PRA_OTIP NHTTAC SC OMB_Supporting Statement_070918

PRA_OTIP NHTTAC SC OMB_Supporting Statement_070918.docx

NHTTAC Consultant and Evaluation Package

OMB: 0970-0519

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Supporting Statements for the

Paperwork Reduction Act Submission

Shape1


Agency: Department of Health and Human Services, Administration for Children and Families

Title: NHTTAC Consultant and Evaluation Package

OMB No: 0970-0401


A. Justification

  1. Circumstances Making the Collection of Information Necessary

The Office on Trafficking in Persons (OTIP) is a federal agency within the Administration for Children and Families (ACF). In 2016, with authority from the Trafficking Victims Protection Act of 2000 (PL 106-386), Section 106(b), as amended at 22 U.S. Code § 7104 and 22 U.S. Code § 7105(c)(4), OTIP established the National Human Trafficking Training and Technical Assistance Center (NHTTAC) to build the capacity of health and human services professionals and help prevent, identify, and respond to trafficking. This is a request for approval of the NHTTAC consultant and evaluation package to assess the ongoing needs of health and human services professionals in preventing, identifying, and responding to trafficking and determine the level of satisfaction with services provided by NHTTAC.

ACF serves as the lead U.S. Department of Health and Human Services (HHS) agency to combat trafficking and modern forms of slavery by administering anti-trafficking programs through grants and contracts and collaborating with federal, state, tribal, and local governmental and nongovernmental organizations. OTIP provides overall leadership of anti-trafficking programs and services under the purview of ACF, including implementation of authorities under the Victims of Trafficking and Violence Protection Act of 2000, as amended; Preventing Sex Trafficking and Strengthening Families Act of 2014; and Justice for Victims of Trafficking Act of 2015.

This training and technical assistance (T/TA) center, NHTTAC, works to further the agency’s mission through increasing access to resources in the field. NHTTAC sponsors T/TA on trafficking for health and human service providers. NHTTAC provides user-friendly, efficient, and cost-effective resources by training individuals, organizations, and communities on trafficking-related topics and by providing technical assistance in areas such as policy and program development, management, and evaluation. NHTTAC does this through a process that includes needs assessment, analysis, service coordination, and follow-up.

NHTTAC relies on consultants to help support content development and delivery of T/TA. There are two consultant categories: survivor impact and T/TA expert. Each consultant category has eligibility requirements. Individuals interested in consulting for NHTTAC must complete an application. To help field applicants, this Office of Management and Budget (OMB) package includes two application forms to solicit information about the experiences and qualifications of potential consultants.

In addition to providing T/TA, NHTTAC offers scholarships designed specifically to allow agencies hosting conferences to apply for scholarships that can be provided to individuals who have experienced human trafficking to attend the conference. NHTTAC also provides scholarships directly to, or to agencies working with, individuals who have experienced human trafficking to engage in professional development. The two scholarship applications included in this OMB package serve as a means for obtaining the information necessary to determine eligibility for the scholarship program.

The package also includes 30 instruments to assist with a comprehensive evaluation of NHTTAC’s T/TA events. This collection of information is necessary to enable NHTTAC to collect recipient and stakeholder feedback in an efficient, timely manner and in accordance with OTIP’s commitment to improving service delivery. The information collected from our recipients and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with NHTTAC’s T/TA services. This feedback will provide insights into recipient or stakeholder perceptions, expectations, and experiences; provide an early warning of issues with T/TA; and focus attention on areas where communication, training, or changes in operations might improve the delivery of T/TA or the responsiveness of NHTTAC. These collections will allow for ongoing, collaborative, and actionable communications between NHTTAC and its recipients and stakeholders. It will also allow feedback to contribute directly to the improvement of program management.

With the exception of focus groups and interviews, all evaluations will be disseminated electronically and no personally identifiable information (PII) will be collected. All quantitative findings will be reported in aggregate form. When applicable, qualitative data collection efforts will collect the minimal amount of PII (e.g., name and contact information) necessary for scheduling purposes. Any contact information will be stored separately from any notes, and all files will be password protected and stored on a secure server. All information collected on the feedback forms is protected in accordance with the Privacy Act of 1974.

  1. Purpose and Use of the Information Collection

On OTIP’s behalf, NHTTAC’s Evaluation Team will collect, analyze, and interpret information gathered through this clearance to identify strengths and weaknesses of its T/TA, make improvements based on this feedback, and identify the types of T/TA services needed. The solicitation of feedback will target areas such as timeliness, appropriateness, accuracy of information, courtesy, efficiency of T/TA delivery, and resolution of issues encountered while interacting with NHTTAC. Responses will be assessed to plan and inform efforts to improve or maintain the quality of T/TA offered to the public. If this information is not collected, vital feedback from recipients and stakeholders on NHTTAC services will be unavailable. Applications will be used to determine eligibility for NHTTAC services and facilitate the process for identifying the specific needs of the requester.

NHTTAC consultants and T/TA participants are from a diverse background with a wide range of experiences within the trafficking and public health fields, including health and human service systems of care. The evaluation instruments and consultant and scholarship application forms allow NHTTAC to capture this diversity and relevant outcomes.

Human Trafficking Leadership Academy (HTLA)

Participants in the HTLA comprise survivors of trafficking and other anti-trafficking service providers, which may include OTIP grantees selected by OTIP to participate in the fellowship. Participants are asked for feedback before and after the program in order to measure differences in knowledge and attitudes about trafficking for grantees and differences in professional development for survivors. This information is collected in the HT Fellowship Pre- and Post-Program Feedback Forms.

Survivor Fellowship Program

Participants in the Survivor Fellowship Program are representatives from health and human service organizations and survivors of trafficking. Participants are asked for their feedback about the program following its conclusion. The forms for this data collection effort are the Survivor Fellowship Organization Feedback Form and the Survivor Fellowship Fellow Feedback form.

Customer Support Center

People who call into the NHTTAC Customer Support Center are primarily health and human service providers requesting materials or T/TA on trafficking service provision. Anyone who contacts the NHTTAC Customer Support Center is asked for feedback on their experience with the Customer Support Center via the Customer Support Center Feedback Form. People who call the NHTTAC Customer Support Center sometimes solely request information, resources, or materials; however, if they request further T/TA, the Customer Support Center staff will discuss their needs and determine if they need other T/TA support available through NHTTAC.

Short-Term and Specialized T/TA

Anyone who receives short-term or specialized T/TA is asked for feedback on their experience following the T/TA activity with the Short-Term T/TA Feedback Form or the Specialized T/TA Feedback Form, respectively. Three to six months after specialized T/TA activities, NHTTAC follows up with participants to measure the outcomes of the T/TA via the Follow-Up Feedback Form Requesters are also asked to provide feedback about their experiences with NHTTAC, including the process and their satisfaction with how NHTTAC fulfilled the request, using the Requester Feedback Form.

OTIP Grantees

NHTTAC supports OTIP grantees by providing information, facilitating information sharing, and hosting meetings and webinars. Following meetings and webinars, NHTTAC asks for feedback from the OTIP grantees via the OTIP Grantee Feedback Form. NHTTAC also facilitates peer-to-peer sharing across the grantees, which can result in T/TA provided by one grantee or consultant to another. In these cases, both the grantee that requested assistance and the grantee (or consultant) who provided assistance are asked for their feedback using the Specialized T/TA Feedback Form.

NHTTAC Website

NHTTAC also hosts a website of information and resources; people who visit the website are asked for their feedback on how the website can be improved via the Website Feedback Form.

Conference and Meeting Support

NHTTAC supports conferences to share information, promising practices, and evidence-based research on trafficking within the field. People who attend the conference sessions or conferences facilitated by NHTTAC are asked for their feedback following the event. NHTTAC also supports the delivery of cluster meetings on behalf of OTIP in order to engage with the field on a specific issue, need, or promising practice and often provides logistical support for these meetings. Participants are also asked for their feedback following these cluster meetings; depending on the nature of the conference and NHTTAC’s role, either the Conference Session Feedback Form or the General Conference Feedback Form will be used.

National Advisory Council (NAC)

Additionally, NHTTAC supports the National Advisory Council on the Sex Trafficking of Children and Youth in the United States (NAC) by facilitating and coordinating meetings. NAC members are asked for their feedback following meetings regarding how well they feel the group is working together and what could be improved in the future via the Advisory Committee Feedback Form.

Organizational Scholarships

An organizational survivor scholarship may be awarded to an organization once within a

12-month period from the start date of its conference. The organization and conference must support OTIP’s stated goals and mission and must work with individuals who have experienced human trafficking and/or populations at risk of trafficking. Organizations sponsoring a citywide conference or training are not eligible for this award. The conference must be statewide, regional, or nationwide in scope and audience. The organization must demonstrate the capacity to administer a scholarship program and a strategy for addressing the needs of individuals who have experienced human trafficking or populations at risk of trafficking through the conference workshops. The Organizational Scholarship Application will be used to help determine eligibility requirements for organizations that apply. The Organizational Scholarship Feedback Form will be used to measure the experiences and satisfaction of organizations that receive a scholarship.

Professional Development Scholarships

Individuals eligible for professional development scholarship funding include child welfare experts, public health professionals, medical service providers, behavioral health professionals, advocates, victim service providers, and individuals who have experienced human trafficking who provide support to other individuals who have experienced trafficking and/or populations at risk of trafficking. Federal, tribal, state, and local agencies and multidisciplinary teams (up to five individuals) that include service providers or professionals who work with individuals who have experienced trafficking or populations at risk of trafficking are also eligible. Individuals who have experienced trafficking and who have a minimum of 1 year of professional experience (including volunteer experience) working with other individuals who have experienced trafficking and/or populations at risk of trafficking are encouraged to apply. Eligible applicants must work with individuals who have experienced trafficking or populations at risk of trafficking within the 50 states, the District of Columbia, and the following U.S. territories: American Samoa, Guam, the Northern Mariana Islands, Puerto Rico, and the U.S. Virgin Islands. Professionals and individuals who have experienced trafficking apply for this scholarship with the Professional Development Survivor Scholarship Application. Those who receive NHTTAC scholarships are asked for their feedback following their use of scholarship funds via the Professional Development Scholarship Feedback Form.

SOAR to Health and Wellness (SOAR)

Tier I trainings of SOAR engages respondents through a variety of modalities: (1) SOAR Online is available to the public on the NHTTAC website. It comprises multiple modules, and respondents can take any combination thereof. Participants are asked to complete a pretest about their attitude/confidence in identifying, serving, and responding to trafficking. These same questions, along with training satisfaction questions, are asked again in the posttest. Participants must complete the pre- and posttest to receive continuing education credit. (2) SOAR trainings at conferences will be facilitated by NHTTAC consultants at select national and regional conferences or similar meetings. Conference/meeting participants and NHTTAC consultants will be asked about their satisfaction with training content, delivery, and coordination. (3) SOAR resources, such as an e-guide and state and territory profiles, will help inform practitioners and professionals who work in the public health field, including health and human service providers. These materials will be available to the public through the NHTTAC website and will be sent directly to consultants to guide their work. Recipients of these resources will be prompted to provide feedback about their satisfaction, content, and ease of use with the materials. (4) SOAR training for U.S. Department of Health and Human Services (HHS) personnel, is similar to SOAR Online but tailored to HHS staff. Participants will be asked to complete a pre- and posttest to capture satisfaction with the training and immediate changes in knowledge about trafficking. (5) Emerging issues webinars are available to the public but targeted to public health professionals, including health and human service providers. Participants will be asked to complete a feedback survey after the webinar. Tier I evaluation forms include the Consultant Feedback Form, Coordination Feedback Form, General Training Feedback Form, Resource Tool Feedback Form, Requestor Feedback Form, SOAR Conference Feedback Form, SOAR Online Participant Feedback Form, and the Webinar Participant Feedback Form.

Tier II of SOAR engages respondents through a targeted, blended online training. Targeted recipients of the blended training are individuals who requested the Tier II training and plan to incorporate the content into their organization’s policies and best practices. Consultants and requesters who provide this training to the participants will provide feedback on their involvement in this blended learning approach, including their satisfaction and experiences working with NHTTAC. Participants who engage in the training will also provide feedback about the blended learning, including information about the online and in-person delivery, the content, its relevancy to their work, and suggestions for improvements in future deliveries. Tier II also includes an option for organizations to add the SOAR Online training to their learning management systems. Each organization that adds SOAR Online to its learning management system will have one representative (typically the individual who added SOAR to their online system) provide feedback on the training. Tier II evaluation forms include the Consultant Feedback Form, Coordination Feedback Form, Pilot Feedback Form, Requestor Feedback Form, SOAR Blended Learning Participant Feedback Form, SOAR Organizational Feedback Form, Interview Guide, Focus Group Demographic Survey, and Focus Group Guide.

Tier III of SOAR engages respondents through intensive, in-person T/TA via SOAR for Communities. The requesting agency is asked to provide feedback on the process of requesting intensive T/TA from NHTTAC. SOAR for Communities participants are asked to provide feedback about their experiences participating in the training, including the utility of the needs assessment, the value and relevance of the strategic planning, and specific questions about their understanding of the action steps developed. Finally, NHTTAC will also follow up at set intervals after the training with SOAR for Communities participants to receive feedback on the participants’ ability to implement learning objectives and action plans. Consultants who provide Tier III-level T/TA will also provide their feedback about facilitating the training and their experiences working with NHTTAC. Prior to facilitating SOAR for Communities, consultants must complete a training designed for trainers. NHTTAC consultants will be asked for their feedback immediately following the completion of the training and at set intervals to check on the progress of understanding/implementing the content taught at trainings. Tier III evaluation forms include the Consultant Feedback Evaluation Form, Coordination Feedback Form, Followup Feedback Form, Pilot Feedback Form, Requestor Feedback Form, Focus Group Demographic Survey, Focus Group Guide, Interview Guide, and SOAR Specialized T/TA Feedback Form.

NHTTAC Consultants

T/TA expert consultants are subject matter experts with at least 7 years of professional experience as either a social service provider in child welfare, social service agency, or in another related field (e.g., advocate, program manager, case manager) or as a public health professional or other member of another allied profession (e.g., medical health, mental health, public health, behavioral health, substance abuse, education, or research). T/TA consultants will have the opportunity to provide expert advice to professionals who wish to build their capacity to serve individuals who have experienced trafficking and populations at risk of trafficking. Survivor impact consultants are individuals who have experienced trafficking and who want to leverage their personal experiences as a means of increasing awareness about trafficking and to inform trafficking programs from their unique perspective. The two applications for the consultant applications are Survivor Impact Consultant Application and Expert T/TA Consultant Application.

Both categories of consultants may be asked to deliver T/TA in some of the following ways: (1) educate health care, behavioral health, and social service professionals on how to identify, treat, and respond appropriately to individuals who are at risk of trafficking, including through the delivery of SOAR; (2) provide training at training events or conferences on a variety of topics relevant to OTIP's priorities; and (3) develop a variety of on-demand resources, tools, webinars, and other products. T/TA expert consultants may also be asked to conduct an organizational assessment of an agency's or organization's policies, protocols, and staff capacity to apply a trauma-informed approach through individualized technical assistance.

  1. Use of Improved Information Technology and Burden Reduction

To the extent possible, OTIP is committed to reducing the burden on applicants. The use of online evaluation forms allows recipients to complete the evaluation at a time and location convenient for them and minimizes data entry. Online responses are anonymous. Customizable instruments with a menu of questions that can be tailored to the most relevant questions for each T/TA helps minimize the burden on respondents. During the development process, the application and evaluation forms were streamlined to focus on including the most relevant questions. These efforts were made to reduce the time burden on respondents.

  1. Efforts to Identify Duplication and Use of Similar Information

No similar data are gathered or maintained by NHTTAC or are available from other sources known to OTIP.

  1. Impact on Small Businesses or Other Small Entities

Small business or other small entities may be involved in these efforts, but OTIP will minimize the burden on them of information collections approved under this clearance by sampling, asking for readily available information, and using short, easy-to-complete information collection instruments.

  1. Consequences of Collecting the Information Less Frequently

Without these types of feedback, OTIP will not have timely information about NHTTAC T/TA activities to adjust its services to meet recipient needs and address the needs of the field. The application forms are needed to allow the field to request the appropriate services desired and determine eligibility for T/TA under NHTTAC.

  1. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5

There are no special circumstances. The information collected will be voluntary and will not be used for statistical purposes.

  1. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency

The 60-day Federal Register notice was published on April 16, 2018 with page numbers 16362 – 16364, Volume 83, Number 73 to solicit public comments in accordance with Paperwork Reduction Act requirements. During the 60-day comment period, OTIP did not receive substantive comments. However, experts in the field of T/TA have been consulted in the creation of the application and evaluation forms included in this package. These experts have helped to refine the forms to ensure that they are comprehensive yet not overly burdensome for respondents.

  1. Explanation of Any Payment or Gift to Respondents

OTIP will not provide payment or other forms of remuneration to respondents of its various forms for collecting feedback.

  1. Assurance of Confidentiality Provided to Respondents

If a confidentiality pledge is deemed useful and feasible, OTIP will only include a pledge of confidentiality supported by authority established in statute or regulation. This in turn must be supported by disclosure and data security policies consistent with the pledge and that does not unnecessarily impede sharing of data with other agencies for compatible confidential use. If OTIP includes a pledge of confidentiality, it will include a citation for the statute or regulation supporting the pledge.


All information will be protected in accordance with the Privacy Act of 1974. Any release of information will conform to the stipulations of the Privacy Act and the guidelines of the Institutional Review Board (IRB) as determined by Title 45 Part 46 of the Code of Federal Regulations (see Section 11 for information on IRB). Only members of NHTTAC’s team will have access to completed forms. Once the information from each form has been entered into an electronic database, only those NHTTAC team members with a valid identification, password, and permissions will have access to the information and raw data. Any physical forms will be maintained in a locked filing cabinet with limited access. Transmission of data from NHTTAC to OTIP will be restricted to de-identified summary data to protect the identity of the respondent (e.g., redacting open-ended comments with contact information and providing interview results in aggregate form).

  1. Justification for Sensitive Questions

No questions of a personal or sensitive nature will be asked on the evaluation forms. The applications only include information necessary to determine eligibility requirements.

  1. Estimates of Annualized Burden Hours

A variety of instruments and platforms will be used to collect information from respondents. The annual burden hours requested (689) is based on the number of collections we expect to conduct over the requested period for this clearance. The information collections are bundled according to their line of business, affected public (e.g., individual or organization), and obligation to respond (e.g., voluntary or required to receive service). The bundles are as follows:

Bundle 1

Line of Business: Administering a Service

Affected Public: Organizations (e.g., nonprofits)

Obligation to Respond: Mandatory (Required to Receive Service)

Instruments:

      • Organizational Scholarship Application



Bundle 2

Line of Business: Administering a Service

Affected Public: Individuals

Obligation to Respond: Mandatory (Required to Receive Service)

Instruments:

      • Survivor Impact Consultant Application

      • Expert T/TA Consultant Application

      • Professional Development Survivor Scholarship Application



Bundle 3

Line of Business: Soliciting Feedback

Affected Public: Individuals

Obligation to Respond: Voluntary

Instruments:

      • Survivor Fellowship Feedback Fellow Protocol

      • Website Feedback Form

      • Consultant Feedback Form

      • Coordination Feedback Form

      • Focus Group Guide

      • Focus Group Demographic Survey

      • Follow-Up Feedback Form

      • General Training Feedback Form

      • Interview Guide

      • Pilot Feedback Form

      • Requester Feedback Form

      • Resource Tool Feedback Form

      • SOAR Blended Learning Participant Feedback Form

      • SOAR Conference Feedback Form

      • SOAR Online Participant Feedback Form

      • SOAR Specialized T/TA Feedback Form

      • Webinar Participant Feedback Form

      • Conference Session Feedback

      • General Conference Feedback

      • HTLA Pre-Program Feedback Form

      • HTLA Post-Program Feedback Form

      • Professional Development Scholarship Feedback

      • Short-Term T/TA Feedback Form

      • Specialized T/TA Feedback Form

      • Call Center Protocol

      • NAC Feedback Protocol



Bundle 4

Line of Business: Soliciting Feedback

Affected Public: Organizations (e.g., nonprofits)

Obligation to Respond: Voluntary

Instruments:

      • Survivor Fellowship Organization Feedback Form

      • SOAR Organizational Feedback Form

      • Organizational Scholarship Feedback Protocol

      • OTIP Grantee Feedback Protocol

Collection Bundle

Number of Respondents

Number of Responses per Respondent

Average Burden Hours per Response

Total Burden Hours

Average Cost per Response

Total Cost

NHTTAC Consultant and Evaluation Mandatory Application Forms for Organizations (1 Instrument)

10

1

.317

3.17

$3.47

$34.70

NHTTAC Consultant and Evaluation Mandatory Application Forms for Individuals (3 Instruments)

70

1

.3

20.99

$5.45

$381.70

NHTTAC Consultant and Evaluation Voluntary Feedback Forms for Organizations (4 Instruments)

105

1

.168

17.69

$3.47

$364.35

NHTTAC Consultant and Evaluation Voluntary Feedback Forms for Individuals (26 Instruments)

5723

1

.113

647.31

$3.53

$20,228.06

Totals




689.16


$21,008.81




Type of Collection


Number of Respondents


Number of Responses per Respondent


Average Burden Hours per Response


Total Burden Hours

Organizational Scholarship Application

10

1

.317

3.17

Survivor Impact Consultant Application

20

1

.283

5.66

Expert T/TA Consultant Application

20

1

.267

5.34

Professional Development Survivor Scholarship Application

30

1

.333

9.99

Survivor Fellowship Organization Feedback Form

10

1

.250

2.50

SOAR Organizational Feedback Form

20

1

.133

2.66

OTIP Grantee Feedback Protocol

50

1

.167

8.35

Organizational Scholarship Feedback Protocol

25

1

.167

4.18

NAC Feedback Protocol

30

1

.083

2.49

Call Center Protocol

300

1

.083

24.90

Conference Session Feedback Form

300

1

.167

50.10

General Conference Feedback Form

100

1

.167

16.70

HTLA Pre-Program Feedback Form

24

1

.250

6.00

HTLA Post-Program Feedback Form

24

1

.250

6.00

Professional Development Scholarship Feedback Form

50

1

.167

8.35

Short-Term T/TA Feedback Form

30

1

.167

5.01

Specialized T/TA Feedback Form

50

1

.250

12.50

Survivor Fellowship Feedback Fellow Protocol

10

1

.250

2.50

Website Feedback Form

300

1

.083

24.90

Consultant Feedback Form

50

1

.083

4.15

Coordination Feedback Form

100

1

.050

5.00

Focus Group Demographic Survey

25

1

.033

.825

Focus Group Guide

25

1

.750

18.75

Follow-Up Feedback Form

300

1

.133

39.90

General Training Feedback Form

150

1

.133

19.95

Interview Guide

25

1

.750

18.75

Pilot Feedback Form

25

1

.150

3.75

Requester Feedback Form

75

1

.117

8.78

Resource Tool Feedback Form

500

1

.033

16.5

SOAR Blended Learning Participant Feedback Form

30

1

.150

4.50

SOAR Conference Feedback Form

500

1

.200

100.00

SOAR Online Participant Feedback Form

1500

1

.100

150.00

SOAR Specialized T/TA Feedback Form

200

1

.150

30.00

Webinar Participant Feedback Form

1000

1

.067

67.00

Total Annual Burden

5,908



689.16

Estimated Total Annual Burden Hours: 689 Hours

  1. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers

The Package contains forms that will require varying levels of burden hours to complete, which will affect the estimated cost burden. The estimates of annualized cost to respondents are based on appropriate wage rate categories and annual salaries for position types in which respondents serve.

The estimated total annual cost burden to respondents resulting from the collection of information as part of the OTIP application and evaluation package is $21,008.81.


Type of Collection


Number of Respondents


Number of Responses per Respondent

Cost per Response

Total Cost

NAC Feedback Form

30

1

$3.47

$104.10

Call Center Feedback Form

300

1

$3.47

$1,041.00

Conference Session Feedback Form

300

1

$3.47

$1,041.00

General Conference Feedback Form

100

1

$3.47

$347.00

HTLA Pre-Program Feedback Form

24

1

$3.47

$83.28

HTLA Post-Program Feedback Form

24

1

$3.47

$83.28

OTIP Grantee Feedback Form

50

1

$3.47

$173.50

Organizational Scholarship Feedback Form

25

1

$3.47

$86.75

Professional Development Scholarship Feedback Form

50

1

$3.47

$173.50

Short-Term T/TA Feedback Form

30

1

$3.47

$104.10

Specialized T/TA Feedback Form

50

1

$3.47

$173.50

Survivor Fellowship Organization Feedback Form

10

1

$3.47

$34.70

Survivor Fellowship Feedback Fellow Protocol

10

1

$3.47

$34.70

Website Feedback Form

300

1

$3.47

$1,041.00

Consultant Feedback Form

50

1

$3.47

$173.50

Coordination Feedback Form

100

1

$1.30

$130.00

Focus Group Demographic Survey

25

1

$1.30

$32.50

Focus Group Guide

25

1

$65.55

$1,638.75

Follow-Up Feedback Form

300

1

$3.47

$1,041.00

General Training Feedback Form

150

1

$3.47

$520.50

Interview Guide

25

1

$6.94

$173.50

Pilot Feedback Form

25

1

$6.94

$173.50

Requester Feedback Form

75

1

$3.47

$260.25

Resource Tool Feedback Form

500

1

$1.30

$650.00

SOAR Blended Learning Participant Feedback Form

30

1

$3.47

$104.10

SOAR Conference Feedback Form

500

1

$3.47

$1,735.00

SOAR Online Participant Feedback Form

1500

1

$3.47

$5,205.00

SOAR Organizational Feedback Form

20

1

$3.47

$69.40

SOAR Specialized T/TA Feedback Form

200

1

$3.47

$694.00

Webinar Participant Feedback Form

1000

1

$3.47

$3,470.00

Survivor Impact Consultant Application

20

1

$6.94

$138.80

Expert T/TA Consultant Application

20

1

$6.94

$138.80

Organizational Scholarship Application

10

1

$3.47

$34.70

Professional Development Survivor Scholarship Application

30

1

$3.47

$104.10

Total Annual Cost Burden

$21,008.81



  1. Annualized Cost to the Federal Government

The estimated annual cost to the Federal government staff is minimal and limited to staff review time of applications. We estimate the overall annualized cost to the Federal government to be $97,585.60. This cost estimate is based on the task order of work projected for completion under the contract for this training and technical assistance effort. As outlined below, the estimated annual Federal costs associated with OTIP’s NHTTAC Consultant and Evaluation Package include the capital/startup and operating and maintenance costs necessary for this information collection to include: the quantification of hours for managerial and support staff to administer the Consultant and Evaluation Package process; the acquisition or development of collection techniques; and operational expenses (e.g., equipment, overhead, printing, etc.) for the three years for which this approval is sought.

  • Capital/Startup costs: $39,065.00. This amount includes instrument design and development. This amount also includes the use and maintenance of information technology to store, generate, and assist in distributing and collecting the data necessary for carrying out this effort.


  • Operating and Maintenance costs: $58,520.60. This amount reflects the total annual costs for operating and maintaining any automated, electronic, mechanical or technological collection techniques, as well as, the labor necessary to implement, analyze and report on this effort.



  1. Explanation for Program Changes or Adjustments

This is a new request for standard OMB approval. The evaluation instruments were previously cleared under a Generic Clearance using the fast tracked process for piloting and standard approval is sought to allow for dissemination of findings and reports. No changes have been made to the previously approved forms. The four applications (Organizational Scholarship Feedback Form, Professional Development Scholarship Feedback Form, Organizational Scholarship Application, and Professional Development Survivor Scholarship Application) have not been previously cleared and have been added to the current package.

  1. Plans for Tabulation and Publication and Project Time Schedule

The evaluation results will be tabulated using parametric and nonparametric statistical tests. All findings will be reported de-identified and in aggregate form. Although OTIP does not intend to publish its findings, it may receive requests to release the information (e.g., congressional inquiry and Freedom of Information Act requests). OTIP will disseminate the findings when appropriate, strictly following HHS’ “Guidelines for Ensuring the Quality of Information Disseminated to the Public,” and will include specific discussion of the limitation of the data.

  1. Reason(s) Display of OMB Expiration Date is Inappropriate

OTIP is not requesting an exemption. The OMB control number and expiration date will be displayed on all forms.

  1. Exceptions to Certification for Paperwork Reduction Act Submissions

These activities comply with the requirements in 5 CFR 1320.9.

B. Statistical Methods (used for collection of information employing statistical methods)

Data collection methods and procedures will vary to accommodate T/TA events; however, the primary use of these collections will be for internal management purposes and to process T/TA requests. We will be employing basic statistical methods in this information collection, including simple descriptive statistics (e.g., frequencies and mean) and aggregating simple descriptive statistics across multiple events. No inferential statistical tests will be conducted or sophisticated statistical techniques (e.g., sampling plans, imputation or other missing data adjustments and statistical estimation techniques); therefore, this section is not addressed.


The organization responsible for collecting and analyzing the data is: ICF, 9300 Lee Highway, Fairfax, VA, 22031. For questions related to statistical methods, please contact Samantha Lowry, MS, at ICF, at [email protected], or 703–251–0368.

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