Health Resources and Services Administration
SUPPORTING STATEMENT
HRSA Division of Home Visiting and Early Childhood Systems
A. Justification
1. Circumstances of Information Collection
This is a request for OMB approval of a qualitative voluntary customer satisfaction survey under HRSA’s generic clearance.
HRSA’s Division of Home Visiting and Early Childhood Systems will obtain feedback from grantees of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program that was authorized under the Social Security Act, Title V, Section 511 (42 USC 711), as amended by Section 2951 of the Patient Protection and Affordable Care Act (Pub. L. No. 111-148).
Executive Order 12862 directs agencies that "provide significant services directly to the public" to "survey customers to determine the kind and quality of services they want and their level of satisfaction with existing services". The objective of surveying the MIECHV grantees is to identify technical assistance priorities for calendar year (CY) 2013.
2. Purpose and Use of the Information
The MIECHV Technical Assistance Coordinating Center (TACC) is tasked with providing technical assistance (TA) resources and services to MIECHV grantees. As part of these responsibilities, the TACC is also charged with conducting a technical assistance needs assessment of MIECHV grantees.
The primary use for information gathered through the survey is to identify TA priorities for CY 2013. HRSA and the TACC will only use the information gathered for internal purposes to get a better understanding of existing grantee needs.
Survey respondents will include MIECHV grantees. The surveys will include questions regarding potential TA topics and will elicit responses regarding pressing needs and other TA topics of interest not previously identified. Copies of the survey instruments are attached.
3. Use of Improved Information Technology
The survey will be disseminated via an online survey tool. Potential respondents will be emailed about the survey, and that email will include a link to the survey.
4. Efforts to Avoid Duplication
This survey is disseminated once annually. It is not duplicative of any other data collection related to technical assistance administered by the program.
5. Involvement of Small Entities
No small businesses will be involved in this study.
6. Consequences if Information Collected Less Frequently
This survey is an important tool in ensuring that grantees receive the TA needed to implement their MIECHV grants as fully and excellently as possible. Grantees will respond to this survey annually. It is important that they respond with this frequency in order to ensure that the resources and services provided by the TACC are relevant and timely.
7. Consistency With the Guidelines in 5 CFR 1320.5(d)(2)
These surveys will be implemented in a manner fully consistent with 5 CFR 1320.5(d)(2).
8. Consultation Outside the Agency
In accordance with 5 CFR 1320.8(d), on April 24, 2009, a 30 day notice was published in the Federal Register for HRSA’s generic clearance, OMB Control No. 0915-0212 (Vol. 74, Page 18726). No public comments were received.
The surveys for this activity were developed by TACC staff with close collaboration of MIECHV staff.
9. Remuneration of Respondents
Not Applicable.
10. Assurance of Confidentiality
To date, the HRSA customer satisfaction surveys have not collected personally identifiable information from respondents. The only personally-identifiable information to be collected will be the state/territory that the respondent works in. The survey will not collect names, titles, or any contact information. Participation is fully voluntary. Respondents will be assured that neither their participation/non-participation nor any responses to items will have any effect on their participation in HRSA programs.
11. Questions of a Sensitive Nature
The survey does not contain questions of a sensitive nature.
12. Estimates of Annualized Hour Burden
Respondents
Respondents will include all MIECHV grantees. These 56 grantees will respond to this survey once annually and the annual hour burden is .25 hours. The time estimate was based on conducting a trial run of reading through the questions and potential answers. The estimate will be revised if needed once the questions are put into the Survey Monkey software and some individual testers take the full survey online.
Annual burden estimates
Type of Collection |
Number of Respondents |
Responses per Respondent |
Total Responses |
Hours per Respondent |
Total Burden Hours |
Wage Rate |
Total Hour Cost |
TACC survey |
56 |
1 |
56 |
0.25 |
14 |
$50 |
$700 |
Total |
56 |
-- |
56 |
-- |
14 |
-- |
$700 |
Planned frequency of information collection
This survey is conducted annually.
13. Estimates of Annualized Cost Burden to Respondents
The only associated cost to respondents is their time to provide the requested information.
14. Estimates of Annualized Cost to the Government
The survey will be administered by the TACC. The estimated cost is $22,000.
15. Change in Burden
Not Applicable. This is a new activity under HRSA’s generic clearance and will be included in the total burden currently approved by OMB under OMB Control No. 0915-0212.
16. Plans for Analysis and Timetable of Key Activities
The online surveys will be completed during a 10 day period, with another 9 day grace period to allow for late respondents. All the responses will be exported to an Excel spreadsheet for analysis. Narrative information from the survey will be read and summarized to highlight key themes. Responses to closed-ended questions will be analyzed using descriptive statistics (e.g., frequencies, averages). The responses will be used to determine the most pressing technical assistance needs across the grantees and to plan technical assistance activities based on the results.
The timetable is as follows:
Within one week of HRSA approval, will send needs assessment out to the MIECHV grantees.
After 8 days, will send reminder emails to all MIECHV grantees reminding them to complete the survey.
After a total of 19 days, will close the survey.
Analysis will be completed within one week of close of survey.
Results written and distributed to HRSA COTR within two weeks of survey closure.
17. Exemption for Display of Expiration Date
No exemption is being requested. The expiration date will be displayed.
18. Certifications
This information collection activity will comply with the requirements in 5 CFR 1320.9.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| File Title | GENERIC - Good Supporting Statement Example |
| Author | Jodi.Duckhorn |
| File Modified | 0000-00-00 |
| File Created | 2021-01-30 |