Supporting Statement B

60 - Supporting Statement B (2020 version 2).docx

Generic Clearance for Medicaid and CHIP State Plan, Waiver, and Program Submissions (CMS-10398)

Supporting Statement B

OMB: 0938-1148

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Supporting Statement – Part B

SUPPORT Act Survey Of Housing-Related Supports And Services Under Medicaid To Individuals With Substance Use Disorders

CMS-10398 #60, OMB 0938-1148


1. Respondent Universe and Sampling Methods

The 1115 Demonstration Support Contract will administer a single mode (PDF/Microsoft Word document) data collection of all eligible 50 states and the District of Columbia. The State Technical Assistance Needs Assessment will collect information on the state’s current activities around providing housing-related supports and services to individuals with substance use disorder (SUD) under Medicaid. The needs assessment also assesses areas of need for technical assistance. Expected response rate is 100 percent.


2. Information Collection Procedures


State Medicaid directors will be emailed a needs assessment packet including a cover letter, State Technical Assistance Needs Assessment and a Glossary of Terms. Directors are encouraged to complete the needs assessment questionnaire via paper or fillable PDF (provided through email), or delegate the survey’s completion to an appropriate staff person. Those that do not respond after two weeks will be sent a reminder email encouraging participation. A glossary of key terms will be provided to respondents (Attachment A.2). Examples of the cover letter and State Technical Assistance Needs Assessment are included as Attachments A.3 and A.1 respectively.


3. Methods to Maximize Response Rates

It is critical to make communication between state directors and the government contractors conducting the study for CMS as fluid and easy as possible. The following methods will be used to maximize response rates for the needs assessment:



  • To handle undelivered email resulting from the needs assessment packet mailing, causing an email error (bounce-back), the contact information will be corrected and re-emailed as necessary.


  • Paper needs assessment will be available upon request and will be included in the needs assessment packet mailing to accommodate state directors that prefer to complete the needs assessment on paper, as opposed to the fillable PDF version. All documents will be requested to be emailed back to the data collection contractor. If hard copy mailing is preferred, the mailing address is provided in the instructions of the needs assessment.


  • Fillable PDF needs assessment will be available upon request and will be emailed to accommodate state directors that prefer to complete the needs assessment electronically via fillable PDF. Completed PDF needs assessments will be emailed back to the data collection contractor.


  • Reminder email to encourage agency staff that have not yet responded, will be sent two weeks after the initial survey packet is mailed. If necessary, a second reminder email will be sent at four weeks.


  • A toll-free telephone helpline is available for state directors to call with questions about the needs assessment. Staff can call the helpline to report a change in the director, a new contact person for the needs assessment, or to ask for assistance in completing the needs assessment.


4. Tests of Procedures or Methods Undertaken

Pretesting is an effective means of refining collections of information to minimize burden and improve utility. Mathematica piloted the needs assessment with Illinois on February 19, 2020 and Washington on February 21, 2020. Helpful feedback from the two states was provided and minor revisions were made to improve questions asked throughout the needs assessment.


5. Statistical Consultants/Individuals Collecting and/or Analyzing Data

The data collected under a contract with Mathematica for the instrument design, development, fielding and data cleaning. Mathematica has a subcontract with the Technical Assistance Collaborative who is responsible for assisting with technical assistance and fielding the needs assessment.


The Project Directors are:


Mathematica Policy Research Technical Assistance Collaborative

Maggie Samra David de Voursney

1100 First Street, NE, 12th Floor 31 St James Avenue Suite 950

Washington, DC 20002-4221 Boston, MA 02116

(202) 264-3471 (202) 460-6741

[email protected] [email protected]


File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
AuthorKevin Manbodh
File Modified0000-00-00
File Created2021-01-14

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