Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0970-0462
ICR Reference No:
201809-0970-007
Status:
Historical Active
Previous ICR Reference No:
201808-0970-004
Agency/Subagency:
HHS/ACF
Agency Tracking No:
Title:
National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants
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:
10/26/2018
Retrieve Notice of Action (NOA)
Date Received in OIRA:
09/28/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2021
06/30/2021
06/30/2021
Responses
31,300
0
31,300
Time Burden (Hours)
11,044
0
11,044
Cost Burden (Dollars)
0
0
0
Abstract:
The ACF Office of Planning, Research and Evaluation (OPRE) has developed a multi-pronged research and evaluation portfolio for the HPOG 2.0 Program to better understand and assess the activities conducted and their results. This submission is in support of two components of the evaluation portfolio, the HPOG 2.0 National Evaluation and HPOG 2.0 Tribal Evaluation. OMB has previously approved several information collection requests under OMB Control Number 0970-0462 in support of both the National and Tribal evaluations. Under this information collect request, ACF seeks approval for the National Evaluation impact study’s Short-Term Follow-up Survey, to be conducted 15 months after randomization. This request is for a non-substantive change. This submission seeks approval for three nonsubstantive changes to previously approved information collection requests. First, it requests approval for minor changes in content to the National Evaluation impact study’s Short-Term Follow-up Survey (Instrument #12, approved in June 2018). Second, it seeks approval to add one additional question to Instrument #12. Third, it seeks approval for a modest increase in burden for the previously approved in-person implementation interviews (Instrument #4, approved in June 2017). Justification for these non-substantive changes can be found in the supplementary document HPOG 2.0 Memo to OMB_Pretest changes_Expanded Site Visits_V4_REV091118.docx.
Authorizing Statute(s):
PL:
Pub.L. 111 - 148 5507 , sec. 2008, (a)(3)(B)
Name of Law: Patient Protection and Affordable Care Act
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
82 FR 41269
08/30/2017
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 5104
02/05/2018
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
13
IC Title
Form No.
Form Name
*NOT NEW* Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form
Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews
Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation
Instrument 4: HPOG 2.0 National Evaluation in-person implementation interviews
Instrument 5a: HPOG 2.0 National Evaluation welcome packet, letter and participant contact update forms
Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews
Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews
Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews
Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups
PAGES Grantee- and Participant-Level Data Collection (all grantees)
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)
ICR Summary 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
31,300
31,300
0
0
0
0
Annual Time Burden (Hours)
11,044
11,044
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:
Annual Cost to Federal Government:
$4,910,849
Does this IC contain surveys, censuses, or employ statistical methods?
No
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.
Yes
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]?
Yes
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?
Uncollected
Agency Contact:
Emily Jabbour 212 264-2890 ext. 273 emily.ball@acf.hhs.gov
Common Form ICR:
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:
(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:
09/28/2018
An official website of the United States government
The .gov means it's official.
The site is secure.
