OPRE Evaluation - National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants [descriptive evaluation, impact evaluation, cost-benefit analysis study, pilot study]

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
OMB#0970-0462_NonSub Change Request_Temporary Use of Verbal Consent Forms_04152020.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2020-04-16	Available
Attachment B3_Tribal Evaluation informed consent Form D (Unique Identifiers_Verbal.docx	Supplementary Document	Uploaded 2020-04-16	Available
Attachment B2_Tribal Evaluation_informed consent Form C (SSNs)_VERBAL.DOCX	Supplementary Document	Uploaded 2020-04-16	Available
Attachment B_National Evaluation informed consent Form D_ lottery not required-Verbal.docx	Supplementary Document	Uploaded 2020-04-16	Available
Attachment B. National Evaluation Informed Consent Form C Lottery Required _Verbal.docx	Supplementary Document	Uploaded 2020-04-16	Available
Attachment Z_ Participant Interview Recruitment Materials.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment Y 60-Day Federal Register Notice.pdf	Supplementary Document	Uploaded 2019-04-18	Available
Attachment X_Complete List of Previously Approved Instruments for HPOG 2.0.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment W_HPOG 2.0_phone based Skills Assessment Pilot_Recruitment Script.docx	Supplementary Document	Uploaded 2019-04-18	Repair queued
Attachment V_HPOG 2.0_phone based Skills Assessment Pilot_ParticipantLetter.docx	Supplementary Document	Uploaded 2019-04-18	Repair queued
Attachment U_HPOG 2.0_phone based Skills Assessment Pilot_Grantee Letter.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment T_HPOG 2.0_phone based Skills Assessment Pilot_Recruitment Flyer.docx	Supplementary Document	Uploaded 2019-04-18	Repair queued
Attachment S_HPOG 2.0_Intermediate Follow-up Email Reminder.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment R_HPOG 2.0_Intermediate Follow-upSurvey_Flyer.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment Q_HPOG 2.0 Intermeditate Follow-up Survey Sources.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment P_HPOG 2.0_Intermediate Follow-up Survey Advance Letter.docx	Supplementary Document	Uploaded 2019-04-18	Available
Attachment O_ResearchQuestions for Previously Approved National and Tribal Evaluation Efforts.docx	Supplementary Document	Uploaded 2018-02-01	Available
Attachment N_HPOG2.0_Short-Term Followup Short-Term Survey_ Email Remind_revised_010918_clean.docx	Supplementary Document	Uploaded 2018-02-01	Available
Attachment M_HPOG 2.0_Short-Term Survey Flyer 01092018.docx	Supplementary Document	Uploaded 2018-02-01	Available
Attachment L_HPOG 2.0 Short-Term Followup Followup Survey Sources_Rev_121217_Clean.docx	Supplementary Document	Uploaded 2018-02-01	Available
Attachment K_HPOG2.0_Short-Term Followup Survey Advance Letter_Rev_01092018_Clean.docx	Supplementary Document	Uploaded 2018-02-01	Available
Attachment K_HPOG 2 0 Incentive Communications_Email and Letter_071117 CLEAN.docx	Supplementary Document	Uploaded 2017-07-12	Repair queued
Attachment J_Interview Verbal Informed Consent Form.docx	Supplementary Document	Uploaded 2016-10-24	Available
Attachment I_Focus Group Informed Consent Form.doc	Supplementary Document	Uploaded 2016-10-24	Repair queued
Attachment H_HPOG- Model.pptx	Supplementary Document	Uploaded 2016-10-24	Available
Attachment B3_Tribal Evaluation Informed Consent Form B (Unique Identifiers).docx	Supplementary Document	Uploaded 2016-06-16	Available
Attachment B2_Tribal Evaluation Informed Consent Form A (SSNs).docx	Supplementary Document	Uploaded 2016-06-16	Available
Attachment B_Approved non-tribal, adult lottery not required consent form.docx	Supplementary Document	Uploaded 2016-06-16	Available
Attachment A_References_Revised 09 02 16.docx	Supplementary Document	Uploaded 2016-10-24	Available
Attachment G. Contact Update Letter and Form.docx	Supplementary Document	Uploaded 2015-05-11	Repair queued
HPOG 2.0_Supporting Statement B_Revised_04152020_Temporary Approval of Verbal Consent.docx	Supporting Statement B	Uploaded 2020-04-16	Available
HPOG 2.0_Supporting Statement A_Revised_04152020_Temporary Approval of Verbal Consent.docx	Supporting Statement A	Uploaded 2020-04-16	Available
Attachment F. First Round of HPOG Grantees Ressearch Portfolio_4.28.15.docx	Supplementary Document	Uploaded 2015-05-06	Available
FINAL updated Attachment E PPR Data List and Mockup 8 4 15 clean.docx	Supplementary Document	Uploaded 2015-08-05	Available
Attachment D. Sources and Justification_5.4.15.docx	Supplementary Document	Uploaded 2015-05-06	Available
Attachment C_HPOG 2.0 15 mos follow up - 60 Day FRN_8.30.17.pdf	Supplementary Document	Uploaded 2018-02-01	Available
Attachment B. Informed Consent Forms_01.25.16 clean.docx	Supplementary Document	Uploaded 2016-01-26	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
235782	Instrument 20: Program cost survey	Other-Survey	Unchanged
235781	Instrument 19: Phone-based Skills Assessment Pilot Instrument	Other-Phone-based Assessment	Unchanged
235780	Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study	Other-Survey	Unchanged
235779	Instrument 17: Participant interview guide	Other-Interview Guide	Unchanged
235778	Instrument 16: Partner interview guide for the systems study	Other-Interview Guide	Unchanged
235777	Instrument 15: Program operator interview guide for the systems study	Other-Interview Guide	Unchanged
235776	Instrument 14: Second round telephone interview protocol for non-tribal HPOG grantee staff and partners	Other-Interview Guide	Modified
235775	Instrument 13: Screening tool for identifying respondents for second-round telephone interviews	Other-Screener	Unchanged
229940	Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation	Other-Survey	Unchanged
229938	Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form	Other-Update Form	Unchanged
224119	Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews	Other-Interview	Unchanged
224118	Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews	Other-Interview	Unchanged
224113	Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups	Other-Focus Group	Unchanged
224112	Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews	Other-Interview	Unchanged
224110	Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews	Other-Interview	Unchanged
224107	Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews	Other-Interview	Unchanged
216432	PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)	Other-Data collection System	Unchanged
216431	PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)	Other-Data collection System	Unchanged
216430	PAGES Grantee- and Participant-Level Data Collection (all grantees)	Other-Data collection System	Unchanged

ICR Details

OMB Control No: 0970-0462	ICR Reference No: 202004-0970-009
Status: Historical Active	Previous ICR Reference No: 201904-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No: OPRE
Title: OPRE Evaluation - National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants [descriptive evaluation, impact evaluation, cost-benefit analysis study, pilot study]
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: 04/23/2020
	Date Received in OIRA: 04/16/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2022	07/31/2022	07/31/2022
Responses	21,040	0	21,040
Time Burden (Hours)	9,780	0	9,780
Cost Burden (Dollars)	0	0	0

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Abstract: The Health Profession Opportunity Grants (HPOG) Program provides healthcare occupational training for Temporary Assistance for Needy Families (TANF) recipients and other low-income people. Under normal study enrollment procedures, local HPOG 2.0 grantee staff conduct face-to-face intake interviews and administer informed consent. As part of the consent process, study participants sign the form in ink. As a result of the recent COVID-19 outbreak, most HPOG programs have changed to operate their programs virtually, including asking staff to work remotely and offering participant trainings online. These restrictions have brought the face-to-face intake and enrollment sessions to a sudden halt in many locations. However, grantees are eager to continue enrollment in the interest of serving the healthcare workforce needs in their communities. In order to facilitate grantees’ continued enrollment of new participants while their programs operate remotely, we have developed a new set of consent forms to allow grantee staff to obtain informed consent verbally. The new set of forms include only minor revisions from the already approved versions for written consent to allow for verbal consent. • Attachment B: National Evaluation informed consent form C (Lottery Required)_Verbal • Attachment B: National Evaluation informed consent form D (Lottery Not Required)_Verbal • Attachment B2: Tribal Evaluation informed consent form C (SSNs)_Verbal • Attachment B3: Tribal Evaluation informed consent form D (Unique identifiers)_Verbal

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Authorizing Statute(s): PL: Pub.L. 111 - 148 5507 , sec. 2008, (a)(3)(B) Name of Law: Patient Protection and Affordable Care Act
  

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:
	83 FR 66715	12/27/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 16870	04/23/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 19

table that charts list of burden

IC Title	Form No.	Form Name
Instrument 13: Screening tool for identifying respondents for second-round telephone interviews
Instrument 15: Program operator interview guide for the systems study
Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study
Instrument 20: Program cost survey
Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups
Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews
Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews
Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews
Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)
PAGES Grantee- and Participant-Level Data Collection (all grantees)
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)
Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form
Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation
Instrument 14: Second round telephone interview protocol for non-tribal HPOG grantee staff and partners
Instrument 16: Partner interview guide for the systems study
Instrument 17: Participant interview guide
Instrument 19: Phone-based Skills Assessment Pilot Instrument

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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	21,040	21,040	0	0	0	0
Annual Time Burden (Hours)	9,780	9,780	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $4,717,923

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.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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? Yes

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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: 04/16/2020

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