Application to Use Burden/Hours from Generic PRA Clearance:
Medicaid and CHIP State Plan, Waiver, and Program Submissions
(CMS-10398, OMB 0938-1148)
Information Collection #22 Health Home State Plan Amendment (SPA)
October 2017
Center for Medicaid and CHIP Services (CMCS)
Centers for Medicare & Medicaid Services (CMS)
The Centers for Medicare & Medicaid Services (CMS) work in partnership with States to implement Medicaid and the Children’s Health Insurance Program (CHIP). Together these programs provide health coverage to millions of Americans. Medicaid and CHIP are based in Federal statute, associated regulations and policy guidance, and the approved State plan documents that serve as a contract between CMS and States about how Medicaid and CHIP will be operated in that State. CMS works collaboratively with States in the ongoing management of programs and policies. CMS provides technical assistance for States who are interested in submitting a Health Home State Plan Amendments (SPA). In addition, CMS developed an Implementation Guide on completing the SPA template for States to use to elect the optional State Plan benefit for Medicaid eligibles with chronic conditions. CMS also continues to work with States through other methods to further the goals of health reform, including program waivers and demonstrations, and other technical assistance initiatives.
Section 2703 of the Affordable Care Act, entitled “State Option to Provide Health Homes for Enrollees with Chronic Conditions,” added section 1945 to the Social Security Act to allow states to elect the health home option under the Medicaid State Plan. Information submitted via the health home State Plan Amendment (SPA) web-based application will be used by CMS Central and Regional Offices to analyze a State’s proposal to implement Section 1945 of the Social Security Act (the Act) to establish a State plan option to provide coordinated care through a health home for individuals with chronic conditions. State Medicaid Agencies will complete the SPA web-based application, and submit it to CMS for a comprehensive analysis.
The Health Home SPA template contains check-off items and free text areas for a State to describe its health home program, such as; population criteria and enrollment, infrastructure, provider standards, delivery service, payment methodology, definition of core health home services, use of health information technology, specific assurances, and quality program monitoring. All information provided by the State in the application is reviewed, approved and maintained based on applicable statutory requirements and CMS guidance. The separate administrative addendum was delinked from the state plan template to allow states to report each year outside the SPA template process. A separate section was developed in MACPro system to allow states to report on quality outcome measures as well as administrative data, in accordance with 1945(f) and 1945(g) of the Act, and Section 3502 of the Affordable Care Act. By delinking the administrative addendum, States can update their outcome measures and administrative data each year in MACPro without having to submit a new amendment.
This collection of this information is critically important in that the provisions in Section 1945 of the Act provide an opportunity for States to build a person-centered system of care that achieves improved outcomes for beneficiaries and better services and value for State Medicaid programs. This provision supports CMS’s overarching approach to improving health care through the simultaneous pursuit of three goals: improving the experience of care; improving the health of populations; and reducing per capita costs of health care.
SMDL# 10-024, ACA #12 - RE: Health Homes for Enrollees with Chronic Conditions. This letter provides preliminary guidance to states on the implementation of section 2703 of the Affordable Care Act. http://downloads.cms.gov/cmsgov/archived-downloads/SMDL/downloads/SMD10024.pdf
CMCS Information Bulletin: December 22, 2010: Web-Based SPA Submission Process for Health Home for Medicaid Enrollees with Chronic Conditions. This bulletin provides guidance on the automated State Plan submission process for Health Homes. http://downloads.cms.gov/cmsgov/archived-downloads/CMCSBulletins/downloads/CIB-12-22-10.pdf
No deviations are requested.
The total approved burden ceiling of the generic ICR is 86,240 hours, and CMS previously requested to use 34,836 hours, leaving our burden ceiling at 51,404 hours. CMS estimates that each State will complete the collection of data and submission to CMS within 80 hours. There is a potential universe of 30 respondents, so the total burden deducted from the total for this request is 2,400 hours.
Wage Estimate
To derive average costs, we used data from the U.S. Bureau of Labor Statistics’ May 2016 National Occupational Employment and Wage Estimates for all salary estimates (http://www.bls.gov/oes/current/oes_nat.htm). In this regard, the following table presents the mean hourly wage, the cost of fringe benefits (calculated at 100 percent of salary), and the adjusted hourly wage.
Occupation Title |
Occupation Code |
Mean Hourly Wage ($/hr) |
Fringe Benefit ($/hr) |
Adjusted Hourly Wage ($/hr) |
Business Operations Specialist |
13-1199 |
35.33 |
35.33 |
70.66 |
As indicated, we are adjusting our employee hourly wage estimates by a factor of 100 percent. This is necessarily a rough adjustment, both because fringe benefits and overhead costs vary significantly from employer to employer, and because methods of estimating these costs vary widely from study to study. Nonetheless, there is no practical alternative and we believe that doubling the hourly wage to estimate total cost is a reasonably accurate estimation method.
In aggregate, we estimate 2,400 hours (30 responses x 80 hours) at a cost of $169,584 (2,400 hrs x $70.66/hr).
Not applicable. This is an extension (without change) of a currently approved GenIC.
Attachments
The following attachment is provided for this information collection:
Health Homes State Plan Amendment
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | CMS |
| File Modified | 0000-00-00 |
| File Created | 2021-01-21 |