Family-to-Family Health Information Center (F2F HIC) Feedback Surveys

ICR 202201-0906-001

OMB: 0906-0040

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Form and Instruction
Modified
Supplementary Document
2022-01-18
Supplementary Document
2022-01-18
Supporting Statement B
2022-01-18
Supporting Statement A
2022-01-18
ICR Details
0906-0040 202201-0906-001
Received in OIRA 201910-0906-002
HHS/HRSA
Family-to-Family Health Information Center (F2F HIC) Feedback Surveys
Extension without change of a currently approved collection   No
Regular 01/18/2022
  Requested Previously Approved
36 Months From Approved 03/31/2022
4,059 1,206
5,851 5,423
0 0

The surveys will provide mechanisms to capture consistent, performance data; provide data to support the HHS Secretary's priorities of engagement; and allow HRSA to determine the extent to which F2F HICs provide service. F2F HICs can also use the data to evaluate the effectiveness of their interventions and improve services. Respondents are family members of children with special health care needs and professionals who serve such families.

US Code: 42 USC 701(c) Name of Law: Social Security Act, Title V, 501(c)
   PL: Pub.L. 115 - 123 50501 Name of Law: Bipartisan Budget Act of 2018
   PL: Pub.L. 114 - 10 216 Name of Law: Medicare Access and CHIP Reautorization Act of 2015
  
None

Not associated with rulemaking

  86 FR 60260 11/01/2021
87 FR 2441 01/14/2022
No

  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 4,059 1,206 0 2,853 0 0
Annual Time Burden (Hours) 5,851 5,423 0 428 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The increase in burden is a result of an increase in the number of respondents for the feedback survey, form #2.

$52,578
No
    No
    No
No
No
No
No
Elyana Bowman 301 443-3983 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
01/18/2022


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