Fatherhood and Marriage Local Evaluation and Cross-Site Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment H - FaMLE Focus Group confirmation letter and reminder script.docx	Supplementary Document	Uploaded 2015-03-23	Repair queued
Attachment G - Assumptions for Calculation of Burden Estimates 03 20 15.docx	Supplementary Document	Uploaded 2015-03-23	Available
Attachment F_Confidentiality pledge.pdf	Supplementary Document	Uploaded 2015-03-23	Available
Attachment E - Guidance on obtaining consent for local evaluations 031815.docx	Supplementary Document	Uploaded 2015-03-23	Available
Attachment C - Memo on FRN responses.docx	Supplementary Document	Uploaded 2015-03-23	Available
Attachment D- FaMLE Focus Group Informed Consent.docx	Supplementary Document	Uploaded 2015-03-23	Available
Attachment A_Claims Res Act_SSA_Title IV_Part A_Section 403_RFHM grants.pdf	Supplementary Document	Uploaded 2015-03-23	Available
Supporting Statement Part B - revised June 2015.docx	Supporting Statement B	Uploaded 2015-06-26	Available
Supporting Statement Part A - revised June 2015.docx	Supporting Statement A	Uploaded 2015-06-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215795	DCS-6: Quarterly Performance Report	Other-QPR HM Grantees	New
215794	DCS-5: Semi-annual Progress Report	Other-PPR HM Grantees	New
215793	DCS 4: SAQ Pre-Test and Post-Test - Program Staff Entry	Other-Pre-test HM Adults	New
215792	DCS 4: SAQ Program Participants Post-Test	Other-Post-test HM Youth	New
215791	DCS 4: SAQ Program Participant Pre-Test	Other-Pre-test HM Adults	New
215790	DCS-3: Service Receipt in MIS	Other-MIS	New
215789	DCS-2: Grantee Program Operations	Other-null	New
215788	DCS-1: Applicant Characteristics - Program Staff	Other-null	New
215787	DCS-1: Applicant Characteristics - Program Applicants	Other-null	New
215786	DCI-3: Focus group Protocol	Other-Topic Guide	New
215785	DCI-2: Topic Guide on Program Implementation	Other-Topic Guide	New
215784	DCI-1: Topic Guide on Program Design	Other-Topic Guide	New

ICR Details

OMB Control No: 0970-0460	ICR Reference No: 201503-0970-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Fatherhood and Marriage Local Evaluation and Cross-Site Data Collection
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: 07/09/2015
	Date Received in OIRA: 03/27/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2018	36 Months From Approved
Responses	575,381	0	0
Time Burden (Hours)	180,090	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In anticipation of the next round of Healthy marriage and responsible fatherhood (HMRF) grant funding expected to be awarded in September 2015, the Administration for Children and Families (ACF) contracted with Mathematica Policy Research to conduct the Fatherhood and Marriage Local Evaluation (FaMLE) Cross-Site project, with the dual goals of supporting quality and consistent collection of performance measures data, and fostering strong local evaluations by the next round of HMRF grantees. More specifically, Mathematica will: (1) collect information on the design and implementation of grantees' programs; and (2) develop data collection tools that grantees can use to collect information on program participation and participant outcomes for use in reporting performance and conducting evaluations. The project will rely on two complementary sources of data collection: (1) data collection by the contractor for cross-site analysis of program design and implementation, hereafter referred to as DCI (Data collected by the Contractor Itself); and (2) data collection by the grantees themselves for performance reporting and cross-site analysis, hereafter referred to as DCS (Data Collected for Cross-Site analyses).

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Authorizing Statute(s): PL: Pub.L. 111 - 291 811(b) Name of Law: Healthy Marriage Promotion and Promoting Responsible Fatherhood Grants of the Claims Resolution Act
  

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:
	79 FR 65973	11/06/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 15231	03/23/2015
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 12

table that charts list of burden

IC Title	Form No.	Form Name
DCS 4: SAQ Program Participant Pre-Test
DCS 4: SAQ Program Participants Post-Test
DCI-2: Topic Guide on Program Implementation
DCS-1: Applicant Characteristics - Program Staff
DCS-2: Grantee Program Operations
DCS-3: Service Receipt in MIS
DCS 4: SAQ Pre-Test and Post-Test - Program Staff Entry
DCS-5: Semi-annual Progress Report
DCI-3: Focus group Protocol
DCS-1: Applicant Characteristics - Program Applicants
DCI-1: Topic Guide on Program Design
DCS-6: Quarterly Performance Report

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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	575,381	0	0	575,381	0	0
Annual Time Burden (Hours)	180,090	0	0	180,090	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 data collection.

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Annual Cost to Federal Government: $410,256

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: 03/27/2015

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