Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection	Form	Modified	Available
Non-Substantive Change to ADSSP Collection Tool.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2017-07-06	Repair queued
2 of 3 ADSSP Definitions for Data Collection.doc	Supplementary Document	Uploaded 2010-05-20	Available
ADSSP_OMB Data Supporting Statement_OMB Updated 6.22.17_v2.docx	Supporting Statement A	Uploaded 2017-06-22	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
178976	Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection	Form	Modified

ICR Details

OMB Control No: 0985-0022	ICR Reference No: 201707-0985-001
Status: Historical Active	Previous ICR Reference No: 201612-0985-004
Agency/Subagency: HHS/ACL	Agency Tracking No: 20468
Title: Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/07/2017
	Date Received in OIRA: 07/06/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2020	06/30/2020	06/30/2020
Responses	228	0	228
Time Burden (Hours)	983	0	983
Cost Burden (Dollars)	0	0	0

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Abstract: The Alzheimer's Disease Supportive Services Program (ADSSP) was established under Section 398 of the Public Health Service Act (P.L. 78-410; 42 U.S.C. 280c-3). It was amended by the Home Health Care and Alzheimer's Disease Amendments of 1990 (PL 101-557) and by the Health Professions Education Partnerships Act of 1998 (PL 105-392). The ADSSP is administered by the Administration on Aging (AoA) within the U.S. Department of Health and Human Services. The ADSSP program helps states extend supports and services to persons with dementia and their family caregivers, with a focus on underserved populations. The PHS Act requires AoA to "provide for an evaluation of each demonstration project for which a grant is made." In compliance with the PHS Act, AoA developed a new State data collection protocol that will require future ADSSP state grantees (those funded starting in FY 2011) to transmit semi-annual data to AoA. In December 2009, AoA initiated a review of the current ADSSP-Data Reporting Tool (ADSSP-DRT) to ensure the acceptability of these items for evaluating the program and minimizing burden for respondents. This review included experts in the field of Alzheimer's disease and long-term care who are familiar with the program, as well as current ADSSP grantees. Feedback was provided by phone and e-mail over a period of 4 months. The result of this input is the revised ADSSP-DRT and supporting documents. As with the current ADSSP-DRT, AoA will work with ADSSP grantees to ensure easy access to a reporting system and offer regular training in using the tool to ensure minimal burden for program grantees.

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Authorizing Statute(s): PL: Pub.L. 101 - 557 398 399 399A Name of Law: Home Health Care and Alzheimer's Disease Amendment of 1990
   PL: Pub.L. 78 - 410 398 Name of Law: Public Health Service Act
   PL: Pub.L. 105 - 392 302 Name of Law: Health Professions Education Partnerships Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 57591	08/23/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 96002	12/29/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Alzheimer's Disease Supportive Services Program (ADSSP) Data Collection	1	Proposed Alzheimer Disease Prevention Reporting Tool

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ICR Summary of Burden

table that charts list of burden

	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	228	228	0	0	0	0
Annual Time Burden (Hours)	983	983	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The annual reporting burden hour estimates have decreased from 1176 hours to 983.44. The following reasons account for the change in burden hour estimates: • Although, for data set approved in 2013, it was anticipated that grantee respondents would spend 39 hours reporting annually, the actual number of hours spent (local and state combined), as reported by the current ADSSP and ADI grantees consulted, was 16.54 hours annually per grant • The 39 hours annual burden hour estimate from 2013 was an over-estimate because data provided from grantees were based on the 2010 version. Several items included in the 2010 tool were not included in the 2013 revised tool. The 2016 revision includes fewer items than the 2013 revision. The following reasons account for the change in burden cost estimates: • The new estimates are for 38 grants, rather than the 30 grants from the previous ADSSP-DRT approval. • The pay rates for both local and grantee staff increased between 2013 and 2016. • The annualized cost to the government decreased due to decreased contractor costs through the elimination of maintenance for a data collection web platform.

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Annual Cost to Federal Government: $22,288

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 07/06/2017

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