Fast Track Memo

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0990-0379)

TITLE OF INFORMATION COLLECTION:

TPP Network grantee technical assistance survey

PURPOSE:

The Office of Population Affairs (OPA) at the U.S. Department of Health and Human Services (HHS) requests permission to collect feedback from its currently funded Teen Pregnancy Prevention (TPP) grantee organizations for the purpose of gathering topics of interest for the provision of technical assistance (TA) to the grantees. The contractor will collect information from TPP program and evaluation leads, including names and email addresses, to assess the topics for which they are interested or perceive a need for future technical assistance in order to make our technical assistance useful and relevant. The feedback collected will inform the provision of technical assistance to the current Teen Pregnancy Prevention Program Tier 2 Impact and Innovation Network Grantees

DESCRIPTION OF RESPONDENTS:

Respondents to this collection will be private sector, nonprofit organizations who have TPP Network cooperative agreements. The contractor will contact TPP grantee program directors and evaluation leads who work on their cooperative agreements. The universe of organizations to be contacted includes the 13 Fiscal Year 2020 TPP Tier 2 Innovation and Impact Network (Tier 2 IIN) Grantees and their local evaluators.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software) [ ] Small Discussion Group

[ ] Focus Group [ ] Other: ______________________

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: ____Tara Rice____________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [X ] Yes [ ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [X] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X ] No

In order to follow up with respondents about their technical assistance (TA) needs, we will ask for their name, grantee organization, and business email address.  The information will be stored on the Survey Monkey platform until the survey window closes, at which time we will export the information into an Excel spreadsheet and save the spreadsheet on Mathematica’s secure network, accessed only by project team members, and delete the information from Survey Monkey. No Privacy Act records will result; for purposes of the Privacy Act, the survey responses will not be records about individuals (i.e., the grantee representatives, i.e., grantee lead and evaluation lead, who provide the responses), but will be records about each grantee organization’s technical assistance needs and desires based on the nature of each organization’s particular grant project(s). The purpose of the survey is to identify technical assistance providers suited to and technical assistance tailored to each grantee organization and its grant project(s)--not to tailor assistance to particular grantee employees. In the event that data were retrieved from the spreadsheet by a grantee employee’s name, email address, or other personal identifier, the data that would be retrieved would not be about that employee, but would be about the technical assistance needs and desires of the employee’s grantee organization. OPA consulted with the HHS Privacy Officer, Beth Kramer, to develop our response.

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Private Sector	26	10 minutes	4 hours
Totals	26		4 hours

FEDERAL COST: The estimated total and annual cost to the Federal government is $774.38.  

 

For cost calculations, we estimate 2 hours of time for a GS-14 for OPA to review the survey and OMB package. For the contractor, we estimate 4 hours of junior staff time to program the survey in Survey Monkey and export the results, and 2 hours of senior staff time to review the results of the survey once it is complete.  

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

OPA will use its administrative records to identify the project directors and evaluation leads from each of the 13 TPP Tier 2 Network grantee organizations. Two individuals, the project director and local evaluator, for each grantee would receive the TA needs assessment survey. All 13 FY 2020 TPP Innovation and Impact Network grantees organizations will receive surveys.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ X ] No

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