Performance Outcome Measurement Demonstration Study

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
6456	Performance Outcome Measurement Demonstration Study	Migrated

ICR Details

OMB Control No: 0915-0222	ICR Reference No: 199712-0915-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HSA	Agency Tracking No:
Title: Performance Outcome Measurement Demonstration Study
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/03/1998
	Date Received in OIRA: 12/29/1997
Terms of Clearance: This information collection is approved through 9-98 as revised by the fax from HRSA sent 2-18-98 and under the following conditions: As discussed with OMB, HRSA is using this demonstration to help the agency understand what variables in the programs lead to the National Workforce Goals and Outcomes, i.e. increasing the number of graduates/program completers in under- served areas. As a result, this demonstration asks for a high level of detail. Based on the results of this demo, HRSA will selectively tailor the anticipated redesign of the Annual Report to those specific elements that affect outcomes. If HRSA is unable to draw such conclusions upon review of the demo results, OMB strongly recommends that HRSA proceed with a full scale evaluation. OMB is unlikely to approve a redesign of the Annual Report which includes the high level of detail in the demo. In addition, as agreed to by HRSA, the agency will collapse the row on Program Completers of 8 hours, with the row on Program Comleters of 8-39 to a singe row for 0-39 hours, for all charts with hour information. HRSA will also delete the third row category in Table 3 on culturally diverse issues, and create a new question in a different section to ascertain whether the program provides training to produce cultural competency.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/1998	09/30/1998
Responses	1,219	0	0
Time Burden (Hours)	6,755	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: A sample of grantees funded under titles VII and VIII of the PHS Act will be asked to participate in a demonstration project to determine the ability of grantees to provide data on 17 crosscutting performance indicators. The project will also provide baseline data on the indicators.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Performance Outcome Measurement Demonstration 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	1,219	0	0	1,219	0	0
Annual Time Burden (Hours)	6,755	0	0	6,755	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:

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

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

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

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

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: 12/29/1997

---