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
Attachment AA_HPOG2.0_ParticipantNewsletter.docx	Supplementary Document	Uploaded 2021-05-19	Repair queued
Attachment N_Revised COVID-19 Short-Term Survey Email Reminder Text.docx	Supplementary Document	Uploaded 2021-05-19	Repair queued
Attachment M_Revised COVID-19 Cohort Short-term Survey Trying to Reach You Flyer.docx	Supplementary Document	Uploaded 2021-05-19	Repair queued
Attachment L_Revised COVID-19 Cohort Short-Term Survey Souces.docx	Supplementary Document	Uploaded 2021-05-19	Repair queued
Attachment K_Revised COVID-19 Cohort Short-Term Survey Advance Letter.docx	Supplementary Document	Uploaded 2021-05-19	Repair queued
Attachment B3_Tribal Evaluation Informed Consent Form B (Unique Identifiers).docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment B2_Tribal Evaluation Informed Consent Form A (SSNs).docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment B. National Evaluation Informed Consent Forms A_Lottery Required_REV.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment B3_Tribal Evaluation informed consent Form D Unique Identifiers_Verbal.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment B2_Tribal Evaluation_informed consent Form C SSNs_Verbal.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment B. National Evaluation Informed Consent Form C Lottery Required _Verbal_REV.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment S_HPOG 2.0_Intermediate Follow-up Email Reminder_REV.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment R_HPOG 2.0_Intermediate Follow-upSurvey_Flyer.docx	Supplementary Document	Uploaded 2019-04-18	Repair queued
Attachment Q_HPOG 2.0 Intermediate Follow-up Survey Sources_REV.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
Attachment P_HPOG 2.0_Intermediate Follow-up Survey Advance Letter_REV.docx	Supplementary Document	Uploaded 2020-06-24	Repair queued
HPOG2.0_CovidCohortSurvey_LT-Tracking SSB_Rev_051321.docx	Supporting Statement B	Uploaded 2021-05-19	Repair queued
HPOG 2 CovidCohortSurvey_LT-Tracking_SSA_Rev_051921.docx	Supporting Statement A	Uploaded 2021-05-19	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
247514	Instrument 12a: COVID-19 Cohort STS	Other-Survey	New
244488	Instrument 5a: HPOG 2.0 National Evaluation Welcome to the Study Packet	Other-Welcome Packet	Modified
242412	Instrument 18a: Intermediate Follow-up Survey for the National Evaluation impact study - Critical Items Only	Other-Survey	Modified
235780	Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study	Other-Survey	Modified
229938	Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form	Other-Update Form	Modified
224119	Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews	Other-Interview	Removed
224118	Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews	Other-Interview	Removed
224113	Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups	Other-Focus Group	Removed
224112	Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews	Other-Interview	Removed
224110	Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews	Other-Interview	Removed
224107	Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews	Other-Interview	Removed
216432	PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)	Other-Data collection System	Modified
216431	PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)	Other-Data collection System	Modified
216430	PAGES Grantee- and Participant-Level Data Collection (all grantees)	Other-Data collection System	Modified

ICR Details

OMB Control No: 0970-0462	ICR Reference No: 202105-0970-010
Status: Received in OIRA	Previous ICR Reference No: 202105-0970-005
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: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 05/21/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2022
Responses	11,815	27,783
Time Burden (Hours)	4,525	9,143
Cost Burden (Dollars)	0	0

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Abstract: This is the fourth request for revisions to OMB #0970-0462. This revised request for clearance seeks approval for: 1. COVID-19 Cohort Short-term Survey (COVID-19 Cohort STS): This survey is a revised version of the previously approved Short-term Follow-Up Survey. The goal is to measure the short-term impacts of HPOG 2.0 for study participants enrolled after the onset of the COVID-19 pandemic (May 2020-September 2021). This will help us understand the impact of COVID-19 on program operations and participant outcomes. This also includes revisions to the supplemental materials associated with this data collection. 2. New supporting materials to support the re-engagement of participants selected for a long-term follow-up survey of HPOG 2.0 participants—a newsletter and an outbound call script for collecting updated contact data, both of which will help enhance the contact information update procedures previously approved under OMB #0970-0462.

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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:
	85 FR 83586	12/22/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 27624	05/21/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews
Instrument 12a: COVID-19 Cohort STS
Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study
Instrument 18a: Intermediate Follow-up Survey for the National Evaluation impact study - Critical Items Only
Instrument 5a: HPOG 2.0 National Evaluation Welcome to the Study Packet
Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form
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 9: HPOG 2.0 Tribal Evaluation program participant focus groups
PAGES Grantee- and Participant-Level Data Collection (all grantees)
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	11,815	27,783	0	-15,968	0	0
Annual Time Burden (Hours)	4,525	9,143	0	-4,618	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This request for clearance is for a new information collection under OMB #0970-0462, the COVID-19 STS (Instrument #12a). This request does not include any changes in burden to previously approved instruments but does reflect the completion of some data collection activities (as described previously in this supporting statement).

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Annual Cost to Federal Government: $2,915,650

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: 05/21/2021

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