FastTrack Submission Form - Jurisdiction Lead Interview

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

TITLE OF INFORMATION COLLECTION: Jurisdiction Lead Interview

PURPOSE: The Capacity Building Collaborative’s Center for States (Center) provides a variety of training and technical assistance in the form of projects, products, services, and supports to states and territories (i.e., jurisdictions). Intensive projects are one such type of training and technical assistance activity. Intensive projects are projects that are expected to last nine months or longer and require a higher level of service intensity versus other types of Center services and projects (e.g., brief projects). The purpose of the proposed Jurisdiction Lead Interview is to gather feedback from intensive project leads from jurisdictions about their perceptions on the overall quality of the Center’s training and technical assistance. The interviews will be used to enhance Center service delivery by identifying successful practices and potential areas for growth as they relate to the provision of training and technical assistance. These interviews will also help explore child welfare jurisdictions’ experiences using Center’ services and the extent to which they enhance child welfare jurisdictions’ policies and practices.

DESCRIPTION OF RESPONDENTS: Jurisdictional intensive project leads that work for public child welfare agencies that are receiving Center services.

TYPE OF COLLECTION:

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

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

[ ] Focus Group [X] Other: Customer Satisfaction Interview

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 primary purpose of the results is not for public dissemination.

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: Beth Claxon, Child Welfare Program Specialist, ACF Administration on

Children, Youth and Families (ACYF) 

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

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 [ ] 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

Information Collection	Category of Respondent	Annual Total No. of Respondents	Annual No. of Responses per Respondent	Estimated Time (Hours) per Response	Annual Burden Hours
Jurisdiction Lead Interview	Individuals from State and Territory Governments	40	1	1	40

FEDERAL COST: The estimated annual cost to the Federal government is $4,432.80

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?

The Center implements approximately 45 tailored services intensive projects each fiscal year. The goal of this data collection is to conduct interviews with all jurisdiction intensive project leads on an ongoing basis as projects’ annual workplans close throughout the year. Based on similar types of data collection efforts, it is expected that some jurisdictional intensive project leads may decline participation due to competing priorities. Therefore, we estimate that approximately 40 interviews will be conducted on an annual basis.

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? [X] Yes [ ] No

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

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