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[Federal Register Volume 77, Number 97 (Friday, May 18, 2012)]
[Notices]
[Pages 29644-29645]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: 2012-12080]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Medicare & Medicaid Services

[Document Identifier CMS-10389]

Agency Information Collection Activities: Proposed Collection; 
Comment Request

AGENCY: Centers for Medicare & Medicaid Services, HHS.
    In compliance with the requirement of section 3506(c)(2)(A) of the 
Paperwork Reduction Act of 1995, the Centers for Medicare & Medicaid 
Services (CMS) is publishing the following summary of proposed 
collections for public comment. Interested persons are invited to send 
comments regarding this burden estimate or any other aspect of this 
collection of information, including any of the following subjects: (1) 
The necessity and utility of the proposed information collection for 
the proper performance of the agency's functions; (2) the accuracy of 
the estimated burden; (3) ways to enhance the quality, utility, and 
clarity of the information to be collected; and (4) the use of 
automated collection techniques or other forms of information 
technology to minimize the information collection burden.
    1. Type of Information Collection Request: New collection (Request 
for a new OMB control number). Title of Information Collection: The 
Home and Community-Based Service (HCBS) Experience Survey. Use: This 
study is a one-time pilot field test involving individuals who receive 
HCBS from Medicaid programs. The field test to be conducted under this 
request will be done for the following purposes: (a) To assess survey 
methodology--to determine how well a face-to-face survey and telephone 
survey performs with individuals who receive HCBS services. (b) 
Psychometric Analysis--to

[[Page 29645]]

provide information for the revision and shortening of the survey based 
on the assessment of the reliability and construct validity of survey 
items and composites. (c) Case mix adjustment analysis--Assess the 
variables that may be considered as case mix adjusters.
    These preliminary research activities are not required by 
regulation, and will not be used by CMS to regulate or sanction its 
customers. They will be entirely voluntary and the confidentiality of 
respondents and their responses will be preserved.
    The information collected will be used to revise and test the 
survey instrument described in the Background section of the Supporting 
Statement. Within the PRA package, Attachment B includes two versions 
of the survey (one modified for accessibility) and Attachment C has the 
introductory information. The end result will be an improvement in 
information collection instruments and in the quality of data 
collected, a reduction or minimization of respondent burden, increased 
agency efficiency, and improved responsiveness to the public. Following 
the field test, CMS will seek approval from the CAHPS consortium for 
the HCBS Experience Survey to be a new addition to the CAHPS[supreg] 
family of surveys.
    Form Number: CMS-10389 (OCN 0938-New). Frequency: Once. Affected 
Public: 1 Individuals and households. Number of Respondents: 18,000. 
Total Annual Responses: 18,000. Total Annual Hours: 9,000. (For policy 
questions regarding this collection contact Anita Yuskauskas at 410-
786-0268. For all other issues call 410-786-1326.)
    To obtain copies of the supporting statement and any related forms 
for the proposed paperwork collections referenced above, access CMS' 
Web Site address at http://www.cms.hhs.gov/PaperworkReductionActof1995, 
or Email your request, including your address, phone number, OMB 
number, and CMS document identifier, to Paperwork@cms.hhs.gov, or call 
the Reports Clearance Office on (410) 786-1326.
    In commenting on the proposed information collections please 
reference the document identifier or OMB control number. To be assured 
consideration, comments and recommendations must be submitted in one of 
the following ways by July 17, 2012:
    1. Electronically. You may submit your comments electronically to 
http://www.regulations.gov. Follow the instructions for ``Comment or 
Submission'' or ``More Search Options'' to find the information 
collection document(s) accepting comments.
    2. By regular mail. You may mail written comments to the following 
address:

CMS, Office of Strategic Operations and Regulatory Affairs, Division of 
Regulations Development, Attention: Document Identifier/OMB Control 
Number----, Room C4-26-05, 7500 Security Boulevard, Baltimore, Maryland 
21244-1850.

    Dated: May 15, 2012.
Martique Jones,
Director, Regulations Development Group, Division B, Office of 
Strategic Operations and Regulatory Affairs.
[FR Doc. 2012-12080 Filed 5-17-12; 8:45 am]
BILLING CODE 4120-01-P
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