POST LABORATORY SURVEY QUESTIONNAIRE, LABORATORY

ICR 199405-0938-005

OMB: 0938-0653

Federal Form Document

Forms and Documents
Document
Name
Status
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC ID
Document
Title
Status
114117 Migrated
ICR Details
0938-0653 199405-0938-005
Historical Active
HHS/CMS
POST LABORATORY SURVEY QUESTIONNAIRE, LABORATORY
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/23/1994
Retrieve Notice of Action (NOA) 05/25/1994
Approved for use through 9/96 with the understanding that this stand alone survey effort as it is designed is inadequate for evaluating satisfaction with the CLIA survey process, for the laboratory universe or a specific subgroup of laboratories. Although the information may be useful in directing future CLIA efforts, it is unclear whether the proposed sample of 1,560 laboratories is adequate to evaluate laborato opinion by state surveyor jurisdiction or laboratory type, e.g. indepe dent laboratory, hospital-based laboratory, physician laboratory, etc. If such a thorough evaluation is a main objective of HCFA's, OMB staf will work with HCFA to: 1) design a survey that will measure laboratory satisfaction without complicating the effort with program evaluation questions; 2) design a sampling methodology that would enab HCFA to evaluate satisfaction by survey team jurisdiction, laboratory type, test menu complexity, etc.; and 3) design a survey plan that would control for respondent biases that could be introduced as a resu of HCFA's role in regulating laboratories. Such issues must be addressed if HCFA intends to use the results of this effort as measure of client satisfaction or CLIA program performance. Finally, this survey cannot be used to fully evaluate CLIA's impact due to the limit detail in its questions, potential data biases and validity issues, an the limited sample size.OMB continues to encourage HHS to provide a briefing on its progress in evaluating CLIA's impact as required by la
  Inventory as of this Action Requested Previously Approved
09/30/1996 09/30/1996
1,560 0 0
390 0 0
0 0 0

OPPORTUNITY FOR LABORATORY TO EVALUATE THE SURVEY PROCESS. THIS FORM WILL BE COMPLETED IN CONJUNCTION WITH THE HCFA FORM 668A. THIS INFORMATION WILL HELP HCFA EVALUATE THE SURVEY PROCESS FROM THE LABORATORY'S PROSPECTIVE.

None
None


No

1
IC Title Form No. Form Name
POST LABORATORY SURVEY QUESTIONNAIRE, LABORATORY HCFA 668B

  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 1,560 0 0 1,560 0 0
Annual Time Burden (Hours) 390 0 0 390 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No

$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected

  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.
05/25/1994


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