Information Collection Request

OPRE Evaluation - National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants [descriptive evaluation, impact evaluation, cost-benefit analysis study, pilot study]

ICR 202006-0970-008 · OMB 0970-0462 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
OMB#0970-0462_NonSubstantive Change Request _June 2020.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-06-24 Repair queued
Attachment J_Interview Verbal Informed Consent Form_Remote.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment I_Focus Group Informed Consent Form_Remote.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment B3_Tribal Evaluation Informed Consent Form B (Unique Identifiers).docx Supplementary Document Uploaded 2020-06-24 Available
Attachment B2_Tribal Evaluation Informed Consent Form A (SSNs).docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment B. National Evaluation Informed Consent Forms A_Lottery Required_REV.docx Supplementary Document Uploaded 2020-06-24 Repair queued
OMB#0970-0462_NonSub Change Request_Temporary Use of Verbal Consent Forms_04152020.docx Justification for No Material/Nonsubstantive Change Uploaded 2020-04-16 Repair queued
Attachment B3_Tribal Evaluation informed consent Form D Unique Identifiers_Verbal.docx Supplementary Document Uploaded 2020-06-24 Available
Attachment B2_Tribal Evaluation_informed consent Form C SSNs_Verbal.docx Supplementary Document Uploaded 2020-06-24 Available
Attachment B_National Evaluation informed consent Form D_ lottery not required-Verbal.docx Supplementary Document Uploaded 2020-04-16 Repair queued
Attachment B. National Evaluation Informed Consent Form C Lottery Required _Verbal_REV.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment Z_ Participant Interview Recruitment Materials.docx Supplementary Document Uploaded 2019-04-18 Repair queued
Attachment Y 60-Day Federal Register Notice.pdf Supplementary Document Uploaded 2019-04-18 Available
Attachment X_Complete List of Previously Approved Instruments for HPOG 2.0.docx Supplementary Document Uploaded 2019-04-18 Available
Attachment W_HPOG 2.0_phone based Skills Assessment Pilot_Recruitment Script.docx Supplementary Document Uploaded 2019-04-18 Repair queued
Attachment V_HPOG 2.0_phone based Skills Assessment Pilot_ParticipantLetter.docx Supplementary Document Uploaded 2019-04-18 Repair queued
Attachment U_HPOG 2.0_phone based Skills Assessment Pilot_Grantee Letter.docx Supplementary Document Uploaded 2019-04-18 Repair queued
Attachment T_HPOG 2.0_phone based Skills Assessment Pilot_Recruitment Flyer.docx Supplementary Document Uploaded 2019-04-18 Repair queued
Attachment S_HPOG 2.0_Intermediate Follow-up Email Reminder_REV.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment R_HPOG 2.0_Intermediate Follow-upSurvey_Flyer.docx Supplementary Document Uploaded 2019-04-18 Repair queued
Attachment Q_HPOG 2.0 Intermediate Follow-up Survey Sources_REV.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment P_HPOG 2.0_Intermediate Follow-up Survey Advance Letter_REV.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment O_ResearchQuestions for Previously Approved National and Tribal Evaluation Efforts.docx Supplementary Document Uploaded 2018-02-01 Available
Attachment N_HPOG2.0_Short-Term Followup Short-Term Survey_ Email Remind_revised_010918_clean.docx Supplementary Document Uploaded 2018-02-01 Repair queued
Attachment M_HPOG 2.0_Short-Term Survey Flyer 01092018.docx Supplementary Document Uploaded 2018-02-01 Available
Attachment L_HPOG 2.0 Short-Term Followup Followup Survey Sources_Rev_121217_Clean.docx Supplementary Document Uploaded 2018-02-01 Available
Attachment K_HPOG2.0_Short-Term Followup Survey Advance Letter_Rev_01092018_Clean.docx Supplementary Document Uploaded 2018-02-01 Repair queued
Attachment K_HPOG 2 0 Incentive Communications_Email and Letter_071117 CLEAN.docx Supplementary Document Uploaded 2017-07-12 Repair queued
Attachment J_Interview Verbal Informed Consent Form.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment I_Focus Group Informed Consent Form.docx Supplementary Document Uploaded 2020-06-24 Repair queued
Attachment H_HPOG- Model.pptx Supplementary Document Uploaded 2016-10-24 Available
Attachment A_References_Revised 09 02 16.docx Supplementary Document Uploaded 2016-10-24 Available
Attachment G. Contact Update Letter and Form.docx Supplementary Document Uploaded 2015-05-11 Available
HPOG 2.0 Supporting Statement B_Revised_NonSubChange_June 2020.docx Supporting Statement B Uploaded 2020-06-24 Available
HPOG 2.0_Supporting Statement A_Revised_NonSubChange June 2020.docx Supporting Statement A Uploaded 2020-06-24 Repair queued
Attachment F. First Round of HPOG Grantees Ressearch Portfolio_4.28.15.docx Supplementary Document Uploaded 2015-05-06 Available
FINAL updated Attachment E PPR Data List and Mockup 8 4 15 clean.docx Supplementary Document Uploaded 2015-08-05 Available
Attachment D. Sources and Justification_5.4.15.docx Supplementary Document Uploaded 2015-05-06 Repair queued
Attachment C_HPOG 2.0 15 mos follow up - 60 Day FRN_8.30.17.pdf Supplementary Document Uploaded 2018-02-01 Available
IC Document Collections
IC IDCollectionTypeStatusForm
242412 Instrument 18a: Intermediate Follow-up Survey for the National Evaluation impact study - Critical Items Only Other-Survey New
235782 Instrument 20: Program cost survey Other-Survey Removed
235781 Instrument 19: Phone-based Skills Assessment Pilot Instrument Other-Phone-based Assessment Removed
235780 Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study Other-Survey Modified
235779 Instrument 17: Participant interview guide Other-Interview Guide Removed
235778 Instrument 16: Partner interview guide for the systems study Other-Interview Guide Removed
235777 Instrument 15: Program operator interview guide for the systems study Other-Interview Guide Removed
235776 Instrument 14: Second round telephone interview protocol for non-tribal HPOG grantee staff and partners Other-Interview Guide Removed
235775 Instrument 13: Screening tool for identifying respondents for second-round telephone interviews Other-Screener Removed
229940 Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation Other-Survey Removed
229938 Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form Other-Update Form Modified
224119 Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews Other-Interview Unchanged
224118 Instrument 10: HPOG 2.0 Tribal Evaluation program participant completer interviews Other-Interview Unchanged
224113 Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups Other-Focus Group Unchanged
224112 Instrument 8: HPOG 2.0 Tribal Evaluation employer interviews Other-Interview Unchanged
224110 Instrument 7: HPOG 2.0 Tribal Evaluation program implementation staff interviews Other-Interview Unchanged
224107 Instrument 6: HPOG 2.0 Tribal Evaluation grantee and partner administrative staff interviews Other-Interview Unchanged
216432 PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees) Other-Data collection System Unchanged
216431 PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study) Other-Data collection System Modified
216430 PAGES Grantee- and Participant-Level Data Collection (all grantees) Other-Data collection System Unchanged
ICR Details
0970-0462 202006-0970-008
Historical Active 202004-0970-009
HHS/ACF OPRE
OPRE Evaluation - National and Tribal Evaluation of the 2nd Generation of the Health Profession Opportunity Grants [descriptive evaluation, impact evaluation, cost-benefit analysis study, pilot study]
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 06/29/2020
Retrieve Notice of Action (NOA) 06/24/2020
  Inventory as of this Action Requested Previously Approved
07/31/2022 07/31/2022 07/31/2022
22,696 0 21,040
8,151 0 9,780
0 0 0

Between August 2015 and July 2019, OMB has approved several information collection instruments, procedures and supporting materials in support HPOG 2.0. These include baseline data collection from HPOG 2.0 National and Tribal Evaluation study participants, data collection protocols and procedures for the HPOG 2.0 Tribal Evaluation, a Short-term Follow-up Survey as part of the National Evaluation’s impact study, and several instruments in support of the National Evaluation, including a phone-based skills assessment pilot instrument and an Intermediate Follow-up Survey to support the HPOG 2.0 National Evaluation impact study. ACF requests approval of non-substantive changes to several of the previously approved information collections and supporting materials. These requested changes are based primarily on three events: (1) ACF’s decision to extend the HPOG Program grants by twelve months, ending in September 2021 instead of September 2020; (2) the National Evaluation team’s experiences completing data collection for the Short-Term Follow-up Survey (Instrument 12) and the results of the Phone-based Skills Assessment Pilot (Instrument 19); and (3) the COVID-19 pandemic and associated travel restrictions.

PL: Pub.L. 111 - 148 5507 , sec. 2008, (a)(3)(B) Name of Law: Patient Protection and Affordable Care Act
  
None

Not associated with rulemaking

  83 FR 66715 12/27/2018
84 FR 16870 04/23/2019
No

12
IC Title Form No. Form Name
Instrument 20: Program cost survey
Instrument 18: Intermediate Follow-up Survey for the National Evaluation impact study
Instrument 9: HPOG 2.0 Tribal Evaluation program participant focus groups
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 10: HPOG 2.0 Tribal Evaluation program participant completer interviews
Instrument 11: HPOG 2.0 Tribal Evaluation program participant non-completer interviews
PAGES Participant-Level Baseline Data Collection (participants at non-Tribal grantees participating in impact study)
PAGES Grantee- and Participant-Level Data Collection (all grantees)
PAGES Participant-Level Baseline Data Collection (participants at Tribal grantees)
Instrument 5b: HPOG 2.0 National Evaluation letter and participant contact update form
Instrument 12: Short-Term Follow-up Survey for the HPOG 2.0 National Evaluation Impact Evaluation
Instrument 13: Screening tool for identifying respondents for second-round telephone interviews
Instrument 14: Second round telephone interview protocol for non-tribal HPOG grantee staff and partners
Instrument 15: Program operator interview guide for the systems study
Instrument 16: Partner interview guide for the systems study
Instrument 19: Phone-based Skills Assessment Pilot Instrument
Instrument 18a: Intermediate Follow-up Survey for the National Evaluation impact study - Critical Items Only
Instrument 17: Participant interview guide

  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 22,696 21,040 0 394 1,262 0
Annual Time Burden (Hours) 8,151 9,780 0 -2,790 1,161 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This change request includes increasing the number of respondents to Instrument 1 PAGES Participant-Level Baseline Data Collection (for participants at non-tribal grantees). Additionally, we took the opportunity to update the information collections and remove ICs that are complete and no longer in use.

$4,717,923
No
    Yes
    No
Yes
No
No
Yes
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.
06/24/2020