OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Health Profession Opportunity Grants (HPOG) program: Third Follow-Up Data Collection

ICR 201706-0970-003 · OMB 0970-0394 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
HPOG Followup OMB Appendix M_Contact Update Call Script_052417.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix K2 72-month Survey Advance Letter_052017.docx Supplementary Document Uploaded 2017-06-14 Repair queued
HPOG Followup OMB Appendix K1 Previously Approved 36-month Survey Advance Letter.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix J_ 72_month_Email Reminder_052017.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix I_ 72_month_Survey Flyer_052017.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix H_Participant Newsletter_052017.docx Supplementary Document Uploaded 2017-06-14 Repair queued
HPOG Followup OMB Appendix G Previously Approved Consent Forms for Participant Surveys.pdf Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix F2_72 Month_Contact Update Letter_052017.docx Supplementary Document Uploaded 2017-06-14 Repair queued
HPOG Followup OMB Appendix F1_Previously Approved_Contact Update Letter.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix E_Previously Approved_Contact Update Form.docx Supplementary Document Uploaded 2017-06-14 Repair queued
HPOG Followup OMB Appendix C 72 Month Followup Survey Sources 042017.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG Followup OMB Appendix A HPOG Logic Model.docx Supplementary Document Uploaded 2017-06-14 Available
HPOG 1 Impact 72 Mo Follow-up OMB Part B 06062017.docx Supporting Statement B Uploaded 2017-06-14 Available
HPOG 1 Impact 72 Mo Follow-up OMB Part A -06092017.docx Supporting Statement A Uploaded 2017-06-14 Available
IC Document Collections
IC IDCollectionTypeStatusForm
227177 HPOG-Impact 72-Month Follow-up Survey Other-Survey New
212776 HPOG-NIE Performance Measurement Semi-Structured Discussion Guide Other-Discussion Guide Removed
212775 HPOG-NIE Performance Measurement Screening Questionnaire Other-Screener Removed
212774 HPOG-Impact 36-month Control Group Follow-Up survey Other-Survey Modified
212773 HPOG-Impact 36-month Participant Follow-Up survey Other-Survey Modified
206801 HPOG-NIE 15-month Participant Follow-Up survey Other-Survey Removed
206800 HPOG-Impact 15-month Control Group Member Follow-Up survey Other-Survey Removed
206799 HPOG-Impact 15-month Participant Follow-Up survey Other-Survey Removed
198341 Semi-annual HPOG Program Performance Report Other-Word Removed
ICR Details
0970-0394 201706-0970-003
Historical Active 201508-0970-005
HHS/ACF 19416
Health Profession Opportunity Grants (HPOG) program: Third Follow-Up Data Collection
Revision of a currently approved collection   No
Regular
Approved without change 09/18/2017
Retrieve Notice of Action (NOA) 06/16/2017
  Inventory as of this Action Requested Previously Approved
09/30/2020 36 Months From Approved 12/31/2017
3,221 0 5,966
2,974 0 6,292
0 0 0
ACF is implementing a multi-pronged research and evaluation approach for the HPOG program to better understand and assess the activities conducted and their results. HPOG-Impact is one project within the broader portfolio of research that OPRE is utilizing to assess the success of career pathways programs and models. This strategy includes a multi-pronged research and evaluation approach for the HPOG program (including this impact study and the national implementation evaluation), as well as the Pathways for Advancing Careers and Education (PACE) study (0970-0397), to better understand and assess the activities conducted and their results. Four data collections related to this current submission were previously approved by the Office of Management and Budget (OMB) under OMB Clearance number 0970-0394. This submission seeks OMB approval for an additional follow-up data collection instrument: a 72-month follow-up survey for the HPOG-Impact study.
PL: Pub.L. 111 - 148 Title V, Subtitle F, Sec. 5507 Name of Law: Patient Protection and Affordable Care Act
  
None
Not associated with rulemaking
  82 FR 3797 01/12/2017
82 FR 27710 06/16/2017
No
  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 3,221 5,966 0 -2,745 0 0
Annual Time Burden (Hours) 2,974 6,292 0 -3,318 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This evaluation involves new and continuing data collection that increases the public reporting burden under this OMB number. Additionally, some data collection under this OMB number has been completed.
$2,186,876
Yes Part B of Supporting Statement
    No
    No
Yes
No
No
Uncollected
Molly Buck 202 205-4724 [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.
06/16/2017