Permanency Innovations Initiative (PII) Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment 4- Implementation Study Recruitment Materials revised.docx	Supplementary Document	Uploaded 2012-08-16	Available
Attachment 3- Matrix Washoe.docx	Supplementary Document	Uploaded 2012-08-16	Available
Attachment 2 - Matrix KIPP.docx	Supplementary Document	Uploaded 2012-08-16	Available
Attachment 1 - Matrix implementation study.docx	Supplementary Document	Uploaded 2012-08-16	Available
Kansas assent (assessment) 8-10-12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Kansas assent (parent training group) 8-10-12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Washoe FAQ Follow up letter_8_10_12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Washoe FAQ letter for New Families_8_10_12.docx	Supplementary Document	Uploaded 2012-08-16	Available
PII Supporting Statement Part B for OMB Approval_FINAL OMB response revised.docx	Supporting Statement B	Uploaded 2012-08-16	Available
Washoe FAQ letter for Existing Families_8_10_12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Washoe Consent_8_10_12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Kansas_KIPP Consent Form - Declined Services Data Collection Only 8-10-12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Kansas_KIPP Consent Form - Treatment Group 8-10-12.docx	Supplementary Document	Uploaded 2012-08-16	Repair queued
Kansas Assessment Group Consent 8-10-12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Grantee Case Study Protocol consent 7-19-12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Implementation Drivers Web Survey consent 7-19-12.docx	Supplementary Document	Uploaded 2012-08-16	Available
Survey of Organizational System Readiness consent 7-19-12.docx	Supplementary Document	Uploaded 2012-08-16	Repair queued
Sample screen shot for web based surveys.JPG	Supplementary Document	Uploaded 2012-05-08	Available
PII Supporting Statement Part A for OMB Approval_FINAL OMB response revised.docx	Supporting Statement A	Uploaded 2012-08-16	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202195	Washoe Family Assessment Battery	Other-Assessment Battery	New
202194	Caseworker discussions for NCFAS-G&R completion	Other-Discussions	New
202193	CAFAS/PECFAS	Other-CAFAS/PECFAS	New
202192	Family Assessment Battery	Other-Assessment Battery	New
202191	Caregiver Initial Information Form	Other-Info Form	New
202190	Fidelity Data (Implementation Quotient Tracker)	Other-Quotient Tracker	New
202189	Grantee Case Study Protocol	Other-Protocol	New
202188	Implementation Drivers Web Survey	Other-Survey	New
202187	Survey of Organization/System Readiness	Other-Survey	New

ICR Details

OMB Control No: 0970-0408	ICR Reference No: 201205-0970-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Permanency Innovations Initiative (PII) Evaluation
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 with change	Conclusion Date: 08/16/2012
	Date Received in OIRA: 05/08/2012
Terms of Clearance: Approved as revised by ACF.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2015	36 Months From Approved
Responses	3,006	0	0
Time Burden (Hours)	2,922	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Administration for Children and Families (ACF), U.S. Department of Health and Human Services (HHS), requests permission to collect data for an evaluation of the Permanency Innovations Initiative (PII). This 5-year initiative, funded by the Children's Bureau (CB) within ACF, will build the evidence base for innovative interventions that enhance well-being and improve permanency outcomes for particular groups of children and youth who are at high risk for long-term foster care and who experience the most serious barriers to timely permanency. A major emphasis of the PII is the design of rigorous evaluations that will provide credible evidence and replicable interventions for achieving faster permanency for children and youth in foster care.

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Authorizing Statute(s): US Code: 42 USC 626 Name of Law: Social Security Act; Research, training, or demonstration projects
  

Citations for New Statutory Requirements: None

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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:
	77 FR 10531	02/22/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 27071	05/08/2012
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Survey of Organization/System Readiness
Implementation Drivers Web Survey
Grantee Case Study Protocol
Fidelity Data (Implementation Quotient Tracker)
Caregiver Initial Information Form
Family Assessment Battery
CAFAS/PECFAS
Caseworker discussions for NCFAS-G&R completion
Washoe Family Assessment Battery

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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	3,006	0	0	1,146	1,860	0
Annual Time Burden (Hours)	2,922	0	0	1,077	1,845	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new information collection request.

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Annual Cost to Federal Government: $535,556

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 05/08/2012

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