Listing of Proposed GC Collections

LISTING OF PROPOSED GENERIC CLEARANCE COLLECTIONS

Below is a comprehensive list and description of all planned generic clearance activities for December 2015 through December 2018. Although we tried to project every possible activity, a situation may arise which will require us to conduct an unanticipated generic clearance. In that case, we will submit a change sheet to adjust the burden for this OMB number. As in the past, before conducting any generic clearance activity, we will submit documentation discussing the activity and a copy of the proposed collection instrument to OMB.

A. MAIL QUESTIONNAIRES

SSA CATEGORY SUB-NUMBER COMPONENT	TITLE & DESCRIPTION OF COLLECTION	Year 1 (December 2015 through November 2016) Burden Hours	Year 2 ( December 2016 through November 2017) Burden Hours	Year 3 (December 2017 through December 2018) Burden Hours
A-01 (DCBQFM)	Report Card Surveys These are brief scannable surveys measuring satisfaction with a specific business process. This category includes annual surveys of customers who have experienced various stages of SSA’s initial disability claims process and customers who have gone through the hearing process in connection with a disability claim. SSA will use the results to track satisfaction trends among these groups with sample sizes large enough to permit National and regional analysis. SSA implemented the annual survey of initial disability claimants in FY 2007 and implemented the annual survey of claimants who experienced the hearing process in FY 2008. We will conduct six surveys (three for the initial level and three for the hearing level) at staggered intervals for each of the upcoming fiscal years. For each of the six surveys, SSA will send a questionnaire with an estimated response time of 5 minutes to 10,000 disability applicants (60,000 total responders). SSA will use a contractor to administer the surveys.	2,500	2,500	2,500
A-02 (DCBQFM)	Service Satisfaction Survey SSA conducts these surveys under the aegis of the agency’s Service Delivery Feedback Program. This survey category includes the Office Visitor Survey (OVS), which is an annual mail questionnaire that obtains satisfaction ratings from people who have visited randomly selected SSA field and hearings offices. Results of the OVS are included in the calculation of the agency’s overall satisfaction performance index. This survey category may also include a brief annual satisfaction survey conducted with people who have used various transactional services on SSA’s website to conduct their business. SSA will also incorporate in the performance index, satisfaction with Internet services. SSA will survey approximately 12,000 respondents each fiscal year, with a response time of 5 minutes. SSA will use a contractor to administer the surveys.	1,000	1,000	1,000
A-03 (DCBFQM)	Special Study Survey SSA plans to conduct satisfaction surveys on topics of current interest focusing on targeted populations or particular features of SSA service. In addition to measuring satisfaction with various SSA services, these surveys may address the service needs and expectations of various client groups currently served by the Agency as well as future client groups. We will form client groups based on factors such as their current or prospective connection with SSA, the type of business conducted by the group, the type of SSA program that affects the group, and demographic factors. Sample sizes will be large enough to permit analysis of pertinent subgroups. SSA will conduct the surveys by mail or the Internet depending on the population we are surveying. Examples of these types of surveys include surveys of prospective SSA clients, a survey of e-mail correspondents, a survey related to field offices’ reception area practices, etc. SSA will use the results to gain insight about the customer experience and for agency planning purposes. Each year we expect to sample no more than 25,000 individuals. We anticipate an average response time of 15 minutes; the actual burden may vary from 10 to 20 minutes depending on the particular survey. SSA will use a contractor to administer the surveys.	6,250	6,250	6,250
A-04 (DCO)	Medicare Enrollment and Other Information Survey SSA field offices provide answers for many complex Medicare issues such as the Medicare enrollment process and equitable relief provisions. We want to make sure our technicians are providing adequate answers at the time of the first contact by our beneficiaries and determine if our beneficiaries make a follow-up contact with SSA or with other sources such as a federal or state agencies, advocacy groups, etc. Our field office technicians will provide the survey along with a return envelope at the end of each in-office visit when a beneficiary is asking for Medicare enrollment or other Medicare information. We believe the survey would require a response time of 5-10 minutes with the potential of 900,000 respondents.	120,000	120,000	120,000

TOTAL BURDEN HOURS REQUESTED FOR MAIL QUESTIONNAIRES:

Year 1	Year 2	Year 3
129,750	129,750	129,750

B. MAIL/INTERNET QUESTIONNAIRES

SSA CATEGORY SUB-NUMBER COMPONENT	TITLE & DESCRIPTION OF COLLECTION	Year 1 (December 2015 through November 2016) Burden Hours	Year 2 (December 2016 through November 2017) Burden Hours	Year 3 (December 2017 through December 2018) Burden Hours
B-01 (DCRDP)	Customer Satisfaction Surveys This is an annual customer satisfaction survey of Social Security Disability Insurance beneficiaries and Supplemental Security Income recipients who have participated in SSA’s Ticket to Work (TTW) Program. We incorporate the customer satisfaction into an annual Employment Network (EN) Report Card and use the results of the survey to monitor and evaluate recipient satisfaction with their EN’s performance. Prospective TTW-eligible participants use the customer satisfaction information on the report card to help them choose an EN. SSA will use the results to track satisfaction trends among these groups with sample sizes large enough to permit national and regional analysis. We will conduct three surveys at staggered intervals for each of the upcoming plan’s years. For each of the surveys, SSA will mail a questionnaire with an estimated response time of 12 minutes to 5,000 to 6,000 participants (11,550 total responders). SSA will use a contractor to administer the surveys.	1,000	1,100	1,200
B-02 (DCBFQM)	Service Satisfaction Survey SSA will conduct surveys to measure satisfaction with a particular business process and interaction with SSA relating to the agency’s anti-fraud initiatives. We use the results to determine the efficacy of processes. Each year, we anticipate a sample size of 20,000 with an estimated time of 5 minutes to complete the survey.	1,667	1,667	1,667

TOTAL BURDEN HOURS REQUESTED FOR MAIL/INTERNET QUESTIONNAIRES:

Year 1	Year 2	Year 3
2,667	2,767	2,867

C. TELEPHONE QUESTIONNAIRES

SSA CATEGORY SUB-NUMBER COMPONENT	TITLE & DESCRIPTION OF COLLECTION	Year 1 (December 2015 through November 2016) Burden Hours	Year 2 (December 2016 through November 2017) Burden Hours	Year 3 (December 2017 through December 2018) Burden Hours
C-01 (DCBFQM)	Service Satisfaction Survey SSA will also conduct these surveys under the aegis of the agency’s Service Delivery Feedback Program. This survey category includes the 800 Number Caller Survey and the Field Office Caller Survey, both designed to obtain satisfaction ratings from people who have conducted business with SSA over the telephone. Results of these two surveys are included in the calculation of the agency’s performance measure for overall satisfaction of people who do business with SSA. The surveys utilize similar short phone questionnaires addressing key factors related to satisfaction with telephone service. We will survey approximately 8,000 respondents with an estimated response time of 15 minutes for each fiscal year.	2,000	2,000	2,000
C-02 (DCBFQM)	Special Study Survey SSA plans to conduct telephone satisfaction surveys with target populations and special-interest issue groups. We will conduct these surveys by telephone. In addition to measuring satisfaction with various SSA services, these surveys may address the service needs and expectations of various client groups currently served by SSA and potential future client groups. Examples of these types of surveys include new features of SSA’s 800-number service, SSA’s online services, and satisfaction with the clarity of specific SSA notices for programs such as the Medicare Part D subsidy program. We will conduct at most two special study surveys each GC plan year with approximately 12,000 total respondents. The estimated response time will be no more than 15 minutes. SSA will use a contractor to administer the surveys.	3,000	3,000	3,000
C-03 (DCO)	Automated Telephone Satisfaction Surveys SSA plans to conduct two on-going automated telephone surveys covering a variety of questions related to SSA’s 800-number service and field office telephone service. SSA will canvassing respondents on their business requests and type of benefits involved; satisfaction with customer service provided and overall rating of 800-number and field office telephone service overall (5 minute survey conducted immediately post call with potentially 5,270,000 respondents/callers; ongoing survey).	439,167	439,167	439,167
C-04	Social Security Administration (SSA) Field Office Network Enterprise (FONE) Satisfaction Survey SSA annually surveys individuals who do business with us to assess their satisfaction with the specific mode of contact they used. As part of this effort, we plan to conduct the SSA FONE satisfaction survey via automation, where we interview members of the public who called SSA’s FONE to conduct their business (5 minute survey conducted immediately post call with potentially 2,070,000 respondents/callers; ongoing survey).	172,500	172,500	172,500

TOTAL BURDEN HOURS REQUESTED FOR TELEPHONE QUESTIONNAIRES:

Year 1	Year 2	Year 3
616,667	616,667	616,667

D. Mail, Online, Telephone Questionnaires

SSA CATEGORY SUB-NUMBER COMPONENT	TITLE & DESCRIPTION OF COLLECTION	Year 1 (December 2015 through November 2016) Burden Hours	Year 2 (December2016 through November 2017) Burden Hours	Year 3 (December 2017 through December 2018) Burden Hours
D-01	Beneficiary Satisfaction Survey To ensure that employment networks (ENs) under our Ticket to Work Program are providing effective and quality service, SSA will assess beneficiaries’ satisfaction with their ENs’ services, staff and supports. In this survey, SSA proposes to conduct a customer satisfaction assessment of select recipients who are currently participating in the Ticket to Work program and have assigned their tickets with a specific EN for three months or longer. We will use the results of the study to monitor and evaluate satisfaction with an EN’s performance. Prospective participants in the Ticket program will use the information to help them choose an EN. We will also incorporate customer satisfaction information derived from the survey into the EN Profile, an online resource guide that contains performance-related data about all ENs. We plan to conduct one survey per year with 30,000 to 40,000 participants per year at 12 minutes per response.	6,000	7,000	8,000

TOTAL BURDEN HOURS REQUESTED FOR COMMENT CARDS:

Year 1	Year 2	Year 3
6,000	7,000	8,000

E. OTHER

SSA CATEGORY SUB-NUMBER COMPONENT	TITLE & DESCRIPTION OF COLLECTION	Year 1 (December 2015 through November 2016) Burden Hours	Year 2 (December 2016 through November 2017) Burden Hours	Year 3 (December 2017 through December 2018) Burden Hours
E-01	Other This includes any possible future clearance that SSA has not covered in the above categories (16,666 respondents per year @ 30 minutes per response).	591,220	591,220	591,220

TOTAL BURDEN HOURS REQUESTED FOR OTHER:

Year 1	Year 2	Year 3
591,220	591,220	591,220

THREE-YEAR GRAND BURDEN TOTAL FOR ALL REQUESTED GENERIC CLEARANCE ACTIVITIES:

GC PLAN YEAR	TOTAL HOURS (FOR ALL CATEGORIES)
Year 1	1,346,304
Year 2	1,347,404
Year 3	1,348,504
3-YEAR TOTAL	4,042,212

Generic Clearance List of Proposed Activities

December 2015 through December 2018

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