The Administration for Community
Living/Administration on Aging (ACL/AoA) is requesting approval
from the Office of Management and Budget (OMB) for data collection
associated with the Process Evaluation and Special Studies Related
to the Long-Term Care Ombudsman Program (LTCOP) (Contract #
HHSP233201500048I). ). The Older Americans Act (OAA) Title III-C
Elderly Nutrition Services Program (statutory authority is
contained in Title II section 205(a)(2)(A) authorizes ACL to
evaluate all named programs. The goal of the LTCOP (named in
section 712 of the Older American’s Act) is to protect and promote
the health, safety, welfare, and rights of long-term care facility
residents. Administered by ACL/AoA, LTCOPs operate in all 50
states, the District of Columbia, Puerto Rico, and Guam. Each of
these programs is led by a full-time ombudsman who is responsible
for statewide program administration and oversight of
representatives of the office and volunteers who assist in carrying
out the core activities of the program, including resolving
residents' complaints, advocating for systemic change, and
providing information and consultation to residents and their
families. In 2014, there were 1,293 paid program staff and 8,155
volunteers serving the program across the country and in Puerto
Rico. The purpose of the process evaluation is to obtain a thorough
understanding of the LTCOP’s structure and operations at the
national, state and local levels; use of resources to carry out
legislative mandates; the nature of program partnerships; and
processes for sharing information on promising program practices
and areas for improvement. Data collection for the process
evaluation consists of two rounds. ACL seeks clearance for round
one and provisional clearance for Round 2 dependent upon receiving
final marked up surveys. The first round focuses on obtaining
information from three respondent categories at the national and
state levels: Federal staff, national stakeholders, and State
ombudsmen. Data collection from these respondents will help inform
and refine the second round of data collection focusing on
obtaining information from respondents at the local level. These
include local directors/regional representatives, local
representatives, and volunteers. For example, data collected from
Round 1 will serve to inform the subsequent data collection for
Task 7 of the project. This task focuses on investigating how the
ombudsman program has been addressing and affecting the changing
landscape of long term services and supports (LTSS). State
ombudsmen responses to questions about reforms in LTSS and home and
community-based care will help identify states for further study
and obtain information at the local level. This package addresses
these two rounds of the project, with an emphasis on the first
round
On behalf of this Federal agency, I certify that
the collection of information encompassed by this request complies
with 5 CFR 1320.9 and the related provisions of 5 CFR
1320.8(b)(3).
The following is a summary of the topics, regarding
the proposed collection of information, that the certification
covers:
(i) Why the information is being collected;
(ii) Use of information;
(iii) Burden estimate;
(iv) Nature of response (voluntary, required for a
benefit, or mandatory);
(v) Nature and extent of confidentiality; and
(vi) Need to display currently valid OMB control
number;
If you are unable to certify compliance with any of
these provisions, identify the item by leaving the box unchecked
and explain the reason in the Supporting Statement.
Form 1 Volunteers Survey
OMB Package Section B_FINAL.docx
Volunteers Survey