Family-to-Family Health Information Center (F2F HIC) Feedback Surveys

ICR 201910-0906-002

OMB: 0906-0040

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Unchanged
Form and Instruction
Unchanged
Supplementary Document
2019-10-10
Supplementary Document
2019-10-10
Justification for No Material/Nonsubstantive Change
2019-10-10
Supplementary Document
2018-12-06
Supporting Statement B
2018-12-06
Supporting Statement A
2019-03-19
ICR Details
0906-0040 201910-0906-002
Active 201812-0906-001
HHS/HRSA
Family-to-Family Health Information Center (F2F HIC) Feedback Surveys
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/15/2019
Retrieve Notice of Action (NOA) 10/10/2019
  Inventory as of this Action Requested Previously Approved
03/31/2022 03/31/2022 03/31/2022
1,206 0 1,206
5,423 0 5,423
0 0 0

The surveys will provide mechanisms to capture consistent, performance data; provide data to support the HHS Secretary's priorities of engagement; and allow HRSA to determine the extent to which F2F HICs provide service. F2F HICs can also use the data to evaluate the effectiveness of their interventions and improve services. Respondents are family members of children with special health care needs and professionals who serve such families.

US Code: 42 USC 701(c) Name of Law: Social Security Act, Title V, 501(c)
   PL: Pub.L. 115 - 123 50501 Name of Law: Bipartisan Budget Act of 2018
   PL: Pub.L. 114 - 10 216 Name of Law: Medicare Access and CHIP Reautorization Act of 2015
  
None

Not associated with rulemaking

  83 FR 7482 02/21/2018
83 FR 63182 12/07/2018
Yes

  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 1,206 1,206 0 0 0 0
Annual Time Burden (Hours) 5,423 5,423 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new ICR, so burden increase is from zero (0).

$52,578
No
    No
    No
No
No
No
Uncollected
Elyana Bowman 301 443-3983 enadjem@hrsa.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
10/10/2019


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