2024-25986. Agency Forms Undergoing Paperwork Reduction Act Review

Estimated Annualized Burden Hours

Type of respondents	Form name	Number of respondents	Number of responses per respondent	Average burden per response (in hours)
Recipients	Evaluability Assessment Nomination Form_NCHP_ICHP	24	1	0.5
	Evaluability Assessment Nomination Form_WW	12	1	0.5
	Eval Assessment CQM Recipient Interview Guide NCHP_ICHP	6	1	1.5
	Eval Assessment CQM Recipient Interview Guide WW	3	1	1.5
	Eval Assessment TBC Recipient Interview Guide NCHP_ICHP	6	1	1.5
	Eval Assessment TBC Recipient Interview Guide WW	3	1	1.5
	Eval Assessment CCL Recipient Interview Guide NCHP_ICHP	3	1	1.5
	Eval Assessment CCL Recipient Interview Guide WW	3	1	1.5
	Ex Assessment CQM Recipient Interview Guide NCHP_ICHP	3	1	1.5
	Ex Assessment CQM Recipient Interview Guide_WW	2	1	1.5
	Ex Assessment TBC Recipient Interview Guide NCHP_ICHP	3	1	1.5
	Ex Assessment TBC Recipient Partner Interview Guide_WW	2	1	1.5
	Ex Assessment CCL Recipient Interview Guide NCHP_ICHP	3	1	1.5
	Ex Assessment CCL Recipient Interview Guide_WW	2	1	1.5
	Cost Study Interview Guide_Recipient	37	1	1
	Comprehensive Evaluation Resource Use and Cost Inventory Tool_Recipient	37	1	2.5
Partners	Eval Assessment CQM Partner Interview Guide NCHP_ICHP	6	1	1.5
	Eval Assessment CQM Partner Interview Guide WW	3	1	1.5
	Eval Assessment TBC Partner Interview Guide NCHP_ICHP	6	1	1.5
	Eval Assessment TBC Partner Interview Guide WW	3	1	1.5
	Eval Assessment CCL Partner Interview Guide NCHP_ICHP	6	1	1.5
	Eval Assessment CCL Partner Interview Guide WW	3	1	1.5
	Ex Assessment CQM Partner Interview Guide NCHP_ICHP	3	1	1.5
	Ex Assessment CQM Partner Interview Guide_WW	1	1	1.5
	Ex Assessment CCL Partner Interview Guide NCHP_ICHP	3	1	1.5
	Ex Assessment CCL Partner Interview Guide_WW	1	1	1.5
	Ex Assessment TBC Partner Interview Guide NCHP_ICHP	3	1	1.5
	Ex Assessment TBC Partner Interview Guide_WW	1	1	1.5
	Cost Study Interview Guide_Partner	55	1	1
	Comprehensive Evaluation Resource Use and Cost Inventory Tool_Partner	55	1	2.5
Learning Collaborative	Eval Assessment LC Interview Guide NCHP ICHP	12	1	1
	Ex Assessment LC Interview Guide NCHP_ICHP	6	1	1