Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

ICR 202406-0906-005

OMB: 0906-0084

Federal Form Document

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Justification for No Material/Nonsubstantive Change
2024-06-28
Justification for No Material/Nonsubstantive Change
2024-06-28
Supplementary Document
2024-01-09
Supplementary Document
2024-01-09
Supplementary Document
2024-01-09
Supplementary Document
2024-01-09
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2024-01-09
Supplementary Document
2024-01-09
Supporting Statement B
2024-01-09
Supporting Statement B
2024-01-09
Supporting Statement A
2024-01-09
Supporting Statement A
2024-01-09
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ICR Details
0906-0084 202406-0906-005
Active 202402-0906-004
HHS/HRSA
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 07/08/2024
Retrieve Notice of Action (NOA) 06/28/2024
  Inventory as of this Action Requested Previously Approved
02/28/2027 02/28/2027 02/28/2027
136,977 0 98,000
15,045 0 13,250
0 0 0

This generic project clearance allows HRSA to conduct voluntary customer satisfaction surveys of its partners to assess strengths and weaknesses in program services and products. Examples of such surveys include satisfaction with technical assistance provided to grantees, in class evaluations of training sessions, and satisfaction with information services.

EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None

Not associated with rulemaking

  88 FR 72494 10/20/2023
89 FR 788 01/05/2024
Yes

27
IC Title Form No. Form Name
BPHC Customer Service Survey 1 Customer Feedback Survey
MIECHV TARC Satisfaction Survey 1, 2, 3, 4, 5, 6, 7, 9, 8, 10 Adaptive Leadership Academy Completion Survey ,   Community of Practice Survey Completion Survey ,   Practicum Check In Survey ,   CQI Practicum Polls ,   Individualized Targeted TA Check in ,   Small Group TA Closeout Survey ,   TARC Meeting Poll ,   Webinar Survey ,   CQI Practicum Completion Survey ,   Individualized Targeted TA
2024 Maternal, Infant, and Early Childhood Home Visiting Program All Grantee Meeting Evaluation Surveys 1 Conference Evaluation Survey
2024 National Ryan White Conference on HIV Care & Treatment Evaluation 2, 3, 1 2024 NWRC Conference Session Questionaire ,   2024 Ryan White CEU Session Evaluation ,   Overall 2024 NRWC Conference Evaluation
Collection of Qualitative Feedback on Telehealth.HHS.gov 1, 2 Website user (page-level survey) ,   Website user (site-wide survey)
Collection of Qualitative Feedback on Telehealth.HHS.gov 1, 2 Telehealth Website - Page Level - SurveyEngSpan ,   Telehealth Website - Site Level - Survey EngSpan
DIR Objective Review Assessment Survey 2D, 2E, 2F, 3A, 3C, 3E, 3D, 3F, 3G, 3H, 1, 2, 3, 1A, 1B, 1C, 3B, 2B, 2C, 2A Questions 1-5 ,   Reviewer Evaluation Form ,   Reviewer Evaluation Field Review ,   Chair Reviewer Evaluation Q1-2 ,   Chair Reviewer Evaluation Review Form Q3-4 ,   Chair Reviewer Evaluation Review Q5 ,   Reviewer Evaluation- Field Review Q1-2 ,   Reviewer Evaluation- Field Review Q3-4 ,   Reviewer Evaluation- Field Review Q5-6 ,   Reviewer Evaluation- Field Review Q7-8 ,   Reviewer Evaluation- Field Review Q9-10 ,   Reviewer Evaluation- Field Review Q11-12 ,   Reviewer Evaluation Q1-2 ,   Reviewer Evaluation- Field Review Q3-4 ,   Reviewer Evaluation- Field Review Q5-6 ,   Reviewer Evaluation Q9-10 ,   Reviewer Evaluation- Field Review Q7-8 ,   Reviewer Evaluation- Field Review Q11-12 ,   Reviewer Evaluation- Field Review Q13-14 ,   Reviewer Evaluation- Field Review Q15
Division of Grants Management Operations Customer Service Satisfaction Survey 1 DGMO Customer Service Survey Questions
Division of Independent Review Objective Review Assessment Survey 1.1, 2, 1, 1.2 Screenshot Reviewer Instr ,   Form Chair Q 1-5 ,   FORM Reviewer Evaluation Q 1- 15 ,   FORM Reviewer Evaluation-Field Review Q 1 - 12
Division of Practitioner Data Bank (DPDB) Webinar Feedback and Satisfaction Surveys 1 Webinar Survey Questions
Early Childhood Systems Technical Assistance and Coordinating Center Customer Satisfaction Surveys A, B, C, Attachment D Attachment A_ECS TACC Community of Practice Surve ,   Attachment B_ECS TACC Webinar Survey ,   Attachment C_ECS TACC TA Resources Products Survey ,   Attachment D_ECS TACC Semi-Annual Interview Protocol
Evaluation Survey of Eligible National Practitioner Data Bank Entity Users: Relevance of Information Collected via NPDB Query Forms 1, 2 Query Survey Intro-Instructions ,   User Survey Questions - Query
Federal Cervical Cancer Collaborative (FCCC) CERV-Net Evaluation 1, 2, 3 CERV-Net 3-Month Follow-Up Test ,   CERV-Net Post-Test ,   CERV-Net Pre-Test
HRSA Electronic Handbooks Customer Service Survey 1 EHB Customer Support Center Survey Screenshot
HRSA Web Survey 1, 2 English Language Survey ,   Spanish Language Survey
HRSA Web Survey 2, 1 HRSA Web Survey ,   HRSA Web Survey (Spanish Language)
HRSA/HIV & AIDS Bureau (HAB) Recipients Satisfaction Survey (RSS). 1 HAB Recipients Satisfaction Survey
Health Center Program Support Customer Service Survey 1 EHBs Customer Support Center Survey Screenshot
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys 1, 2, 3, 4, 5, 6, 7, 8, 9, 10 Attachment A_Individualized Targeted TA Check in ,   Attachment B_Individualized Targeted TA Closeout ,   Attachment C_Project Officer Survey ,   Attachment D_Webinar Survey ,   Attachment E_Community of Practice Survey ,   Attachment F_Leadership Academy Session Survey ,   Attachment G_Leadership Academy Completion Survey ,   Attachment H_Quarterly Overall TA Survey ,   Attachment I_CQI Practicum Check in Survey ,   CQI Practicum Completion Survey
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center Satisfaction Surveys 2, 1, 3 Annual Awardee Survey ,   Instrument B_Post Webinar Survey ,   Post Learning Collaborative Survey
Maternal, Infant, and Early Childhood Home Visiting Program On-Site Compliance Review Awardee Feedback Form 1 On Site Compliance Review Awardee Feedback Form
Maternal, Infant, and Early Childhood Home Visiting Site Visit Awardee Feedback Form 1, A Instrument A MIECHV Site Visit Compliance Review Awardee Feedback Form Boilerplate ,   Instrument A MIECHV Site Visit Compliance Review Awardee Feedback Form
National Marrow Donor Program Donation Experience Survey 1 Donation Experience Survey
National Practitioner Data Bank Usability Survey 1 0915-0212_UsabiltyTesting Instrument_NPDBSystem
Technical Assistance to Support the HHS Viral Hepatitis National Strategic Plan
Title V Information System User Satisfaction Survey 1 Screen Shots of Title V Information System Survey 2021
Tree Testing of HRSA's Ryan White HIV/AIDS Program website 1 Tree Test Script

  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 136,977 98,000 0 38,977 0 0
Annual Time Burden (Hours) 15,045 13,250 0 1,795 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
HRSA is requesting an increase in increase the number of responses and burden hours, due to an error that occurred when HRSA renewed this umbrella ICR in February. When HRSA revised this ICR in February, it updated five of its renewed information collections (ICs), resulting in the ICs having their hours deducted from the ICR twice. This error means that approximately 40% of the respondent budget and 14% of the burden hour budget are used on outdated collections. Since the ROCIS functionality does not allow HRSA to discontinue individual ICs within a larger Umbrella ICR, HRSA is requesting an increase of 38,977 respondents and 1,795 burden hours so that HRSA can use the Umbrella ICR, as HRSA had originally planned.

$249,390
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
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.
06/28/2024


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