View Information Collection Request (ICR) Package
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 Generic ICR - OIRA Conclusion
OMB Control No:
0915-0379
ICR Reference No:
202306-0915-006
Status:
Active
Previous ICR Reference No:
202004-0915-007
Agency/Subagency:
HHS/HSA
Agency Tracking No:
21433
Title:
Questionnaire and Data Collection Testing, Evaluation, and Research for the Health Resources and Services Administration (HRSA)
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
11/15/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
06/29/2023
Terms of Clearance:
Previous terms continue: Under this generic clearance, HRSA may conduct cognitive interviews, focus groups, field tests/pilot interviews, and experimental research in laboratory and field settings, both for evaluating questionnaires and more basic research on response errors in surveys. OMB will respond with approval or comments within two weeks of receipt. OMB and HRSA will revisit the terms of this generic clearance, as appropriate.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
11/30/2026
36 Months From Approved
11/30/2023
Responses
5,575
0
5,225
Time Burden (Hours)
3,482
0
3,200
Cost Burden (Dollars)
0
0
0
Abstract:
The overarching generic clearance for Questionnaire and Data Collection Testing, Evaluation, and Research provides HRSA with the opportunity to collect feedback from members of the public for HRSA to use when developing new questions, questionnaires, and tools; pilot/pre-test instruments to be deployed by HRSA; and to identify problems in instruments currently in use. HRSA seeks to extend OMB approval of this ICR and existing ICRs that fall under it while including a slight increase in the burden estimate to account for HRSA’s implementation of Executive Order 13985, which calls on agencies to advance racial equity and support for underserved communities through identifying and addressing barriers to equal opportunity that underserved communities may face. HRSA will likely conduct additional collections to gather information from the public so that HRSA may effectively implement this Executive Order. This generic clearance is limited to data collection for the development or revision of HRSA tools and data collection instruments, as well as reports for internal decision-making and development purposes. Information collected under this generic clearance will not be used for data collection, reports, or policy documents to be released to the public. It is anticipated that data collection approved under this generic clearance will rely heavily on qualitative techniques and not the collection of numerical data. In general, these activities are not designed to yield results that meet generally accepted standards of statistical rigor but designed to obtain information to develop clearer and more effective and efficient data collection tools that will yield more accurate results and decrease public non-response. The forms submitted under this generic clearance will be voluntary, low-burden, and uncontroversial. In addition, HRSA requests to renew the following currently approved instruments under 0915-0379 along with the renewal of this generic umbrella collection: • Health Center Workforce Well-Being Survey: Listening Sessions • Health Center Workforce Well-Being Survey: Cognitive Sessions • Health Center Workforce Well-Being Survey: Pilot Testing • Health Center Workforce Survey Evaluation and Technical Assistance: Pilot Survey • Fast Track Interviews with National Hypertension Control Initiative (NHCI) Group 2 Participants. • Usability Testing for HRSA.gov website properties (moving from 0990-0379) • Organ Procurement and Transplantation Network (OPTN) Stakeholder Focus Groups • Ryan White HIV/AIDS Program Tree Testing Plan • PRA Questions for CEN Groups
Authorizing Statute(s):
US Code:
42 USC 299c-3(c) Sec. 934(c)
Name of Law: Public Health Service 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:
88 FR 22459
04/13/2023
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 42083
06/29/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
15
IC Title
Form No.
Form Name
Evaluation Survey of Eligible National Practitioner Data Bank (NPDB) Entity Users: Relevance of Information Collected via NPDB Report Forms
5, 2, 4, 3, 1
Adverse Action Reports Module
,
Closing Questions
,
Judgment or Conviction Reports Module
,
Medical Malpractice Payment Reports Module
,
Opening Questions
HRSA Health Center Workforce Survey: Cognitive Interviews
1
Cognitive Interview Informed Consent
HRSA Health Center Workforce Survey: Pilot Survey
2, 1
HRSA Survey Draft
,
Informed Consent
Health Center Community Engagement Network (CEN) – New Applicant Toolkit Project
Health Center Community Engagement Network (CEN) – New Applicant Toolkit Project- Group 2
1
Facilitator Guide - New Applicant Toolkit (Part 2)
Health Center Community Engagement Network (CEN)- Financial Sustainability AG
1
CEN Financial Facilitator Guide
Health Center Workforce Survey: Listening Sessions
1
Listening Session Consent Form
Interviews with National Hypertension Control Initiative (NHCI) Group 2 Participants
Morgan State University Maternal Health Equity Coordinating Center (MSU MHECC) Feedback Forms
2, 1, 3, 4
Collaborators Feedback Form
,
Faculty Training Feedback Form
,
Operations Partner Feedback Form
,
Student Training Feedback Form
National Organ Donation Expert Opinion Survey for Information Dissemination
1
Final Report Stakeholder Contact Language
Organ Procurement and Transplantation Network (OPTN) Stakeholder Focus Groups
PRA Questions for CEN Groups
Primary Care and Behavioral Health Integration (PCBHI) Training Follow Up Discussion
Usability Testing for HRSA.gov website properties
ealth Center Workforce Survey Evaluation and Technical Assistance: Pilot Survey
1
Survey
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
5,575
5,225
0
350
0
0
Annual Time Burden (Hours)
3,482
3,200
0
282
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
Yes
Burden Increase Due to:
Miscellaneous Actions
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
HRSA seeks to include a slight increase in the burden estimate from the 2020 ICR to account for HRSA’s implementation of Executive Order 13985 calling on agencies to advance racial equity and support for underserved communities through identifying and addressing barriers to equal opportunity that underserved communities may face. HRSA will likely be conducting additional collections to gather information from the public so that HRSA may effectively implement this Executive Order. HRSA seeks to increase the number of hours under this ICR from 3,200 hours in the previously-approved ICR to 3,482 hours in this ICR. HRSA requests to renew the following currently approved instruments under 0915-0379 along with the renewal of this generic umbrella collection. We have put these instruments and the accompanying memos into the IC List. • Health Center Workforce Well-Being Survey: Listening Sessions • Health Center Workforce Well-Being Survey: Cognitive Sessions • Health Center Workforce Well-Being Survey: Pilot Testing • Health Center Workforce Survey Evaluation and Technical Assistance: Pilot Survey • Fast Track Interviews with National Hypertension Control Initiative (NHCI) Group 2 Participants. • Usability Testing for HRSA.gov website properties (moving from 0990-0379) • Organ Procurement and Transplantation Network (OPTN) Stakeholder Focus Groups • Ryan White HIV/AIDS Program Tree Testing Plan • PRA Questions for CEN Groups
Annual Cost to Federal Government:
$2,583,874
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
Agency Contact:
Laura Cooper 301 443-2126 lcooper@hrsa.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:
06/29/2023