[Federal Register Volume 86, Number 143 (Thursday, July 29, 2021)]
[Notices]
[Pages 40848-40849]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2021-16132]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Administration for Community Living


Agency Information Collection Activities; Submission for OMB 
Review; Public Comment Request; State Annual Long-Term Care Ombudsman 
Report-National Ombudsman Reporting System; OMB #0985-0005

AGENCY: Administration for Community Living, HHS.

ACTION: Notice.

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SUMMARY: The Administration for Community Living is announcing that the 
proposed collection of information listed above has been submitted to 
the Office of Management and Budget (OMB) for review and clearance as 
required under section 506(c)(2)(A) of the Paperwork Reduction Act of 
1995. This 30-Day notice collects comments on the information 
collection requirements related to the State Annual Long-Term Care 
Ombudsman Report-National Ombudsman Reporting System [OMB #0985-0005].

DATES: Submit written comments on the collection of information by 
August 30, 2021.

ADDRESSES: Submit written comments and recommendations for the proposed 
information collection within 30 days of publication of this notice to 
www.reginfo.gov/public/do/PRAMain. Find the information collection by 
selecting ``Currently under 30-day Review--Open for Public Comments'' 
or by using the search function. By mail to the Office of Information 
and Regulatory Affairs, OMB, New Executive Office Bldg., 725 17th St. 
NW, Rm. 10235, Washington, DC 20503, Attn: OMB Desk Officer for ACL.

FOR FURTHER INFORMATION CONTACT: Louise Ryan, Administration for 
Community Living, Washington, DC 20201, (206) 615-2299 or by email: 
<a href="/cdn-cgi/l/email-protection#e78b88928e9482c9959e8689a786848bc98f8f94c9808891"><span class="__cf_email__" data-cfemail="264a49534f554308545f47486647454a084e4e5508414950">[email protected]</span></a>.

SUPPLEMENTARY INFORMATION: In compliance with 44 U.S.C. 3507, ACL has 
submitted the following proposed collection of information to OMB for 
review and clearance.
    The Administration for Community Living (ACL) is requesting 
approval to collect data for the State Annual Long-Term Care Ombudsman 
Report-National Ombudsman Reporting System [OMB #0985-0005]. This 
request covers minor changes and corrections to the current information 
collection, with a total of 11,154 annual burden hours. The data 
collection tool will enhance ACL's ability to understand and report on 
Long-Term Care Ombudsman (LTCO) program operations, experiences of 
long-term care facility residents and will reflect changes in LTCO 
program operations and long-term supports and services policies, 
research, and practices. States will continue to provide the following 
data and narrative information in the report:
    1. Numbers and descriptions of cases filed and complaints made on 
behalf of long-term care facility residents to the statewide ombudsman 
program;
    2. Major issues identified impacting on the quality of care and 
life of long-term care facility residents;
    3. Statewide program operations;
    4. Ombudsman activities in addition to complaint investigation; and
    5. Organizational conflict of interest reporting as required by 45 
CFR part 1324.21.

Comments in Response to the 60-Day Federal Register Notice

    A notice was published in the Federal Register on March 10, 2021 
(86 FR 13720). There were four public comments received during the 60-
day FRN. Please see ACLs response to comment listed below.
    Two of the four respondents (Maryland Ombudsman program and the 
National Association of State Ombudsman Programs (NASOP)) recommended 
adding a new complaint code ``infection control.''
    Response: ACL agrees to add one complaint code ``infection 
control'' and corresponding definition, examples and reporting tips. 
The Iowa Ombudsman program recommended adding clarifying information to 
the Code I05 (Housekeeping) to be inclusive of infection control, ACL 
will incorporate its suggestion into the new ``Infection control'' 
code. Two of the four respondents (Maryland Ombudsman program and 
NASOP) recommended changes to the ``examples and reporting tips'' under 
complaint code J01.
    Response: ACL agrees to modify the ``examples and reporting tips'' 
on Complaint Code J01 ``Administrative oversight'' to incorporate 
problems with a facility planning and responding to an emergency.
    ACL received the following comments and did not accept them for 
inclusion in NORS.
    The Maryland Ombudsman proposed adding more detail and examples in 
the description fields in the following cells: S02, S06, S08, S09, 
S12.1, and S13 stating that this would give the State Ombudsman more 
guidance on how to approach the narratives and to help ensure greater 
consistency across the country.

[[Page 40849]]

    Response: ACL in coordination with ACL's grantee, the National 
Ombudsman Resource Center (NORC) created in-depth training and training 
manuals on all aspects of NORS reporting, including examples of 
narratives for both complaint examples and systems issues and does not 
believe that additional guidance is necessary. See https://ltcombudsman.org/omb_support/nors.
    The Maryland Ombudsman program also recommended the addition of a 
new complaint code in Facility Policies, Procedures and Practices (Code 
J) for emergency planning complaints. The Maryland Ombudsman program 
noted that there have been many instances of facilities needing to 
temporarily or permanently relocate residents for a variety of reasons 
from disasters to lack of appropriate staff in the building, facility 
closure, or the facility did not have an appropriate plan or did not 
have a plan at all.
    Response: ACL will not add a new complaint code, but will modify 
complaint code J01 ``Administrative Oversight'' to be inclusive of 
emergency planning.
    One recommendation was to include the addition of a county field 
(e.g., Federal Information Processing Standard code). The commenter 
noted that although looking at differences/variation between states is 
important and valuable, having the ability to look at differences/
variation within each state would be immensely beneficial for the 
conduct of ACL's functions and would allow for analytics to be shared 
with state ombudsmen and other programs nationwide.
    Response: ACL does not accept this recommendation because of the 
level of burden necessary to gather and report this level of data.
    NASOP made recommendations to broaden the types of activities 
reported on systems issues work performed by the State Long-Term 
Ombudsman, the Office and local Ombudsman entities. NASOP asserts that 
this reporting element would provide needed depth and clarity about 
whether a State Long-Term Care Ombudsman has the necessary independence 
and resources to perform systems advocacy as required by the Older 
Americans Act. NASOP proposes that data collected as narrative examples 
of Systems Issues is insufficient and does not have practical utility 
without additional data collection to explain the scope of a state's 
work on systems advocacy. ``By only collecting two examples of a 
systems issue from each state, ACL has no objective means of 
determining a state's compliance with the Act nor the independence of 
the Office. With our proposed addition data collection in Table 3, ACL 
will collect and provide the public with a more accurate picture of 
whether a state program is fulfilling the requirements of the Act.''
    Response: ACL does not agree with NASOP's assessment of the current 
data collection on systems advocacy for several reasons. First, the FY 
2020 data is not yet final and ACL has not been able to share systems 
advocacy data. Additionally, while NORS is one part of measuring 
program effectiveness it is not the only way that ACL determines 
compliance with the Older Americans Act. ACL provides continuous 
technical assistance on matters of compliance, conducted in-depth 
review of states compliance with the Ombudsman program regulation, and 
worked with states to develop compliance plans. ACL also has an on-
going project to evaluate the effectiveness of the Ombudsman program 
and has gathered in-depth data on both state and local level Ombudsman 
program's ability to conduct systemic advocacy. See https://acl.gov/programs/program-evaluations-and-reports. In addition, the proposed 
data collection would be very burdensome on state and local programs to 
collect and report because the two recommended data elements include a 
sub-set of 10 possible elements to select and to keep track of the 
number of instances of each sub-set ultimately resulting in 20 new data 
elements. This type of data would not add meaningful information that 
would benefit ACL considering the level of effort required of states to 
train on this type of data collection, adapt software and report.

Estimated Program Burden

    ACL estimates the burden associated with this collection of 
information as follows: Approximately 11,154 hours, with 52 state 
Ombudsman programs responding annually.

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                                                 Number of      Responses per      Hours per      Annual burden
     Respondent/data collection activity        respondents       respondent        response          hours
----------------------------------------------------------------------------------------------------------------
Total.......................................              52                1            214.5           11,154
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    Dated: July 23, 2021.
Alison Barkoff,
Acting Administrator and Assistant Secretary for Aging.
[FR Doc. 2021-16132 Filed 7-28-21; 8:45 am]
BILLING CODE 4154-01-P


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