Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Document Name	Status
Form 1 HRSA Division of Transplantation (DoT) Concept Testing Form and Instruction	Unchanged
Form 2 White House Conference on Food, Nutrition, Hunger, and Health listening sessions/convenings and online public comment form. Form and Instruction	Unchanged
Intranet Survey.docx Justification for No Material/Nonsubstantive Change	2022-06-17
0090-0379-60-day FRN.docx Supplementary Document	2020-07-10
2020-14595.pdf Supplementary Document	2020-07-10
0990-0379 Change Request_DKC.doc Justification for No Material/Nonsubstantive Change	2015-03-03
0990-0379_B.docx Supporting Statement B	2014-07-02
0990-0379_Father Generic8-11-20.docx Supporting Statement A	2020-08-11
Generic Clearance Submission Template.docx Supplementary Document	2011-06-14

IC Document Collections

IC ID	Document Title	Status
254221	HRSA Division of Transplantation (DoT) Concept Testing Form and Instruction	Unchanged
254087	TPP20 Tier 1 and Tier 2 Grantee Informational Form Other-Survey	Unchanged
253316	White House Conference on Food, Nutrition, Hunger, and Health listening sessions/convenings and online public comment form. Form and Instruction	Unchanged
253036	Tree Testing of Funding Section on HRSA.gov Instruction	Unchanged
252998	Tree Testing of HRSA's MCHB Website Instruction	Unchanged
252633	TPP Performance measures Technical Assistance Survey Other-survey script instructions and reminder emails	Unchanged
252396	Focus Group Feedback OPA Adolescent Health Strategic Plan Other-Focus Group Questions	Unchanged
252391	Interviews for OPA Adolescent Health National Strategic Plan Development Other-structured interview guide	Unchanged
252239	Office of Population Affairs Grantee Satisfaction Survey 2022 Other-survey with instructions	Unchanged
251908	Key Informant Impact and Gap Feedback Tool - 2021 California Wildfires Disaster Other-	Unchanged
251266	Customer Feedback on Previously Developed Health Messaging to Promote Vaccination Among Older African American Community Health Workers Other-Questionnaire	Unchanged
248927	Intranet Customers Feedback Other-FT Generic Survey	Modified
248813	ASPR Listening Sessions Other-Registration Form	Unchanged
248522	ASPR Candidate Experience Survey Other-survey	Unchanged
248369	OMH WEBINAR PROMISING PROGRAMS AND PRACTICES ASSESSMENTS Other-webinar	Unchanged
248263	TPP Network grantee technical assistance survey Other-survey and instructions	Unchanged
246920	Office of Population Affairs (OPA) 2021 Annual Grantee Satisfaction Survey Other-survey and instruction	Unchanged
246659	Office of the Assistant Secretary for Health (OASH) Office of Regional Health Operations (ORHO) External Customer Satisfaction Survey Other-survey	Unchanged
246466	Bureau of Health Workforce (BHW) Website Usability Testing Other-Test Script instrument	Unchanged
246463	National Hypertension Control Initiative (NHCI) Community Health Center Assessment Other-test script	Unchanged
245995	HHS.gov Continuous Improvement Survey Other-survey	Unchanged
245932	Federal Office of Rural Health Policy (FORHP) Website Card Sort Other-card sort script	Unchanged
245888	COVID-19 VIRTUAL LEARNING SESSIONS FEEDBACK ASSESSMENT Other-learning session	Unchanged
245749	HRSA HIV/AIDS Bureau (HAB) Website Card Sort Other-HAB cart test script	Unchanged
245748	Maternal and Child Health Bureau (MCHB) Website Card Sort Other-MCHB card test script	Unchanged
245430	Bureau of Primary Health Care (BPHC) Website Card Sort Other-Survey-test script	Unchanged
244597	Teen Pregnancy Prevention (TPP) Evaluation Technical Assistance: Satisfaction Survey for Group TA Activities Other-survey and instructions	Unchanged
244596	Teen Pregnancy Prevention (TPP) Evaluation Technical Assistance Product Satisfaction Feedback Survey Other-survey and instructions	Unchanged
244370	User feedback for the Benefit Cliff Calculator Other-Survey	Unchanged
244171	www.medicalcountermeasures.gov customer site feedback form Other-question	Unchanged
243723	Office of Population Affairs (OPA) Training and Technical Assistance (T/TA) Satisfaction Survey Other-survey and instructions	Unchanged
243333	ADVANCING THE RESPONSE TO COVID-19: SHARING PROMISING PROGRAMS AND PRACTICES FOR RACIAL AND ETHNIC MINORITY COMMUNITIES VIRTUAL SYMPOSIUM WEBINAR ASSESSMENT Other-Survey	Unchanged
243178	Office of Population Affairs (OPA) Title X Family Planning Annual Reporting (FPAR) 2.0 Grantee Readiness Survey Other-survey and script	Unchanged

ICR Details

OMB Control No: 0990-0379	ICR Reference No: 202206-0990-003
Status: Received in OIRA	Previous ICR Reference No: 202007-0990-001
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/23/2022

	Requested	Previously Approved
Expiration Date	08/31/2023	08/31/2023
Responses	420,000	420,000
Time Burden (Hours)	70,000	70,000
Cost Burden (Dollars)	0	0

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Abstract: This collection of information is necessary to enable HHS to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with HHS programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

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:
	85 FR 26485	05/04/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 41056	07/08/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 33

IC Title	Form No.	Form Name
Bureau of Primary Health Care (BPHC) Website Card Sort
ADVANCING THE RESPONSE TO COVID-19: SHARING PROMISING PROGRAMS AND PRACTICES FOR RACIAL AND ETHNIC MINORITY COMMUNITIES VIRTUAL SYMPOSIUM WEBINAR ASSESSMENT
ASPR Candidate Experience Survey
ASPR Listening Sessions
Bureau of Health Workforce (BHW) Website Usability Testing
COVID-19 VIRTUAL LEARNING SESSIONS FEEDBACK ASSESSMENT
Customer Feedback on Previously Developed Health Messaging to Promote Vaccination Among Older African American Community Health Workers
Federal Office of Rural Health Policy (FORHP) Website Card Sort
Focus Group Feedback OPA Adolescent Health Strategic Plan
HHS.gov Continuous Improvement Survey
HRSA Division of Transplantation (DoT) Concept Testing	1	Informed Consent: DoT Concept Testing
HRSA HIV/AIDS Bureau (HAB) Website Card Sort
Interviews for OPA Adolescent Health National Strategic Plan Development
Intranet Customers Feedback
Key Informant Impact and Gap Feedback Tool - 2021 California Wildfires Disaster
Maternal and Child Health Bureau (MCHB) Website Card Sort
National Hypertension Control Initiative (NHCI) Community Health Center Assessment
OMH WEBINAR PROMISING PROGRAMS AND PRACTICES ASSESSMENTS
Office of Population Affairs (OPA) 2021 Annual Grantee Satisfaction Survey
Office of Population Affairs (OPA) Title X Family Planning Annual Reporting (FPAR) 2.0 Grantee Readiness Survey
Office of Population Affairs (OPA) Training and Technical Assistance (T/TA) Satisfaction Survey
Office of Population Affairs Grantee Satisfaction Survey 2022
Office of the Assistant Secretary for Health (OASH) Office of Regional Health Operations (ORHO) External Customer Satisfaction Survey
TPP Network grantee technical assistance survey
TPP Performance measures Technical Assistance Survey
TPP20 Tier 1 and Tier 2 Grantee Informational Form
Teen Pregnancy Prevention (TPP) Evaluation Technical Assistance Product Satisfaction Feedback Survey
Teen Pregnancy Prevention (TPP) Evaluation Technical Assistance: Satisfaction Survey for Group TA Activities
Tree Testing of Funding Section on HRSA.gov
Tree Testing of HRSA's MCHB Website
User feedback for the Benefit Cliff Calculator
White House Conference on Food, Nutrition, Hunger, and Health listening sessions/convenings and online public comment form.	2, 1, 3	Partner Led Convenings ,   White House Led Convening Tool Kit ,   Regional Led Convening Tool Kit
www.medicalcountermeasures.gov customer site feedback form

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ICR Summary of Burden

	Total Request	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	420,000	420,000	0	0	0	0
Annual Time Burden (Hours)	70,000	70,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $300,000

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 06/23/2022

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