Understanding Changes to Local Health Department Clinical Service Provision

DOCUMENTATION FOR THE GENERIC CLEARANCE
FOR THE COLLECTION OF QUALITATIVE RESEARCH &
ASSESSMENT

TITLE OF INFORMATION COLLECTION:
Understanding Changes to Local Health Department Clinical Service Provision
[X] INTERVIEWS
[ ] SMALL DISCUSSION GROUPS
[ ] FOCUS GROUPS
[X ] QUESTIONNAIRES
[ ] OTHER (EXPLAIN: )
DESCRIPTION OF THIS SPECIFIC COLLECTION
1.

Intended purpose

This is an exploratory project to identify and learn from local health departments (LHDs) who
have been able to continue providing clinical services in states that have and have not expanded
Medicaid. We aim to examine where supply of clinical services delivered by LHDs are meeting
potential demand for these services as well as how LHDs may or may not have changed as a
result of the changes in insurance coverage as a result of the Affordable Care Act (ACA). The
goal of the project is to begin to understand if there are appropriate questions that can be asked of
LHDs to determine, on a regular basis, if and how their service delivery mix changes over time
or not.

2.

Need for the collection

To our knowledge, there is no information that has been or is currently being collected similar to
this. This is an exploratory study to answer questions that we currently do not have the data to
answer through interviews.
3.

Planned use of the data

Data will be collected and used for identifying potential mechanisms used by LHDs to
potentially monitor if and how their service delivery mix changes over time or not.

4.

Date(s) and location(s)

Data collection will begin in October 2015 and continue until August 2016.
5.

Collection procedures

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We are proposing to use interviews with local health departments (LHDs) identified through a
positive deviance approach to understanding how LHDs may or may not be changing as a result
of expanded insurance coverage. We anticipate a sample of 30-40 LHDs to be targeted for key
informant interviews.
We have developed a telephone interview guide (not more than 1 hour in length) that focuses on
the following topics: types of clinical services provided, changes in service provisions over the
past 5 years, LHD funding sources, changes in funding over the past 5 years, interactions with
payers (Medicaid, private payers, etc.), and challenges to service provisions and reimbursement,
among other topics. Dr. Klaiman has convened an expert panel of six to seven federal experts in
LHD services and billing for feedback on the interview guide prior to implementing it. She will
also pilot the interview guide prior to administering it to participants with no more than nine
individuals.
6.

Number of collections (e.g., focus groups, surveys, sessions)

We anticipate a sample of 30-40 LHDs to be targeted for interviews.
7.

Description of respondents/participants

Respondents will be LHD staff with oversight responsibilities of clinical service delivery and
billing activities.
8.

Description of how results will be used

Results will be used to determine if a tool for quantitative data collection may be useful to test
theories developed in the qualitative analysis.

9.

Description of how results will or will not be disseminated and why or why not

ASPE will not publish the data collected.
AMOUNT OF ANY PROPOSED STIPEND OR INCENTIVE
There is no proposed stipend or incentive.

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BURDEN HOUR COMPUTATION (Number of responses (X) estimated response or
participation time in minutes (/60) = annual burden hours):

Type of
Respondent

No. of
Respondent
s

No. of
Responses per
Respondent

Average
Burden
per
Response
(in hours)

Local Health
Department
Staff

40

1

1

TOTALS

40

40

Total
Burden
Hours

Hourly
Wage
Rate

Total
Responden
t Costs

40

$34.21

$1,368.40

40

$1,368.40

BURDEN COST COMPUTATION
Not applicable.
OTHER SUPPORTING INFORMATION
REQUESTED APPROVAL DATE: November 1, 2015
NAME OF CONTACT PERSON: Amanda Cash, Contracting Officer Representative,
HHS/ASPE
TELEPHONE NUMBER: 202.260.0362, amanda.cash@hhs.gov
DEPARTMENT/OFFICE/BUREAU: U.S. Department of Health and Human Services (HHS),
Assistant Secretary of Planning and Evaluation (ASPE)

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