State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act	Form and Instruction	Modified	Available
Modify for State Plan supportng statement 2009.doc	Supporting Statement A	Uploaded 2009-07-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
10180	State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act	Form and Instruction	Modified

ICR Details

OMB Control No: 0980-0141	ICR Reference No: 200908-0980-001
Status: Historical Active	Previous ICR Reference No: 200809-0980-001
Agency/Subagency: HHS/HDSO	Agency Tracking No:
Title: State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/13/2009
	Date Received in OIRA: 08/06/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2012	36 Months From Approved	12/31/2011
Responses	33	0	13
Time Burden (Hours)	528	0	195
Cost Burden (Dollars)	0	0	0

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Abstract: A State plan is required by sections 471 and 477(b)(2), part IV-E of the Social Security Act for each public child welfare agency claiming Federal funding for foster care and independent living services and adoption assistance. The State plan is a comprehensive description of the nature and scope of the State's program and provides assurance the program will be administered in conformity with the specific requirements stipulated in title IV-E.

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Authorizing Statute(s): US Code: 42 USC 671 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: PL: Pub.L. 110 - 351 471 Name of Law: Fostering Connections to Success and Increasing Adoptions Act of 2008

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 10594	03/11/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 37713	07/29/2009
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act	1	IV-E Pre Print

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ICR Summary of Burden

table that charts list 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	33	13	20	0	0	0
Annual Time Burden (Hours)	528	195	333	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement: Program change due to new statute causing increase in number of hours and responses.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? Yes

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)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 08/06/2009

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