Understanding How Families Access and Use Long-Term Care Services

ASPE Generic Clearance for the Collection of Qualitative Research and Assessment

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0990-0421 can be found here:

Documents and Forms

Document Name Document Type
Attachment A Draft FG Discusion Guide.docx Other-survey
Attachment B Recruitment Screener.docx Other-screener
SSA_Longtermcare Focus Groups_minus remuneration.docx Support statement A IC Document
SSB_Longtermcare Focus Groups.docx Suppt st. B IC Document
LTC Focus Groups_Cover Sheet_0990-0421.doc cover memo IC Document

Information Collection (IC) Details

IC Title:	Understanding How Families Access and Use Long-Term Care Services	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-screener			Attachment B Recruitment Screener.docx		No		Paper Only
Other-survey			Attachment A Draft FG Discusion Guide.docx		No		Paper Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 40	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	40	40
Annual IC Time Burden (Hours)	80	80
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Support statement A	SSA_Longtermcare Focus Groups_minus remuneration.docx	05/10/2016
Suppt st. B	SSB_Longtermcare Focus Groups.docx	05/10/2016
cover memo	LTC Focus Groups_Cover Sheet_0990-0421.doc	05/10/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.