FastTrack Submission Form - FVPSA Formula Grants Applications Due Date Change Survey

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0970-0401)

TITLE OF INFORMATION COLLECTION: Family Violence Prevention and Services Act (FVPSA) Formula Grants Applications Due Date Change Survey

PURPOSE: In response to Family Violence Prevention and Services Act (FVSPA) formula grant recipient requests for earlier dissemination of annual grant awards, all FVPSA formula grant application submission deadlines are being changed to January 31, 2023, to ensure that the Office of Grants Management (OGM) can issue the formula grant awards by May 30, 2023.

The FVPSA program and OGM would like to solicit feedback from FVPSA funded states, tribes, and coalitions to understand the impact of changing the formula grants application due date to January 31, 2023. Information collected through the FVPSA Formula Grants Application Due Date Change Survey will be used to inform internal planning around the dissemination of annual grant awards and to identify potential needs for supports to assist states, territories, tribes, and coalitions meet the updated due date. The ultimate goal is to ensure ACF is meeting the needs of current and future funding recipients through the grant application process.

DESCRIPTION OF RESPONDENTS: Respondents are FVPSA federal grant recipients of the 2022 FVPSA Formula Grants. Respondents represent states, territories and tribes, tribal administrators, state administrators, territory administrators and coalition staff.

TYPE OF COLLECTION: (Check one)

[X ] Customer Comment Card/Complaint Form [ ] 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 and affiliation :_Shawndell Dawson, FVPSA Director; Diana Lee, FVPSA Program Manager; and Jan-Sheri Morris, FVPSA Program Manager

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

Personally Identifiable Information:

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

Gifts or Payments:

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

BURDEN HOURS

Instrument	Category of Respondent	No. of Respondents	Participation Time	Burden
FVPSA Formula Grants Application Due Date Change Survey	State Administrators, Tribes and Tribal Administrators, Coalitions, Territory Government Administrators, and Resource Centers	284	5 minutes	24 Hours

FEDERAL COST: The estimated annual cost to the Federal government is:

The cost to the Federal government was calculated using the Bureau of Labor Statistics (BLS) job code for Child and Family Social Workers [21-1021] and wage data from May 2021, which is $26.39 per hour. To account for fringe benefits and overhead the rate was multiplied by two which is $52.78. The estimate of annualized cost to the federal government for administering the survey and analyzing the data is $52.78 times total hours or $1,266.72. https://www.bls.gov/oes/current/oes211021.htm

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?

There were 364 FVPSA formula grant recipients of the 2022 FVPSA Formula Grants. We will send the survey to all grant recipients to solicit feedback. We expect that 284 formula grant recipients will respond to the survey with one response per grantee.

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

Please make sure that all instruments, instructions, and scripts are submitted with the request.

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