Cover Letter

SUBMISSION OF INFORMATION COLLECTION UNDER THE

Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery

DATE OF REQUEST: 01.04.2022

SUB AGENCY (I/C): HHS/AHRQ

TITLE: TA User Feedback for Program and User Support and Quality Measure Tool Development for CAHPS® and SOPS™

GENERIC CLEARANCE UNDER OMB#: 0935-0179 EXP. DATE: 11/30/2023

ABSTRACT:

In order to assess the effectiveness of the CAHPS and SOPS technical assistance that Westat provides, Westat will ask those that receive technical assistance to complete a brief web-based questionnaire. The feedback will allow Westat to evaluate its performance in meeting user needs and to identify ways to improve its customer service. Westat will ask all users who contact the CAHPS technical assistance mailbox (CAHPS1@westat.com) and the SOPS technical assistance mailbox (SafetyCultureSurveys@westat.com) to complete a brief web based questionnaire hosted on SurveyMonkey. SurveyMonkey was chosen because it allows for free, easy to use and secure web-based administration. The questionnaire addresses user experience with obtaining timely and useful technical assistance.

TOTAL ANNUAL BURDEN APPROVED: 3,383 Hours Per year

BURDEN USED TO DATE: 1687 hours.

BURDEN THIS REQUEST: 54 hours.

FEDERAL COST: The estimated annual cost to the Federal government is $9,871__.

IS RACE AND ETHNICITY DATA COLLECTED AS REQUIRED?

______YES ______ NO _x____ N/A

OBLIGATION TO RESPOND:

___x___ VOLUNTARY

______ REQUIRED TO OBTAIN OR RETAIN BENEFITS

______ MANDATORY

HOW WILL THIS SURVEY BE OFFERED?

___X___ WEB SITE

____ _ TELEPHONE INTERVIEW

_____ MAIL RESPONSE

____ IN PERSON INTERVIEW

____ OTHER: _ __________

CONTACT INFORMATION:

NAME: _Erwin Brown______________________________

TELEPHONE NUMBER: 301.427.1652________________

EMAIL ADDRESS: _ebrown@ahrq.gov________________