242 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
09/30/1997


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