OMB Comments on
SHIP Reporting – Client Contact Form, Public and Media Activity Form, and Resource Report Form (0938-0850)
1. (Question 12) How are data that states are already collecting being incorporated into this information collection? To what extent will this information collection be duplicating state efforts?
Answer: The data elements included on the three NPR forms were agreed to by each of the 54 states so that there could be a common set of data elements for CMS comparison and performance assessment purposes. For many states, this is the only data collection instrument for the services they provide. Some states collect information for grantors other than CMS (state and local government, other federal programs, or foundations) and may use different data systems. They then extract NPR data required by CMS from their files and upload it into the NPR database. There is some duplication of a few of the data elements by some states.
2. (Question 15) Why is the burden of filling out these forms being shifted from the SCHIP Program Director to each of the counselors and staff conducting the counseling and outreach events?
Answer: (Please note that the SCHIP program is different from the SHIP program that this data is being collected.) SHIP counselors are the front line persons counseling Medicare beneficiaries and can complete the forms real time while with the beneficiary. Some counselors enter data directly into the NPR data base (website) while counseling the beneficiary; others complete the paper form. The forms are then collected by the SHIP Director who may use a single entry point for submitting the data into the NPR data base (website).
3. (Question 11) How is information on age, income, gender, disability, and ethnicity/race being used to evaluate whether a SHIP is adequately making its services available? Will this demographic information be used for any other purpose?
Answer: Information is collected to ensure that SHIP services are accessible to all members of the Medicare community such that no group is unserved or underserved. The information is used by CMS and by the SHIPs in program development, to identify the need for additional and update training for counselors, and in helping to target hard-to-reach populations at the local level. LIS, disability, and racial/ethnic populations are a primary focus of CMS as we continue to implement MMA. Performance measures introduced in the 2007 SHIP grant announcement include specific measures for providing access to low-income persons, beneficiaries with disabilities, and for partners to help SHIPs in providing a wider network of resources. This information is not used for any other purpose. CMS does not use any beneficiary names and does not collect Medicare numbers or SSN. The information on beneficiary names was requested by SHIPs so that counselors could have contact information should they need to provide additional information to a beneficiary. Only the States have access to beneficiary names, telephone numbers and addresses.
4. In the last cell of the Client Contact Form table, why was the COBRA option deleted?
Answer: SHIP Directors said they were not getting requests for this information. When data was run on the frequency of the topics discussed, this had a very low frequency.
5. For the race/ethnicity questions on the forms, is it possible for a respondent to identify with more than one race?
Answer: Yes, a respondent can identify with more than one race.
Division of SHIP Relations, 6/15/07
| File Type | application/msword |
| File Title | OMB Comments on |
| Author | Cafarella_N |
| Last Modified By | CMS |
| File Modified | 2007-06-15 |
| File Created | 2007-06-15 |