Justification for Changes

October 25, 2016

Non Substantive Request Justification

OMB No. 0920-1099, exp. 2/28/2019

“Capacity Building Assistance Program: Assessment and Quality Control”

Following a meeting with NCHHSTP IT Security, the program is requesting to make a minor change to the OMB approved HPAT instrument 0920-1099 Attachment 3.  According to IT Security, it would be better to specify that the information requested is business contact information.  If this minor change to the contact information at the top of the HPAT form is approved, then IT Security will consider the information business-personally identifying information (business-PII) instead of personally identifying information (PII).  This change will reduce the level of data security required and will facilitate better data collection and follow-up with applicants.

In addition, we are reversing the order of the Race and Ethnicity questions. In the revised October 2016 version of the form, the Ethnicity question will precede the Race question.

The changes are:

Approved Form	Requested Change
Address	Business Address
Daytime Phone	Bus. Phone
Alternative Phone	Alt. Bus. Phone
Email	Bus. Email
Race and Ethnicity Questions 11 & 12	Reordered questions 11 & 12 so ethnicity question is first.

To see the changes in context, please refer to:

Att 3 HPAT-wordversion_approved Feb 2016 (original version, to be discontinued)

Att 3 HPAT-wordversion_revised Oct 2016 (new version that replaces the original)

Effect on the burden estimate:

None. There are no changes to the estimated burden per response, estimated number of respondents, or total burden hours.