Combating Autism Act Initiative Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 AMCHP SEMI-STRUCTURED INTERVIEW PROTOCOL	Form and Instruction	New	Available
Form 1 AUCD SEMI-STRUCTURED INTERVIEW PROTOCOL	Form and Instruction	New	Available
Form 1 RESEARCH NETWORK QUESTIONNAIRE	Form and Instruction	New	Available
Form 1 R40 INTERVIEW PROTOCOL	Form and Instruction	New	Available
Form 1 RESEARCH NETWORK SEMI-STRUCTURED INTERVIEW PROTOCOL	Form and Instruction	New	Available
Form 1 STATE IMPLEMENTATION GRANT PROGRAM QUESTIONNAIRE	Form and Instruction	New	Available
Form 4 STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTERVIEW PROTOCOL	Form and Instruction	New	Available
Form 2 DBP Interview Protocol	Form and Instruction	New	Available
Form 002_CAAI_State Sys 002_CAAI_State Systems	Form and Instruction	Removed	Available
Form 001_CAAI_State Sys 001_CAAI_State Systems	Form and Instruction	Removed	Available
Form 004_CAAI_Research 004_CAAI_Research	Form and Instruction	Removed	Available
Form 003_CAAI_Research 003_CAAI_Research	Form and Instruction	Removed	Available
Form 001_CAAI_Researh 001_CAAI_Researh	Form and Instruction	Removed	Available
Form 002_CAAI_Research 002_CAAI_Research	Form and Instruction	Removed	Available
Form 1 LEND Interview Protocol	Form and Instruction	Modified	Available
Part B.docx	Supporting Statement B	Uploaded 2013-12-05	Available
AttachA AUTISM CAAI OMB Package revised 11 24 13 (3).doc	Supplementary Document	Uploaded 2013-12-05	Available
Supporting Statement.doc	Supporting Statement A	Uploaded 2014-03-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
209772	Resource Centers Interview Protocol	Form and Instruction	New	AMCHP SEMI-STRUCTURED INTERVIEW PROTOCOL
209772	Resource Centers Interview Protocol	Form and Instruction	New	AUCD SEMI-STRUCTURED INTERVIEW PROTOCOL
209771	RESEARCH NETWORK QUESTIONNAIRE	Form and Instruction	New	RESEARCH NETWORK QUESTIONNAIRE
209770	R40 INTERVIEW PROTOCOL	Form and Instruction	New	R40 INTERVIEW PROTOCOL
209769	RESEARCH NETWORK SEMI-STRUCTURED INTERVIEW PROTOCOL	Form and Instruction	New	RESEARCH NETWORK SEMI-STRUCTURED INTERVIEW PROTOCOL
209768	STATE IMPLEMENTATION GRANT PROGRAM QUESTIONNAIRE	Form and Instruction	New	STATE IMPLEMENTATION GRANT PROGRAM QUESTIONNAIRE
209767	STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTERVIEW PROTOCOL	Form and Instruction	New	STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTERVIEW PROTOCOL
209766	DBP Interview Protocol	Form and Instruction	New	DBP Interview Protocol
194886	Combating Autism Act Initiative Evaluation - Improving State Systems of Care Program	Form and Instruction	Removed	002_CAAI_State Systems
194886	Combating Autism Act Initiative Evaluation - Improving State Systems of Care Program	Form and Instruction	Removed	001_CAAI_State Systems
194885	Combating Autism Act Initiative Evaluation - Research Programs	Form and Instruction	Removed	004_CAAI_Research
194885	Combating Autism Act Initiative Evaluation - Research Programs	Form and Instruction	Removed	003_CAAI_Research
194885	Combating Autism Act Initiative Evaluation - Research Programs	Form and Instruction	Removed	001_CAAI_Researh
194885	Combating Autism Act Initiative Evaluation - Research Programs	Form and Instruction	Removed	002_CAAI_Research
194884	Combating Autism Act Initiative Evalutation - Training Programs - LEND	Form and Instruction	Modified	LEND Interview Protocol

ICR Details

OMB Control No: 0915-0335	ICR Reference No: 201312-0915-003
Status: Historical Active	Previous ICR Reference No: 201010-0915-003
Agency/Subagency: HHS/HSA	Agency Tracking No: 21064
Title: Combating Autism Act Initiative Evaluation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/14/2014
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/19/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2017	36 Months From Approved	03/31/2014
Responses	107	0	342
Time Burden (Hours)	110	0	258
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this information collection is to determine the effectiveness of HRSA/MCHB's activities related to screening, evaluation and treatment for Autism Spectrum Disorders (ASD) and other developmental disabilities (DD), as mandated by the Combating Autism Act of 2006.

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Authorizing Statute(s): US Code: 42 USC 1 Name of Law: Combating Autism Reauthorization Act
   PL: Pub.L. 112 - 32 125 Name of Law: Combating Autism Act of 2006
  

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:
	78 FR 52536	08/23/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 75356	12/11/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Combating Autism Act Initiative Evaluation - Improving State Systems of Care Program	001_CAAI_State Systems, 002_CAAI_State Systems	001_CAAI_State Systems ,   002_CAAI_State Systems
Combating Autism Act Initiative Evaluation - Research Programs	001_CAAI_Researh, 002_CAAI_Research, 003_CAAI_Research, 004_CAAI_Research	001_CAAI_Researh ,   002_CAAI_Research ,   003_CAAI_Research ,   004_CAAI_Research
Combating Autism Act Initiative Evalutation - Training Programs - LEND	1	LEND Interview Protocol
DBP Interview Protocol	2	DBP Interview Protocol
R40 INTERVIEW PROTOCOL	1	R40 INTERVIEW PROTOCOL
RESEARCH NETWORK QUESTIONNAIRE	1	RESEARCH NETWORK QUESTIONNAIRE
RESEARCH NETWORK SEMI-STRUCTURED INTERVIEW PROTOCOL	1	RESEARCH NETWORK SEMI-STRUCTURED INTERVIEW PROTOCOL
Resource Centers Interview Protocol	1, 1	AUCD SEMI-STRUCTURED INTERVIEW PROTOCOL ,   AMCHP SEMI-STRUCTURED INTERVIEW PROTOCOL
STATE IMPLEMENTATION GRANT PROGRAM QUESTIONNAIRE	1	STATE IMPLEMENTATION GRANT PROGRAM QUESTIONNAIRE
STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTERVIEW PROTOCOL	4	STATE IMPLEMENTATION GRANT PROGRAM SEMI-STRUCTURED INTERVIEW PROTOCOL

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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	107	342	0	-235	0	0
Annual Time Burden (Hours)	110	258	0	-148	0	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The current evaluation will use the same design and data collection methods as the prior evaluation, with some minor updates to the interview protocols based on program revisions. Many of the grantees, however, have changed since the prior study, and other CAAI-supported programs that were not previously subject to formal evaluation will be included in the current evaluation. Specifically, the evaluation will include the two Resource Centers that are charged with providing grantees with technical support and promoting coordination across grant programs.

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Annual Cost to Federal Government: $255,000

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: 12/19/2013

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