Generic Submission Form - Cross-Sector

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 1670-0027)

TITLE OF INFORMATION COLLECTION:

Critical Infrastructure Stakeholder Feedback Survey: Cross-Sector Events Feedback

PURPOSE:

The NPPD Office of Infrastructure Protection (IP) leads and coordinates national programs and policies on critical infrastructure security and resilience and has established strong partnerships across government and the private sector. IP would like to collect cross-sector events feedback from its stakeholders in order to improve IP products and events. Survey results will help to ensure IP events’ continued utility to IP stakeholders in the private sector and state, local, territorial and tribal governments in furtherance of IP’s core mission to strengthen the security and resilience of the Nation’s critical infrastructure through collaborative and integrated efforts of the critical infrastructure community.

The Cross-Sector Events Feedback Survey will gather feedback on respondents’ experiences with IP sector and cross-sector exercises, IP regional workshops, IP meetings, and IP Active Shooter Preparedness Program workshops. The survey will be used to help assess participants’ satisfaction with such events and identify areas for improvement. Information will be collected through mobile PDF forms that will be distributed by e-mail and submitted to an e-mail inbox. Information will also be collected through paper surveys that will be distributed and collected in person. Surveys submitted to an e-mail inbox will be separated from e-mail addresses and saved and stored in a DHS/NPPD/IP network folder in a manner that will not reveal information about the submitter.

DESCRIPTION OF RESPONDENTS:

Private sector, Federal, State, Local, and Tribal government employees who participate in the events identified above. Participants will be asked to voluntarily complete a 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: Ms. Ryan Donaghy, Analyst, DHS/NPPD/IP and Ms. Stephanie Woods, Program Planning and Evaluation Lead, DHS/NPPD/IP/SOPD

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

Personally Identifiable Information:

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

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

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

Gifts or Payments:

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

BURDEN HOURS

Type of Respondent (State, local, tribal, territorial, or private sector) [Estimated from 2016 metrics]	Number of Respondents	Number of Responses per Respondent	Average Burden per Response (in hours)	Total Annual Burden (in hours)	Average Hourly Wage Rate	Total Annual Respondent Cost
Executives	537	1	0.05 (3 minutes)	27	$125.09	$3377
Management Analyst	1075	1	0.05 (3 minutes)	54	$61.77	$3336
Security Analyst	3223	1	0.05 (3 minutes)	161	$62.76	$10104
Totals	4835			242		$ 16817

It is estimated that 537 executives will spend a total of 27 hours at an average rate of $125.09 ($89.35 base wage rate x 1.4 benefit multiplier = $125.09) (source: https://www.bls.gov/Oes/current/oes111011.htm); 1075 management analysts at an average rate of $61.77 ($44.12 base wage rate x 1.4 benefit multiplier = $61.77) (source: https://www.bls.gov/oes/current/oes131111.htm); and 3223 security analysts at an average rate of $62.76 ($44.83 base wage rate x 1.4 benefit multiplier = $62.76) (source: https://www.bls.gov/oes/current/oes151122.htm), for an estimated total annual respondent cost of $16,817.

FEDERAL COST: The estimated annual cost to the Federal government is $3,828.60

It is estimated that 1 analyst at a GS level 13, Step 1 will be spending approximately 60 hours annually to review, analyze, and assimilate survey responses.

Using the FY17 (Washington-Baltimore-Northern Virginia) GS pay scale, the fully-loaded wage rate for a GS13, Step 1 is $ 63.81 ($ 94,796 annual salary/2080 = $45.58 base wage rate x 1.4 benefit multiplier = $ 63.81 fully-loaded wage rate).

The annual government cost is estimated to be $ 3,828.60 (60 hours annually x $63.81 = $3,828.30).

STATISTICAL METHOD:

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?

Recipients are determined by standard distribution lists dependent upon product type.

Administration of the Instrument

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

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[X] Other (email response)

Surveys will be submitted to an e-mail inbox. Surveys will be separated from e-mail addresses and saved and stored in DHS/NPPD/IP network folder in a manner that will not reveal information about the submitter.

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

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

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

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. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

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

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