Cost Study of Evidence-Based Teen Pregnancy Prevention Programs

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-Part B - TPP Cost Study.docx	Supporting Statement B	Uploaded 2014-07-03	Available
0990-Part A - TPP Cost Study.docx	Supporting Statement A	Uploaded 2014-07-03	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212003	Economic Evaluation Form+	Other-survey	New
211259	Staff Time Use Survey	Other-survey	New
211257	Implementation Tool	Other-interview	New
211256	Cost Tool	Other-spreadsheet	New

ICR Details

OMB Control No: 0990-0425	ICR Reference No: 201404-0990-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Cost Study of Evidence-Based Teen Pregnancy Prevention Programs
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: 09/08/2014
	Date Received in OIRA: 07/08/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved
Responses	1,275	0	0
Time Burden (Hours)	715	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The proposed study has three key objectives (Table A.1). The first is to determine the cost of implementing select evidence-based teen pregnancy prevention programs. To carry out this objective, the study team will collect detailed cost information from a subset of up to 30 OAH TPP Program grantees. For each grantee, the study team will administer three data collection instruments: (1) a Cost Tool used to collect comprehensive information on the cost of implementing of each select program (Instrument #1); (2) an Implementation Tool used to collect basic information on the characteristics of the grantee organization and program implementation (Instrument #2); and (3) a Staff Time Use survey used to collect information on how program staff allocate their time across different program activities (Instrument #3). Data from these instruments will be used to construct estimates of total program costs, cost per program participant, and the distribution of program costs across different programs and activities.

---

Authorizing Statute(s): PL: Pub.L. 111 - 117 213 Name of Law: Consolidated Appropriations Act 2010
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 14043	03/12/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 36807	06/30/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Economic Evaluation Form+
Staff Time Use Survey
Implementation Tool
Cost Tool

---

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	1,275	0	0	1,275	0	0
Annual Time Burden (Hours)	715	0	0	715	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: No

Burden Reduction Due to:

Short Statement: This is a new collection.

---

Annual Cost to Federal Government: $313,000

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

---

Common Form ICR:  No

---

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: 07/08/2014

---