Information Collection

Assessment of Performance Management and Improvement Practices

IC 204461 under ICR 201110-0920-004 · OMB 0920-0879.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0879 can be found here:

Documents and Forms

Document Name Document Type
Assessment of Performance Management and Improvement Practices Form
NPHII Annual Assessment Attachment H. NPHII Annual Assessment (web version).docx Form
Attachment A. Original NPHII Funding Opportunity Announcement.docx NPHII FOA IC Document
NPHII Supporting Statement B.docx Supporting Statement B IC Document
Attachment B. Map and Listing of NPHII Awardees.docx Map and List of NPHII Awardees IC Document
Attachment C. Continuation Guidance for Year 2 of NPHII.doc Guidance for NPHII Year 2 IC Document
Attachment D. Continuation Guidance for Year 3 of NPHII.doc Guidance for NPHII Year 3 IC Document
Attachment E. PHAB Standards and Measures (version 1.0).pdf PHAB Standards and Measures IC Document
Attachment F. Logic Model for NPHII evaluation.docx Logic Model for Evaluation IC Document
Attachment G. NPHII Evaluation Questions.docx Evaluation questions IC Document
Attachment I. NPHII Annual Assessment (Word Version).docx NPHII Assessment - Word IC Document
Attachment L. Reminder email for NPHII Assessment.docx Email Reminder IC Document
Attachment J. Advance Notification of NPHII Assessment.docx Advance Email IC Document
Attachment K. Email with NPHII Assessment Instructions and Link.docx Email with Assessment IC Document
Attachment M. Phone Reminder for NPHII Assessment.docx Phone Reminder IC Document
Attachment N. NORC Data Privacy Policy.docx Data Privacy Policy IC Document
NPHII Supporting Statement A (updated 10 4 12).docx Supporting Statement A IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Assessment of Performance Management and Improvement Practices	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	none	NPHII Annual Assessment	Attachment H. NPHII Annual Assessment (web version).docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Immunization Management

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 74	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	74	0	0	0	0	0
Annual IC Time Burden (Hours)	31	0	0	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
NPHII FOA	Attachment A. Original NPHII Funding Opportunity Announcement.docx	10/04/2012
Supporting Statement B	NPHII Supporting Statement B.docx	10/04/2012
Map and List of NPHII Awardees	Attachment B. Map and Listing of NPHII Awardees.docx	10/04/2012
Guidance for NPHII Year 2	Attachment C. Continuation Guidance for Year 2 of NPHII.doc	10/04/2012
Guidance for NPHII Year 3	Attachment D. Continuation Guidance for Year 3 of NPHII.doc	10/04/2012
PHAB Standards and Measures	Attachment E. PHAB Standards and Measures (version 1.0).pdf	10/04/2012
Logic Model for Evaluation	Attachment F. Logic Model for NPHII evaluation.docx	10/04/2012
Evaluation questions	Attachment G. NPHII Evaluation Questions.docx	10/04/2012
NPHII Assessment - Word	Attachment I. NPHII Annual Assessment (Word Version).docx	10/04/2012
Email Reminder	Attachment L. Reminder email for NPHII Assessment.docx	10/04/2012
Advance Email	Attachment J. Advance Notification of NPHII Assessment.docx	10/04/2012
Email with Assessment	Attachment K. Email with NPHII Assessment Instructions and Link.docx	10/04/2012
Phone Reminder	Attachment M. Phone Reminder for NPHII Assessment.docx	10/04/2012
Data Privacy Policy	Attachment N. NORC Data Privacy Policy.docx	10/04/2012
Supporting Statement A	NPHII Supporting Statement A (updated 10 4 12).docx	10/04/2012

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.