Pilot Participation Form

Form Approved

OMB No. 4040-0017

Exp. Date 03/31/2019

Pilot Participation Form Questions

1. Please review brief descriptions of each of the five Test Models below and place a check in the box for all Test Models in which you are interested in participating and submit to DAP by <<INSERT DATE HERE>>. DAP will provide you with additional information upon receiving your responses. Please note all Test Models will be conducted remotely via email or through an online webinar.

• CDER Library

Background: In May 2015, HHS launched the Common Data Element Repository (CDER) Library. The tool is designed to be a repository for common resources to facilitate consistency of Federal terminology focused on financial assistance terms and definitions.

Participation: DAP will electronically provide Test Model participants with a test packet consisting of: test instructions, two scenarios relating to the grants process, two forms, and a link to the CDER Library. The participant will use the first scenario to complete one of the forms without using the CDER Library. Subsequently, the participant will complete the other form while using the CDER Library. The participant will self-report the length of time it took to complete each form and be asked to complete a short survey regarding his/her experience using the CDER Library.

• Consolidated Federal Financial Report

Background: Federal grant recipients are required to fill out the Federal Financial Report (FFR) and submit the form to their grant-awarding agency. Many agencies require recipients to submit the FFR through multiple entry points. A Consolidated FFR will allow pilot participants to submit the FFR form (SF-425) in one system, rather than in multiple entry systems. This will allow for a single point of data entry, easier validation of FFR data, and a potential future streamlining of the close-out process.

Participation: DAP will hold online webinars providing an overview of the Consolidated FFR process. Participants will be asked to participate in a webinar and complete a survey regarding the Consolidated FFR.

• Single Audit

Background: The Single Audit is a financial statement audit and a federal grants audit of an organization who expends $750,000 or more in federal funds. Data is currently being reported on the Single Audit Data Collection Form (SF-SAC) that is duplicative of data reported on the Schedule of Expenditures of Federal Awards (SEFA). If a modified SF-SAC combining the data required of recipients from both the SF-SAC and the SEFA can be created, grant recipients would see a reduction in burden through the elimination of reporting duplicative information.

Participation: DAP will collaborate with the Federal Audit Clearinghouse (FAC) to create an environment where participants can submit key sections of the modified SF-SAC. The submission would fulfill

Participants’ SF-SAC requirement and the FAC would automatically generate a downloadable template SEFA based on the recipients SF-SAC. After submittal, the participants would fill out a survey gauging their sentiments about aspects of the new modified SF-SAC. This effort will be conducted remotely.

• Notice of Award – Proof of Concept

Background: The Notice of Award (NOA) is a document that contains information that the grant recipient needs to perform routine accounting and finance operations. NOAs often differ in format and content across Departments and Agencies.

Participation: DAP will electronically provide Test Model participants with a test packet consisting of: test instructions, several non-standardized NOAs, a standardized NOA, and a data collection spreadsheet. The participant will be asked to fill out the data collection spreadsheet using the non-standardized NOAs. Subsequently, the participant will complete another data collection spreadsheet using the standardized NOA. The participant will self-report the length of time it took to complete each data collection spreadsheet and be asked to complete a short survey regarding his/her experience using a standardized NOA.

• Learn Grants

Background: In May 2015, HHS launched the Learn Grants tab on Grants.gov to provide the public with easier access to grants lifecycle information.

Participation: DAP will electronically provide participants with a knowledge quiz derived from information existing on the Learn Grants tab. The participants will first be asked to complete the knowledge quiz without access to Learn Grants. Subsequently, participants will be asked to complete the same knowledge quiz with access to Learn Grants. The participant will be asked to complete a short survey regarding his/her experience using the Learn Grants tab.

Demographics

2. Name of Organization: _______________________

3. Type of Organization:

• State Government

• Local Government

• School

• Higher Education Institution

• Native American Tribe

• Non-Profit Organization

• Mid-size or Large Business

• Small Business

• Other (please describe) _______________________

4. Point of Contact Name: ________________________

5. Point of Contact Email: _______________________

6. Point of Contact Phone Number: ________________________

7. Point of Contact Position/Role: ________________________

8. Point of Contact Department/Unit: ________________________

9. Point of Contact Physical Address: ________________________

10. Organization Approximate Federal Award Value (FY 2015): ________________________

11. Your Department/Unit Approximate Federal Award Value (FY2015): ________________________

12. Did your organization submit a Single Audit in the most recent fiscal year?
    
    
    

Yes

No

Unsure

13. Other comments:

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 4040-0017. The time required to complete this information collection is estimated to average 15 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health & Human Services, OS/OCIO/PRA, 200 Independence Ave., S.W., Suite 336-E, Washington D.C. 20201, Attention: PRA Reports Clearance Officer