Generic Template

Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: XXXX-YYYY)

TITLE OF INFORMATION COLLECTION: Thriving Communities Program (TCP) Website portal - Collection of baseline information to provide technical assistance to US DOT program participants via a web-based form

PURPOSE:

The purpose of this request is for the Office of Management and Budget (OMB) to grant the Reconnecting Communities Institute (RCI) a “Generic Clearance for the Collection of Qualitative Feedback on Agency Service Delivery” to collect baseline information through a web portal from Build America Bureau program participants which includes The Thriving Communities Program. This information will be used to ensure Thriving Communities Program can deliver requested Technical Assistance (TA) for program participants directly impacted by a disaster.

The Bipartisan Infrastructure Law (BIL) enacted as the Infrastructure Investment and Jobs Act (IIJA) (H.R. 3684, Public Law No. 117-58) created several new programs at the US Department of Transportation (DOT) that allow local governments, non-profit organizations, tribal governments, and other political subdivisions of state or local governments to apply directly for DOT discretionary grant funding. In response to President Biden’s Executive Order 13985¹ and Executive Oder 14008², DOT has included criteria in its notices of funding opportunity to prioritize the needs of disadvantaged communities for many of these new programs.

The Thriving Communities Program (TCP) is a U.S. DOT program designed to deliver grant funding for communities, states, local governments, Tribal governments, Metropolitan Planning Organizations (MPOs), community-based organizations (CBOs), and non-profit organizations to help repair historical injustices that resulted from the development of the Nation’s transportation infrastructure by funding transportation reconnection projects. As part of the existing Thriving Communities Program, this web-based form will be used to identify communities eligible to receive technical assistance support related to disaster recovery. Communities will have the opportunity to apply for TA and receive TA. A total of 12 eligible communities will be supported as part of the disaster recovery work

The collection of information for the Thriving Communities disaster TA is necessary for underserved and disadvantaged communities to receive the needed technical assistance and capacity building to support their ability to develop funding applications and deliver transformative projects funded by the Department of Transportation. Given the need to respond to the impacts of Hurricane Helene and Hurricane Milton, in addition to the proposed 9 month timeline for technical assistance related to disaster recovery, it is critical that the technical assistance disaster support launch quickly.

The implementation of the Thriving Communities technical assistance disaster support is critical in order to provide direct, coordinated, and placed-based technical assistance and capacity building to underserved and disadvantaged communities. The Department is directed to implement the program as swiftly as possible to support disadvantaged communities in the planning and development of transportation and community revitalization activities that increase mobility, reduce pollution from transportation sources, expand affordable transportation options, facilitate efficient land use, preserve, or expand jobs, improve housing conditions, enhance connections to health care, education, and food security, or improve health outcomes. The Thriving Communities programs are unique for DOT in that it allows for pre-application technical assistance and planning support. Both are essential to supporting communities that may be applying for FY2025 federal funding that may support long term disaster recovery. This information collection is critical to allow DOT to support those communities most in need of the assistance provided through these programs.

DESCRIPTION OF RESPONDENTS:

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [ ] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X ] Other: Intake form via web portal

The DOT will collect this information via a short online intake form. The purpose of this data collection is to enable the DOT to deliver capacity building and technical assistance providers to eligible communities seeking to advance transformative, equitable, and climate-friendly infrastructure projects that benefit disadvantaged communities impacted by disasters. *The Intake form is attached to this application*

Participants will apply for technical assistance through the Thriving Communities disaster website portal. Technical assistance will be provided on a first come, first served basis, until allotted program funds are exhausted. The application is planned as a one-time information collection. DOT will utilize an Expression of Interest (EOI) simplified in-take form from communities interested in receiving technical assistance and capacity building through these programs. The intake form to be used by communities seeking technical assistance is estimated 20 mins to complete.

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name:_ Monica Ines Guerra__________________________

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ X ] Yes [ ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [X ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [X ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [ X ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
(3) State, local, or tribal governments	300	20 minutes
Totals

TOTAL BURDEN HOURS: 116

300 participants x 20 minutes x 1 per year = 100 hours

FEDERAL COST: The estimated annual cost to the Federal government is ____________

The cost estimate is based on the mean hourly rate of a General and Operations Manager ³. The mean hourly pay for a General and Operations Manager is $59 (rounded), multiplied by 2 to account for benefits plus other overhead costs such as rent, utilities and office equipment, for a fully loaded hourly wage of $118.

$118 x 100 hours = $11,800

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [ ] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

No focus group or survey is being deployed. This is not a statistical data collection; it is an online electronic intake form. Therefore, no answers apply to the following questions.

This information collection does not require respondents to submit proprietary information.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[ ] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [ ] No

Please make sure that all instruments, instructions, and scripts are submitted with the request.

*Intake form is attached to this request*

Instructions for completing Request for Approval under the “Generic Clearance for the Collection of Routine Customer Feedback”

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request. (e.g. Comment card for soliciting feedback on xxxx)

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used. If this is part of a larger study or effort, please include this in your explanation.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

TYPE OF COLLECTION: Check one box. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

Personally Identifiable Information: Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

Gifts or Payments: If you answer yes to the question, please describe the incentive and provide a justification for the amount.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households;(2) Private Sector; (3) State, local, or tribal governments; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the Number of respondents.

Participation Time: Provide an estimate of the amount of time required for a respondent to participate (e.g. fill out a survey or participate in a focus group)

Burden: Provide the Annual burden hours: Multiply the Number of responses and the participation time and divide by 60.

FEDERAL COST: Provide an estimate of the annual cost to the Federal government.

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents. Please provide a description of how you plan to identify your potential group of respondents and how you will select them. If the answer is yes, to the first question, you may provide the sampling plan in an attachment.

Administration of the Instrument: Identify how the information will be collected. More than one box may be checked. Indicate whether there will be interviewers (e.g. for surveys) or facilitators (e.g., for focus groups) used.

Submit all instruments, instructions, and scripts are submitted with the request.

1. 1Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities Through the Federal Government

2. 2Executive Order 14008: Tackling the Climate Crisis at Home and Abroad, which established the Justice40 Initiative and supports the Administration’s approach to advancing equity for all in line with Executive Order 13985.

3 Based on Occupation 11-1021, BLS Occupational Employment Statistics, May 2019. See

https://www.bls.gov/oes/current/oes_nat.htm - 11-0000

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