5800-027 Facilitated Dialogue Participant Questionnaire

OMB Number: 2010-0042

Approval Expiry Date: 11/30/2017

Facilitated Dialogue Participant Questionnaire

This collection of information is approved by OMB under the Paperwork Reduction Act, 44 U.S.C. 3501 et seq. (OMB Control No. 2010-0042). Responses to this collection of information are voluntary. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The public reporting and recordkeeping burden for this collection of information is estimated to range from 3 to 32 minutes per response. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates and any suggested methods for minimizing respondent burden to the Regulatory Support Division Director, U.S. Environmental Protection Agency (2821T), 1200 Pennsylvania Ave., NW, Washington, D.C. 20460. Include the OMB control number in any correspondence. Do not send the completed form to this address.

The U.S. Environmental Protection Agency, Conflict Prevention and Resolution Center (CPRC) requests your assistance in evaluating this facilitated process. As a part of this evaluation, we ask the various participants who have been involved in this project or case to provide us with information about their experience. The data compiled will be used to improve future facilitation services provided by the CPRC.

The CPRC will not report information from this evaluation in a way that respondents or their organizations can be identified. Moreover, the identity of individual respondents will be kept confidential and will not be disclosed.

1. To what extent will or did this facilitated process contribute to EPA’s or other stakeholders’ decisions?

SELECT ONE

• The matter will be essentially resolved

• Good possibility that the matter can be resolved

• Will not make much difference to resolving the matter. (TO 3)

• Not sure (TO 3)

2. Please elaborate on the contributions to addressing the matter. (TO 4)

3. Please elaborate on the challenges in making progress towards addressing the matter. (TO 6)

4. Rate your level of agreement with the following statements regarding the decision(s)

[0=Not at all, 10=Completely, DK]

1. The decision(s) reached takes account of our key interests.

2. The decision (s) that was reached will effectively resolve the key issues considered in this process.

3. The decision(s) that were reached can be implemented.

4. The facilitator’s involvement was important to efforts to achieving convergence of views among the participating interests.

5. Do you expect to be satisfied with the decisions the facilitated dialogue contributed to?

[0=Not at all, 10=Completely]

_____

6. Did the process break an impasse on this matter?

• Yes

• No (to 8)

• Don’t know (to 8)

7. How important was breaking the impasse to the overall result of the process?

[0=Not at all, 10=Completely]

8. To what extent was there change over the course of the process in the ability of participants to work together on this matter and in your level of trust in each other? WILL TURN INTO RADIO BUTTONS ON THE FORM

	Much improved	Somewhat improved	About the same	Somewhat worse	Much worse
Change in our ability to work together cooperatively.					
Change in our trust of each other.					

Please use this space if you wish to elaborate on changes in the levels of cooperation and trust. _________________________________________________________________

9. Did you participate in developing the approach for the facilitated process (e.g., agenda setting, meeting frequency and location, ground rules)?

One only

• I/we participated and my participation was appropriate

• I/we participated and my participation was unnecessary

• I/we participated and my participation was insufficient

• I/we declined to participate

• I was/we were unable to participate

• My/our participation was unnecessary

• Other (please describe)

10. Please rate your level of agreement with the following about the early phases of the facilitated process.

[0=Not at all, 10=Completely].

1. I/we had a good understanding of the process from the outset.

2. I was/we were able to assess the risks and costs associated with participating in the facilitated process from the outset.

3. Early discussions with the facilitator were critical in helping me/us understand how a facilitated process might serve my/our interests.

4. I/we had a good understanding of how I/we would contribute to the facilitated process.

5. Participants were encouraged to engage in considering the key issues in the dialogue.

6. The facilitated dialogue process was structured to consider the key issues in an appropriate sequence.

11. Use this space if you wish to elaborate on your answers to any of these questions.

12. Please rate your level of agreement with the following about the participants:

[0=Not at all, 10=Completely].

1. The participants, as a group, represented all affected concerns.

2. The participants continued to be engaged so long as their involvement was needed.

3. I/we had the resources (e.g., time, money) needed to participate effectively in the process.

13. Use this space if you wish to elaborate on your answers to any of these questions.

14. Please rate your level of agreement with the following about the process:

[0=Not at all, 10=Completely]

1. The process enabled me to gain a good understanding of the issues important to the other participants.

2. The process enabled me to gain a good understanding of why issues addressed in the process were important to other participants.

3. The topics discussed in this process were all worthy of our consideration.

4. The process enabled participants to be civil to each other.

5. This was an appropriate process to consider the matter.

15. Use this space if you wish to elaborate on your answers to any of these questions.

16. Please rate your level of agreement with the following about the information and issues:

[0=Not at all, 10=Completely]

1. The information used was good enough for the discussions.

2. I/we understood all of the technical discussions sufficiently to represent my/our interests.

3. The process helped participants identify the key issues that needed to be considered.

4. The participants focused primarily on the key issues once they were identified.

5. The other participants listened to me.

6. The other participants respected the views I/we expressed.

17. Use this space if you wish to elaborate on your answers to any of these questions.

18. Please rate your level of agreement with the following about the facilitator:

[0=Not at all, 10=Completely; N/A]

1. When needed the facilitator helped us find ways to move forward constructively.

2. The facilitator dealt with all participants fairly.

3. I/we trusted the facilitator.

4. The facilitator ensured my/our views and perspectives were considered in the process.

5. The facilitator helped participants test the practicality of the options under discussion.

19. Use this space if you wish to elaborate on your answers to any of these questions.

20. Please rate your agreement with the following statement. Private communications I/we had with the facilitator that did not include all parties (e.g., a private caucus) were important for advancing the process.

[0=Do not agree at all, 10=Agree completely, NA]

21. Please rate your agreement with the following statements about whether you would recommend a facilitated process and this facilitator to colleagues in a similar situation? [0=Do not agree at all, 10=Agree completely, NA]

1. I/we would recommend this type of facilitated process to colleagues in a similar situation.

2. I/we would recommend this facilitator to colleagues in a similar situation.

22. Did or will the facilitated dialogue enhance decision making about the issues in ways that would not have happened if the facilitated dialogue did not occur?

(CHECK ONLY ONE)

• Yes

• No (TO 24)

• Don't know (TO 24)

• Too soon to tell (TO 24)

23. Please describe how decision making was or will be enhanced by using a facilitated dialogue.

________________________

24. Based on your experience what is the greatest advantage and disadvantage of this facilitated process?

Greatest advantage

Greatest disadvantage

25. What is your top suggestion on how this facilitated process could have been improved?

PLEASE WRITE "NONE" IF YOU FEEL THIS PROCESS COULD NOT HAVE BEEN IMPROVED.

26. Please use the space below for any additional comments you would like to make.

Thank you for taking the time to complete this questionnaire.

PERSONS WITH DISABILITIES WHO REQUIRE ALTERNATIVE MEANS FOR COMMUNICATION OF PROGRAM EVALUATION INFORMATION SHOULD CONTACT THE CPRC OFFICE.

Burden Statement: Public reporting burden for this collection of information is estimated to average 13 minutes per response, including the time for reviewing instructions, gathering information, and completing and reviewing the collection of information. Send comments on the Agency’s need for this information, the accuracy of the provided burden estimates, and any suggestions for reducing the burden, including the use of automated collection techniques to:

CONFLICT PREVENTION AND RESOLUTION CENTER

U.S. Environmental Protection Agency (MC: 2388A)

1200 Pennsylvania Avenue, NW, Washington, DC 20460

Telephone: 202.564.0214, Fax: 202.501.1715

Website: www.epa.gov/adr

Email: [email protected]

109871100Form # 5800-027 6