Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0990-0379 HHS OIG Website Survey Questions	Form and Instruction	Unchanged	Available
Form 0990-0379 OIG HHS Website feedback	Form and Instruction	Unchanged	Missing upstream
Form 1 National Hypertension Control Initiative (NHCI) Community Health Center Assessment	Form and Instruction	Unchanged	Available
Form 1 National Hypertension Control Initiative (NHCI) Community Health Center Assessment	Form and Instruction	Unchanged	Repair queued
0990-0379_Non Sub Change Memo_8 2 24.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-08-02	Available
0990-0379_Non Sub Change Memo_8 2 24.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2024-08-02	Missing upstream
HHS Survery Change_Memo_Feb 2024.pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2024-02-21	Available
HHS Survery Change_Memo_Feb 2024.pdf	Justification for No Material/Nonsubstantive Change	Uploaded 2024-02-21	Repair queued
HHS.gov Slider Survey UPDATES_2.1.2024.pdf	Supplementary Document	Uploaded 2024-02-21	Available
HHS.gov Slider Survey UPDATES_2.1.2024.pdf	Supplementary Document	Uploaded 2024-02-21	Missing upstream
HHS.gov Slider Survey CURRENT Version_1.2.24.pdf	Supplementary Document	Uploaded 2024-02-21	Repair queued
HHS.gov Slider Survey CURRENT Version_1.2.24.pdf	Supplementary Document	Uploaded 2024-02-21	Available
Intranet Survey.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-06-17	Available
Intranet Survey.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2022-06-17	Repair queued
0990-0379 Change Request_DKC.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2015-03-03	Repair queued
0990-0379 Change Request_DKC.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2015-03-03	Missing upstream
0990-0379_B.docx	Supporting Statement B	Uploaded 2014-07-02	Available
0990-0379_B.docx	Supporting Statement B	Uploaded 2014-07-02	Repair queued
0990-0379_Father Generic 10_5_23 (3).docx	Supporting Statement A	Uploaded 2023-10-11	Repair queued
0990-0379_Father Generic 10_5_23 (3).docx	Supporting Statement A	Uploaded 2023-10-11	Missing upstream
Generic Clearance Submission Template.docx	Supplementary Document	Uploaded 2011-06-14	Repair queued
Generic Clearance Submission Template.docx	Supplementary Document	Uploaded 2011-06-14	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
280768	Comprehensive Systems of Care for Sickle Cell Disease Roundtable Series - Post Virtual Event Survey (HHS OMH)	Other-Feedback Survey	New
280190	Office of Population Affairs (OPA) Grantee Satisfaction Survey (GSS) 2026	Other-survey and instruction	New
278766	TPP23 Recipient Technical Assistance needs assessment survey	Other-Survey	New
275373	OPA Grantee Satisfaction Survey 2025	Other-survey and script	New
272790	Key Informant Interviews for Adapting the Plan A Program for Special Populations	Other-interview guide, script, questions	New
269999	Language Assistance Symbol	Other-Survey	Unchanged
268121	Office of Population Affairs' Grantee Satisfaction Survey 2024	Other-survey and script	Unchanged
266558	President's Council on Sports, Fitness & Nutrition Awards Nomination Criteria and Submission Materials Request	Instruction	Unchanged
266438	OIG HHS Website feedback	Form and Instruction	Unchanged	HHS OIG Website Survey Questions
266438	OIG HHS Website feedback	Form and Instruction	Unchanged
266325	Ease of understanding and navigating the Notice of Funding Opportunity (NOFO)	Instruction	Unchanged
266104	User feedback revised Office of Climate Change and Health Equity website	Other-Qualitative data collection instrument/process	Unchanged
265875	COVID-19 Response Effort (ASPR / ED)	Instruction	Unchanged
264653	Evaluation of Harm Reduction Practices and Policies Aimed at Reducing Infectious Disease Risks and Substance Use Disorders in Rural Communities	Other-Focus Group Protocol	Unchanged
263695	OMH Minority Leadership Development Program Post-Program Questionnaire	Other-Evaluation	Unchanged
263257	National Hypertension Control Initiative (NHCI) Community Health Center Assessment	Form and Instruction	Unchanged	National Hypertension Control Initiative (NHCI) Community Health Center Assessment
263257	National Hypertension Control Initiative (NHCI) Community Health Center Assessment	Form and Instruction	Unchanged
262849	Research and Evaluation Support for Office of Population Affairs: Group TA	Other-Survey	Modified
262847	Research and Evaluation Support for Office of Population Affairs Evaluation Technical Assistance Product Satisfaction Survey	Other-Survey	Unchanged

ICR Details

OMB Control No: 0990-0379	ICR Reference No: 202409-0990-001
Status: Active	Previous ICR Reference No: 202406-0990-001
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Fast Track Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/25/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/11/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2026	10/31/2026	10/31/2026
Responses	300,000	0	300,000
Time Burden (Hours)	50,000	0	50,000
Cost Burden (Dollars)	0	0	0

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Abstract: This collection of information is necessary to enable HHS to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with HHS programs.

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Authorizing Statute(s): EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 23446	04/17/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 45432	07/17/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 17

table that charts list of burden

IC Title	Form No.	Form Name
COVID-19 Response Effort (ASPR / ED)
Comprehensive Systems of Care for Sickle Cell Disease Roundtable Series - Post Virtual Event Survey (HHS OMH)
Ease of understanding and navigating the Notice of Funding Opportunity (NOFO)
Evaluation of Harm Reduction Practices and Policies Aimed at Reducing Infectious Disease Risks and Substance Use Disorders in Rural Communities
Key Informant Interviews for Adapting the Plan A Program for Special Populations
Language Assistance Symbol
National Hypertension Control Initiative (NHCI) Community Health Center Assessment	1	National Hypertension Control Initiative (NHCI) Community Health Center Assessment
OIG HHS Website feedback	0990-0379	HHS OIG Website Survey Questions
OMH Minority Leadership Development Program Post-Program Questionnaire
OPA Grantee Satisfaction Survey 2025
Office of Population Affairs (OPA) Grantee Satisfaction Survey (GSS) 2026
Office of Population Affairs' Grantee Satisfaction Survey 2024
President's Council on Sports, Fitness & Nutrition Awards Nomination Criteria and Submission Materials Request
Research and Evaluation Support for Office of Population Affairs Evaluation Technical Assistance Product Satisfaction Survey
Research and Evaluation Support for Office of Population Affairs: Group TA
TPP23 Recipient Technical Assistance needs assessment survey
User feedback revised Office of Climate Change and Health Equity website

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ICR Summary of Burden

table that charts list of burden

	Total Approved	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	300,000	300,000	0	0	0	0
Annual Time Burden (Hours)	50,000	50,000	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $300,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 09/11/2024

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