Performance Measurement Surveys

Forms and Documents

Document Name	Status
Form 3206-0253 OPM Website Feedback Form	New
Form 0 OPM Leadership 360 Form and Instruction	New
Form 0 Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Child Survey Form and Instruction	New
Form 0 Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Adults Form and Instruction	New
30 day published PMS.pdf Supplementary Document	2010-10-21
Performance Measurement Surveys SSB-2010.doc Supporting Statement B	2010-10-19
Generic Survey Performance Measurement SSA 2010_1.doc Supporting Statement A	2010-10-19
60 day published2010-14837[1].pdf Supplementary Document	2010-06-25
Generic Performance Measurement submission master.xls Supplementary Document	2010-05-05

IC Document Collections

IC ID	Document Title	Status
203663	OPM Website Feedback Form	New
192587	OPM Leadership 360 Form and Instruction	New
192586	Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Child Survey Form and Instruction	New
192585	Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Adults Form and Instruction	New

ICR Details

OMB Control No: 3206-0253	ICR Reference No: 200908-3206-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: OPM	Agency Tracking No:
Title: Performance Measurement Surveys
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 02/14/2011
	Date Received in OIRA: 10/21/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2014	36 Months From Approved
Responses	814,950	0	0
Time Burden (Hours)	372,213	0	0
Cost Burden (Dollars)	200,000	0	0

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Abstract: The Office of Personnel Management (OPM) leads Federal agencies in shaping human resources management (HRM) systems to effectively recruit, develop, manage and retain a high quality and diverse workforce. We need to solicit input from our customers to measure our performance in providing services that are citizen-centered, results-oriented and market-based. Performance surveys are valuable tools to gather information about our customers' view of our performance so we can design and implement new ways to improve our service to meet their needs. Our customers include the general public, Federal benefit recipients, Federal agencies and Federal employees. This meets all requirements for Executive Order 12862 and OMB Memorandum 93-14.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 35092	06/21/2010
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 65039	10/21/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
OPM Website Feedback	3206-0253	Website Feedback Form
Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Child Survey	0	Consumer Assessment of Healthcare Providers and Systems (CAHPS) ? Child Survey
Consumer Assessment of Healthcare Providers and Systems (CAHPS) – Adults	0	Consumer Assessment of Healthcare Providers and Systems (CAHPS) � Adults
OPM Leadership 360	0	OPM Leadership 360

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	814,950	0	0	814,950	0	0
Annual Time Burden (Hours)	372,213	0	0	372,213	0	0
Annual Cost Burden (Dollars)	200,000	0	0	200,000	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: The Performance Measurement surveys were previously approved under OMB Control Number 3206-0236. OPM is requesting a separate control number for surveys pertaining to Performance Measurement.

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Annual Cost to Federal Government: $200,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 10/21/2010

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