Change Memo

DATE: January 15, 2021

TO: Daniel Cline, OMB Desk Officer

Quinn Hirsch, OMB Desk Officer

FROM: Lisa Wright-Solomon, HRSA Information Collection Clearance Officer

_____________________________________________________________________________

Request: The Health Resources and Services Administration’s (HRSA) Maternal and Child Health Bureau (MCHB) requests approval for this non-substantive change memo for the Family-to-Family Health Information Center (F2F HIC) Feedback Surveys information collection request (OMB # 0906-0040, expires 3/31/2022). The data collection instruments currently consist of grant recipient instructions and three surveys: 1) Family Survey (One-to-One), 2) Professional Survey (One-to-One Service), and the 3) Training Survey. Through this non-substantive change memo, HRSA is requesting OMB approval for the Spanish translations of these instruments.

Purpose: The purpose of the translated surveys is to gather feedback from families with children with special health care needs (CSHCN) whose primary language is Spanish.

The F2F HIC grant recipients are required to conduct feedback surveys with the families and professionals served. The purpose of the surveys is to determine the extent to which F2F HICs provide service to families of CYSHCN and professionals who serve such families. Each F2F HIC will administer the surveys and report the data to HRSA. Survey respondents will be asked to answer questions about how useful they found the information, assistance, or resources received from the F2F HICs.

Data from the surveys will support the HHS Secretary's priorities of engagement and performance and will provide mechanisms to capture consistent, performance data from F2F HIC grant recipients. The data will also allow F2F HICs to evaluate the effectiveness of their interventions and improve services provided to families and the professionals who serve CYSHCN. The information collected will also help HRSA demonstrate the reach of the F2F HIC program and respond to requests from Congress related to the F2F HIC program and program data.

Time Sensitivity: Upon approval of this change memo, grant recipients will begin using the Spanish translated surveys.

Burden: A burden impact is not anticipated.

Attachments: OMB approved survey instruments and Spanish translations of the instruments

Requested Changes to Health Resources and Services Administration’s (HRSA’s) Family-to-Family Health Information Center Feedback Surveys (OMB # 0906-0040, expires 03/31/2022), Page 1