Otip

Updated – May 31, 2016

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

TITLE OF INFORMATION COLLECTION: Health and Human Services (HHS) Administration for Children and Families (ACF) Office on Trafficking in Persons (OTIP) Request for Statements of Interest to Participate in the National Advisory Committee on the Trafficking of Children and Youth in the United States

PURPOSE: The National Advisory Committee on the Trafficking of Children and Youth in the United States is authorized by the Preventing Sex Trafficking and Strengthening Families Act of 2014 (PL 113-183), requiring the U.S. Department of Health and Human Services (HHS) Secretary to establish and appoint all members of the Advisory Committee no later than September 29, 2016. Not more than 21 members of the Advisory Committee will represent diverse customer segments benefiting from Federal anti-trafficking initiatives to provide feedback and inform recommendations for improvements to the Nation’s response to the human trafficking of children and youth in the United States.

The Administration for Children and Families (ACF), HHS will identify potential members of the Advisory Committee by requesting responses to a Statement of Interest Form that will be published in the Federal Register with a target date of early June to provide the time necessary to establish the Advisory Committee before the statutory deadline.

DESCRIPTION OF RESPONDENTS:

Anyone from the general public is welcome to submit responses to the Statement of Interest Form on a voluntary basis. Respondents may represent customer segments from various service systems and sectors impacted by anti-trafficking efforts including State, Tribal, and local government; child welfare, social services, and health care; courts, juvenile justice, and law enforcement; schools and youth-serving businesses; and the gaming and entertainment industry.

TYPE OF COLLECTION: (Check one)

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

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

[X] Focus Group [ ] Other: End-of-Course Evaluation

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 as recipients of government services, advocates, service providers, or government officials and policymakers.

Name: Katherine Chon

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

Personally Identifiable Information:

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

2. If yes, is the information that will be collected included in records that are subject to the Privacy Act of 1974? [X ] Yes [ ] No N/A

3. If Applicable, has a System or Records Notice been published? [ ] Yes [ ] No N/A

Gifts or Payments:

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

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time (minutes)	Burden (hours)
Survey participants	300	15 minutes	75
Totals	300	15 minutes	75

FEDERAL COST: The estimated annual cost to the Federal Government is minimal and limited to staff review time of responses to the Statement of Interest.

If you are conducting a focus group or survey, 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?

ACF will inform the public through a Federal Register Notice of the availability of the Statement of Interest Form. In addition, ACF will distribute information about the availability of the Statement of Interest Form to stakeholder listservs, including the Office on Trafficking in Persons EndTrafficking Newsletter (approximately 5,470 recipients) and to ACF anti-trafficking grantees and subgrantees (approximately 160 organizations). It is likely that other partners (e.g. U.S. Department of Justice and National Governors Association) may distribute the announcement to their respective listservs as well.

Administration of the Instrument

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

[ X ] Web-based

[ ] Telephone

[ ] In-person

[X] Mail

[X] Other, Explain (Email)

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

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

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