Evaluation and System Design for Career Pathways Programs: 2nd Generation of HPOG (HPOG Next Gen Design)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment B3_Tribal Evaluation Informed Consent Form B (Unique Identifiers).docx	Supplementary Document	Uploaded 2016-06-16	Available
Attachment B2_Tribal Evaluation Informed Consent Form A (SSNs).docx	Supplementary Document	Uploaded 2016-06-16	Available
Attachment B_Approved non-tribal, adult lottery not required consent form.docx	Supplementary Document	Uploaded 2016-06-16	Available
HPOG2 Supporting Statement_Updated Part A_June 2016 - TRACK CHANGES.docx	Supplementary Document	Uploaded 2016-06-16	Available
Memo to OMB RE_Revised Consent Forms for Tribal Study_06 15 16.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-06-16	Available
Memo to OMB RE_Revised Consent Forms 011116_v3.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2016-01-26	Available
Attachment A. References_5.11.15.docx	Supplementary Document	Uploaded 2015-05-11	Available
Attachment G. Contact Update Letter and Form.docx	Supplementary Document	Uploaded 2015-05-11	Available
HPOG2 Supporting Statement_Part B_01.14.16_clean.docx	Supporting Statement B	Uploaded 2016-01-26	Available
HPOG2 Supporting Statement_Part A_Revised 06 15 16_clean.docx	Supporting Statement A	Uploaded 2016-06-16	Available
Attachment F. First Round of HPOG Grantees Ressearch Portfolio_4.28.15.docx	Supplementary Document	Uploaded 2015-05-06	Available
FINAL updated Attachment E PPR Data List and Mockup 8 4 15 clean.docx	Supplementary Document	Uploaded 2015-08-05	Available
Attachment D. Sources and Justification_5.4.15.docx	Supplementary Document	Uploaded 2015-05-06	Available
Attachment B. Informed Consent Forms_01.25.16 clean.docx	Supplementary Document	Uploaded 2016-01-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
216432	PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)	Other-Data collection System	Unchanged
216431	PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)	Other-Data collection System	Unchanged
216430	PAGES Grantee- and Participant-Level Data Collection (all grantees)	Other-Data collection System	Unchanged

ICR Details

OMB Control No: 0970-0462	ICR Reference No: 201606-0970-006
Status: Historical Active	Previous ICR Reference No: 201601-0970-009
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Evaluation and System Design for Career Pathways Programs: 2nd Generation of HPOG (HPOG Next Gen Design)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/12/2016
	Date Received in OIRA: 06/16/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2018	08/31/2018	08/31/2018
Responses	9,064	0	9,064
Time Burden (Hours)	6,432	0	6,432
Cost Burden (Dollars)	0	0	0

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Abstract: The Evaluation and System Design for Career Pathways Programs: 2nd Generation of Health Profession Opportunity Grants (HPOG Next Gen Design) is funded by the U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF). The ACF Office of Family Assistance (OFA) has announced plans to award a second round of HPOG grants by September 2015. One of the key objectives of HPOG Next Gen Design is to establish a new data system to support program management and evaluation of the new HPOG grantees. The data system will meet the performance data needs of the HPOG Next Gen grantees and of OFA to monitor the performance of the grants and prepare the report to Congress on the grants, as well as support an impact study, a separate but coordinated Tribal evaluation, and other future research and evaluation efforts sponsored by ACF. ACF is seeking clearance from OMB for the data collection via the new data system, called the HPOG Next Gen Participant Accomplishment and Grant Evaluation System (PAGES). The information collection proposed is internet-based and includes gathering data from the HPOG Next Gen grantees on: (1) grantee program designs and offerings; (2) intake information on eligible applicants (both treatment and control) through baseline data collection; and (3) individual enrolled program participants' activities and outcomes.

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Authorizing Statute(s): PL: Pub.L. 111 - 148 5507 , sec. 2008, (a)(3)(B) Name of Law: Patient Protection and Affordable Care Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 11679	03/04/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 26927	05/11/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)
PAGES Grantee- and Participant-Level Data Collection (all grantees)
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)

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ICR Summary of Burden

table that charts list of burden

	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	9,064	9,064	0	0	0	0
Annual Time Burden (Hours)	6,432	6,432	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: Burden estimates updated based on actual number of grants.

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Annual Cost to Federal Government: $673,416

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 06/16/2016

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