Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration

ICR 202312-0915-001

OMB: 0915-0212

Federal Form Document

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Justification for No Material/Nonsubstantive Change
2023-12-14
Justification for No Material/Nonsubstantive Change
2023-12-14
Justification for No Material/Nonsubstantive Change
2023-08-17
Supporting Statement B
2021-03-08
Supporting Statement A
2021-03-08
Supplementary Document
2018-05-07
Supplementary Document
2018-05-07
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2018-05-07
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2018-05-07
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263816 Modified
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ICR Details
0915-0212 202312-0915-001
Received in OIRA 202308-0915-005
HHS/HSA
Voluntary Partner Surveys to Implement Executive Order 12862 in the Health Resources and Services Administration
No material or nonsubstantive change to a currently approved collection   No
Regular 12/14/2023
  Requested Previously Approved
04/30/2024 04/30/2024
69,250 69,250
6,725 6,725
0 0

This generic project clearance allows HRSA to conduct voluntary customer satisfaction surveys of its partners to assess strengths and weaknesses in program services and products. Examples of such surveys include satisfaction with technical assistance provided to grantees, in class evaluations of training sessions, and satisfaction with information services.

EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  
None

Not associated with rulemaking

  85 FR 81210 12/15/2020
86 FR 14462 03/16/2021
No

28
IC Title Form No. Form Name
MCH Nutrition Training Needs Assessment 1 Survey 2022 MCH Nutrition Training Needs Assessment_10.29.21.docx
2022 National Ryan White Conference on HIV Care & Treatment Evaluation 1, 2, 3, 4 Conference Plenary Session Evaluation ,   Conference Breakout Session Evaluation ,   CEU Breakout Session Evaluation ,   Conference (Overall) Evaluation
2024 Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program All Grantee Meeting Evaluation Surveys 1, 2, 3, 4 Conference Evaluation Survey ,   Plenary Session Evaluation Survey ,   Concurrent Session Evaluation Survey ,   AGM Poster Session Evaluation Survey
Be The Match Donation Experience Survey 1 BTM Donation Experience Survey - CLEAN.docx
Collection of Qualitative Feedback on Telehealth.HHS.gov 1, 2 Telehealth Website - Page Level - SurveyEngSpan.docx ,   Telehealth Website - Site Level - Survey EngSpan.docx
Customer Feedback Survey 1 Customer Feedback Survey
DGMO Customer Service Satisfaction Survey 1 DGMO Customer Service Survey Questions.docx
DIR Objective Review Assessment Survey 1, 1.2, 2 Reviewer Evaluation Q 1- 15.pdf ,   Reviewer Evaluation-Field Review Q 1 - 12.pdf ,   FORM CHAIR Q 1-5.pdf
Early Childhood Systems Technical Assistance and Coordinating Center (ECS TACC) Customer Satisfaction Surveys A, B, C, D Attachment A_ECS TACC Community of Practice Survey.docx ,   Attachment B_ECS TACC Webinar Survey.docx ,   Attachment C_ECS TACC TA Resources Products Survey.docx ,   Attachment D_ECS TACC Semi-Annual Interview Protocol.docx
Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Query Forms 1 User Survey Questions-Query FINAL For Clearance
Federal Cervical Cancer Collaborative (FCCC) Post-Roundtable Evaluation 1 Post-Roundtable-Survey_V02-Final.pdf
Feedback and Lessons Learned from CBO Program Award Recipients
HRSA Division of Transplantation (DoT) Formative Evaluation Minority Organ Donation Outreach (Online Focus Groups) 1, 3, 2 Focus Group Moderators Guide ,   Informed Consent ,   Screening Questions
HRSA Electronic Handbooks Customer Service Survey 1 EHBs Customer Support Center Survey Screenshot.docx
HRSA Web Survey 1, 2 English Version_HRSA Web Survey ,   Spanish Version_HRSA Web Survey
Health Center COVID-19 Vaccine Program (HCVP) After-Action Survey
Health Center Program Support (HCPS) Customer Service Survey 1 HCPS - 2021 Sample Customer Service Survey--Salesforce In Sandbox.docx
Listening Session Questions 1 Listening Session Questions
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program On-Site Compliance Review Awardee Feedback Form 1 MIECHV On-Site Compliance Review Awardee Feedback Form_May2021.docx
Maternal, Infant, and Early Childhood Home Visiting Innovation Technical Assistant Center (ITAC) Satisfaction Surveys 2, 1, 3 Annual Awardee Survey ,   Post Webinar Survey ,   Post Learning Collaborative Survey
Maternal, Infant, and Early Childhood Home Visiting Program Technical Assistance Resource Center (TARC) Satisfaction Surveys 7, 8, 1, 2, 3, 4, 6, 9, 10, 5 Attachment A_Individualized Targeted TA Check in ,   Attachment B_Individualized Targeted TA Closeout ,   Attachment C_Project Officer Survey ,   Attachment D_Webinar Survey ,   Attachment E_Community of Practice Survey ,   Attachment F_Leadership Academy Session Survey ,   Attachment G_Leadership Academy Completion Survey ,   Attachment H_Quarterly Overall TA Survey ,   Attachment I_CQI Practicum Check in Survey ,   Attachment J_CQI Practicum Completion Survey
National Organ Donation Expert Opinion Survey
National Practitioner Data Bank (NPDB) Usability Survey 1 National Practitioner Data Bank (NPDB) Usability Survey
Organdonor.gov Website Survey 1 HRSA DoT Organdonor.gov Website Survey Questionnaire.docx
Primary Health Care Digest Newsletter Subscriber Survey 1 Primary Health Care Digest Newsletter Subscriber Survey
Title V Information System (TVIS) User Satisfaction Survey 1 Screen Shots of Title V Information System Survey 2021
Trainee Ambassador Group Survey 1 Trainee Ambassador Group Survey
Tree Testing of HRSA's Ryan White HIV/AIDS Program website 1, 1 Tree Test Plan ,   Tree Test Script

  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 69,250 69,250 0 0 0 0
Annual Time Burden (Hours) 6,725 6,725 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There has been an increase in interest in the use of fast-track generic packages within HRSA. As a result, HRSA has seen increased use of the burden hours and responses in the original ICR.As a result, HRSA is requesting an increase in 17,000 responses and 1,000 burden hours to allow HRSA to continue to use this generic umbrella ICR as necessary. HRSA is not requesting changes to the instruments currently approved at this time. We have already alerted our desk office.

$700,000
Yes Part B of Supporting Statement
    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.
12/14/2023


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