Justification

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

T ITLE OF INFORMATION COLLECTION:
Utah Work Success Financial Education Workshop Customer Satisfaction Survey

PURPOSE:

The U.S. Dept. of Health and Human Services (HHS) Administration for Children and Families (ACF) Office of Community Services (OCS) has contracted with the Corporation for Enterprise Development (CFED) to conduct activities encouraging the integration of asset-building strategies, such as financial education, into social service programs.

Under this contract, titled the ASSET Initiative Partnership (AIP), CFED has partnered with ICF International to support an effort led by the Utah Department of Workforce Services (DWS) to integrate a financial education workshop into the Utah Work Success program. The financial education workshop is a monthly six-hour training delivered by Fair Credit Foundation. The target population for the workshops is Utah Work Success participants who are usually eligible for or receiving Temporary Assistance for Needy Families (TANF) in Utah. This effort is a partnership that combines state (DWS and the University of Utah), private (Fair Credit Foundation and CFED), and federal (ACF/OCS) resources.

At the conclusion of each workshop, participants have opportunity to opt in to a three-month follow-up Customer Satisfaction Survey. The University of Utah, under contract with DWS, collects contact information for those participants that opt in. These participants will be contacted by ICF International via telephone approximately three months after the workshop, and the attached Customer Satisfaction Survey instrument will be used to elicit their feedback on the workshop. Participant feedback from the Customer Satisfaction Survey will be shared with DWS and other project partners to improve the financial education workshop for future participants. Follow-up calls are slated to begin in February 2014. Currently 12 workshops are anticipated, leading to 12 participant cohorts.

DESCRIPTION OF RESPONDENTS:

Respondents will be Utah Work Success participants (who are usually eligible for or receiving Temporary Assistance for Needy Families [TANF] in the State of Utah) who have participated in the financial education workshop and indicated their willingness to participate in the Customer Satisfaction Survey.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:___Gretchen Lehman___

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. NA
   If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. NA
   If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [X] Yes [ ] No

Participants who complete the Customer Satisfaction Survey are entered into a raffle to win a $100 prepaid card, purchased with private funds (provided by the Fair Credit Foundation and CFED). The amount of the incentive was determined by raffles held for similar projects. One raffle will be held for each financial education workshop for a total of 12 raffles. Federal funds will not be used to provide the incentive for this customer satisfaction survey.

BURDEN HOURS

Category of Respondent	Estimated No. of Respondents	Estimated Participation Time	Estimated Burden
(1) Individuals or Households	75	30 minutes	37.5 annual burden hours
Totals	75	30 minutes	37.5 annual burden hours

FEDERAL COST: The estimated annual cost to the Federal government is _$11,000.00____

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe?
   [ X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Financial education workshop participants may opt in to the three-month, follow-up Customer Satisfaction Survey at the conclusion of the workshop. The University of Utah will provide the list of those participants that have opted-in to ICF International, and ICF International will attempt to contact these participants.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[X] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [X] Yes [ ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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