Justification for Nonsubstantive Change

Justification for Nonsubstantive Change

Healthy Indiana Program (HIP) 2.0 Beneficiary Surveys, Focus Groups, and Informational Interviews

CMS-10615, OMB 0938-1300

Summary

The following describes this iteration’s nonsubstantive changes, consisting of three adjustments. Adjustment #1 removes the beneficiary survey data collection activities. Adjustment #2 increases the number of focus groups in the State of Indiana. Adjustment #3 reflects changes to the focus group moderator guide. Adjustment #4 updates cost burden estimates based on more current wage rate data for Indiana.

Adjustments 1 and 2 introduce changes to the burden. Overall, the burden will decrease.

While Adjustment #2 increases the number of respondents, Adjustment #1 substantially decreases the overall number of respondents by eliminating the beneficiary survey.

This request does not revise any requirements, nor does it propose any program changes. Likewise, our per response burden estimate is unchanged for focus groups and informational interviews.

Adjustment #1

Our most recent information collection extension request (approved on 11/15/2016) included beneficiary survey data collection activities.

Since the approval of the information collection request, the scope of work in the federal evaluation has changed.

This nonsubstantive iteration reflects those changes in the scope of work in the federal evaluation and removes all beneficiary survey data collection activities. Thereby, removing 5,182 respondents for this information collection.

Adjustment #2

Our most recent information collection extension request (approved on 11/15/2016) included focus group data collection activities.

Since the approval of the information collection request, the scope of work in the federal evaluation has changed.

This nonsubstantive iteration reflects those changes in the scope of work in the federal evaluation and increases the number of focus groups from 4 to up to 8, thereby increasing the number of respondents from 40 to up to 80 for this information collection.

Adjustment #3

Since the approval of the information collection request, the evaluation team re-engaged with the state of Indiana to obtain and incorporate their feedback on changes to the focus group moderator guide. These changes do not change the intent of the questions in the guide, but are updates to the phrasing of the questions that introduce more clarity and will enable the evaluation team to obtain more comprehensive responses from focus group participants.

Adjustment #4

Our most recent information collection extension request (approved on 11/15/2016) included information based on May 2015 wage rates for Indiana (median overall hourly wage estimates for the State of Indiana (http://www.bls.gov/oes/current/oes_in.htm).

This nonsubstantive iteration adjusts upward the cost estimates per respondent based on most recent (May 2016) data on wage rates for Indiana, and increases the estimates from $15.82/hour to $16.25/hour.

Adjustment

This nonsubstantive iteration adjusts:

• The overall number of respondents by -5,095

• The overall number of responses by -5,095

• The overall number of hours by -1,045.5

• The annual wage cost per respondent by +$0.43

Summary of Changes

The following figures reconcile this iteration’s nonsubstantive changes that culminate in our final burden estimates.

Respondents (Total)
Nov. 15, 2016 (Supporting Statement) – Beneficiary survey	(5,182 - 5,182)
-- Focus groups	80 (40 + 40)
Adjustment	-5,095 (40 – 5,182)
Final Estimate	80 (5,182 - 5,182 + 40 + 40 )

Responses (Total)
Nov. 15, 2016 Jan 15, 2014 (Supporting Statement) – Beneficiary survey	0 (5,182 - 5,182)
--Focus groups	80 (40 + 40)
--Informational Interviews	18
Adjustment	-5,095 (80 + 7 – 5,182)
Final Estimate	80 (5,182 - 5,182 + 40 + 40)

Participation Time
Nov. 15, 2016 Jan 15, 2014 (Supporting Statement) – Beneficiary survey	0 hours (.25 - .25)
--Focus groups	3 hours
--Informational Interviews	1.5 hours
Adjustment	-.25 (4.75 - .25)
Final Estimate	4.5

Total Hours (annual)
Nov. 15, 2016 Jan 15, 2014 (Supporting Statement) – Beneficiary survey	0 (1,296 – 1,296)
--Focus groups	240 (120+ 120)
--Informational Interviews	18 (27)
Adjustment	-1,045.5
Final Estimate	258 (1,296 – 1,296 + 120 +120 +27 )

Wage Costs per Respondent per Hour (dollars)
Nov. 15, 2016 Jan 15, 2014 (Supporting Statement) – Beneficiary survey	0 (15.82 – 15.82)
--Focus groups	+0.43 (16.25 - 15.82)
--Informational Interviews	+0.43 (16.25 - 15.82)
Adjustment	+0.43
Final Estimate	16.25

Collection Instruments and Supplemental Documents

The information collection documents included with this request consists of the following:

• Supporting Statement A (Revised)

• Supporting Statement B (Revised)

• Supporting Materials: Focus Groups (Revised)

• Beneficiary Surveys Paper Versions (Removed, N/A)

• Beneficiary Survey Web Screenshots (Removed, N/A)

• Beneficiary Survey Cover Letter (Removed, N/A)

• Beneficiary Survey Envelopes (Removed, N/A)

• Focus Group Recruitment Script (Revised)

• Focus Group Moderator’s Guide (Revised)

• Informational Interview Protocol (Revised)

• Focus Group Recruitment Script Crosswalk (Revised)

• Focus Group Moderator’s Guide Crosswalk (Revised)

• Focus Group Informed Consent Crosswalk (Revised)

• Informational Interview Protocol Crosswalk (Revised)

All revised documents are provided in versions with tracked changes and a clean Word document in which all tracked changes have been accepted.

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