Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Fast Track)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Justification for Non substantive Changes - 0788.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-07-25	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
237680	Interviews to Collect Customer Feedback Regarding SSA's Earnings Submission Process.	Other-Interviews to Collect Customer Feedback Regarding SSA’s Ea	New
237129	Consultative Examination Satisfaction Survey	Other-Consultative Examination Satisfaction Survey	New
235830	Fast Healthcare Interoperability Resources (FHIR) and Consumer Directed Exchange Feasiblility Study Questinnaire	Other-FHIR Reasiblility Study Questionnaire	Unchanged
235336	Usability Testing of SSA Electronic Projects	Other-Usability Testing of SSA Electronic Projects FY19 Product	Unchanged
234816	FY 19 Caller Surveys	Other-FY19 800# Caller Survey	Unchanged
233960	eCBSV Outreach Survey under the Economic Growth, Regulatory Relief, and Consumer Protection Act	Other-2018 SSA Initiative Needs Assessment Survey	Unchanged
233486	IdeaScale Forum for Advance Designation of Representative Payees	Other-IdeaScale Forum Questions	Unchanged
233131	National Disability Forum (NDF)	Other-Disability Forum Evaluation Form FY 19	Unchanged
232688	Interviews to Collect Customer Feedback Regarding SSA's Earnings Submission Process.	Other-Survey Documentation	Unchanged
232149	User Research for SSA Projects - Usability Testing	Other-Sample Questionnaire	Unchanged
231951	Retirement Research Consortium (RRC) and Disability Research Consortium (DRC)	Other-Survey	Unchanged
229969	Usability Testing of SSA Electronic Projects	Other-Usability Testing of SSA Electronic Projects FY18 Product	Unchanged
229102	Work Incentive Planning and Assistance (WIPA) Customer Comment Instrument	Other-WIPA Sample	Unchanged
228823	Chicago Model FO Employee Feedback Survey and Visitor Feedback Survey	Other-Survey Documentation	Unchanged
227442	Fast Track Template Blank	Other-Generic Clearance Blank Template	Unchanged

ICR Details

OMB Control No: 0960-0788	ICR Reference No: 201907-0960-006
Status: Historical Active	Previous ICR Reference No: 201707-0960-002
Agency/Subagency: SSA	Agency Tracking No:
Title: Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery (Fast Track)
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: 07/28/2019
Retrieve Notice of Action (NOA)	Date Received in OIRA: 07/25/2019
Terms of Clearance: Terms of the Generic ICR remain in effect. Approved consistent with the following terms of clearance: SSA will submit to OMB an annual progress report summarizing actual burden, reporting results achieved. In the event that additional hours are required, SSA will need to submit a nonmaterial/nonsubstantive change in burden request for the overall Generic ICR. For each information collection that SSA undertakes, SSA will provide OMB a summary of objectives, specific burden estimates, and all final survey instruments. Each information collection must be entered into ROCIS as an IC. OMB will attempt to provide comments within ten days of official receipt of an individual clearance package. However, the SSA must receive explicit OMB approval prior to initiating any proposed collections under this clearance.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2020	09/30/2020	09/30/2020
Responses	1,700,000	0	205,485
Time Burden (Hours)	425,000	0	38,559
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable SSA to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders helps ensure that users have an effective, efficient, and satisfying experience with SSA's programs. This is a Non-Substantive Change Request to increase the burden for this collection.

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Authorizing Statute(s): None

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:
	82 FR 17494	04/11/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 27939	06/19/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 15

table that charts list of burden

IC Title	Form No.	Form Name
Interviews to Collect Customer Feedback Regarding SSA's Earnings Submission Process.
Chicago Model FO Employee Feedback Survey and Visitor Feedback Survey
Consultative Examination Satisfaction Survey
FY 19 Caller Surveys
Fast Healthcare Interoperability Resources (FHIR) and Consumer Directed Exchange Feasiblility Study Questinnaire
Fast Track Template Blank
IdeaScale Forum for Advance Designation of Representative Payees
Interviews to Collect Customer Feedback Regarding SSA's Earnings Submission Process.
National Disability Forum (NDF)
Retirement Research Consortium (RRC) and Disability Research Consortium (DRC)
Usability Testing of SSA Electronic Projects
Usability Testing of SSA Electronic Projects
User Research for SSA Projects - Usability Testing
Work Incentive Planning and Assistance (WIPA) Customer Comment Instrument
eCBSV Outreach Survey under the Economic Growth, Regulatory Relief, and Consumer Protection Act

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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	1,700,000	205,485	0	1,494,515	0	0
Annual Time Burden (Hours)	425,000	38,559	0	386,441	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: We are increasing the overall ICR burden to account for the submission of a generic clearance request to cover a qualitative customer satisfaction survey for claimants and beneficiaries receiving consultative examinations. We did not anticipate this large-scale qualitative survey when we submitted the initial burden information in 2017.

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Annual Cost to Federal Government: $131,204

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

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: 07/25/2019

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