Permanency Innovations Initiative (PII) Evaluation - Phase 4

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment B3 Caregiver Reminder Postcard English-Spanish 8-15.docx	Supplementary Document	Uploaded 2015-11-17	Repair queued
Attachment B2b Parent-Legal Guardian Questionnaire Distributor Script Spanish 10-15.docx	Supplementary Document	Uploaded 2015-11-17	Repair queued
Attachment B2a Parent-Legal Guardian Questionnaire Distributor Script 10-15.docx	Supplementary Document	Uploaded 2015-11-17	Available
Attachment B1b FAQ Letter for Caregivers Spanish 8-15.docx	Supplementary Document	Uploaded 2015-11-17	Available
Attachment B1a FAQ Letter for Caregivers 8-15.docx	Supplementary Document	Uploaded 2015-11-17	Available
Attachment A2 CAPP Research Matrix .docx	Supplementary Document	Uploaded 2015-11-17	Repair queued
Attachment A1 PII Research Matrix.docx	Supplementary Document	Uploaded 2015-11-17	Available
PII - Nonsubstantive Change Request 10 7 2014.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2014-10-07	Repair queued
Attachment B1 RISE Research Matrix 6 12 14_clean.docx	Supplementary Document	Uploaded 2014-06-30	Available
Attachment D1 Cross-Site Administrative Data Study Research Matrix 6 12 14.docx	Supplementary Document	Uploaded 2014-06-30	Available
Attachment C1 Cost Study Research Matrix.docx	Supplementary Document	Uploaded 2014-04-01	Repair queued
Attachment B1 RISE Research Matrix 6 12 14_clean.docx	Supplementary Document	Uploaded 2014-06-30	Available
Attachment A PII Research Matrix.docx	Supplementary Document	Uploaded 2014-04-01	Available
SSB CAPP_2015-11-06.docx	Supporting Statement B	Uploaded 2015-11-17	Available
Attachment D6 RISE Posttest Reminder.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment D4 RISE ORB Summative Posttest Consent.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment D2 RISE ORB Summative Pretest BoR and Consent.docx	Supplementary Document	Uploaded 2013-05-22	Repair queued
Attachment D1 RISE Research Matrix.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment C10 DCFS CASI-ACASI Measures and Instruction Screens.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment C8 DCFS Youth FAQ Letter and Assent Form.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment C5 DCFS Foster Parent FAQ Letter and Consent Form.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment C2 DCFS Biological Parent FAQ Letter and Consent Script.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment C1 DCFS Research Matrix.docx	Supplementary Document	Uploaded 2013-05-22	Available
Attachment A1 Research Matrix for Implementation, KS, and Washoe Studies.docx	Supplementary Document	Uploaded 2013-05-22	Available
Sample screen shot for web based surveys.JPG	Supplementary Document	Uploaded 2012-05-08	Available
SSA CAPP_2015-11-06.docx	Supporting Statement A	Uploaded 2015-11-17	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218900	CAPP Caregiver Questionnaire	Other-Questionnaire	New
218899	CAPP Parent-Legal Guardian Questionnaire	Other-Questionnaire	New
211060	D3: Admin Data file submission with added fields	Instruction	Modified
211059	D2: Admin Data file submission, no added fields	Instruction	Modified
211058	C7: Monthly Management/Administration Log	Other-Log	Unchanged
211057	C6: Weekly Supervision Activity Log	Other-Log	Unchanged
211056	C5: Weekly Casework Activity Log	Other-Logs	Unchanged
211055	C4: Trial Administration of Logs	Other-Logs	Unchanged
211054	C3: Cost Focus Group Guide	Other-Discussion Guide	Modified
211053	C2: Cost Study Focus Group Preparation	Instruction	Modified
211052	B10: RISE Staff Follow-Up Survey	Other-Survey	Modified
211050	B8: RISE Current Caregiver Interview	Other-Interview	Unchanged
211049	B7: RISE Permanency Resource Interview	Other-Interview	Modified
211048	B6: RISE Facilitator submission of CAFAS data	Instruction	Unchanged
211047	B5: RISE CCT Facilitator Survey	Other-Survey	Unchanged
211046	B4: RISE CCT Facilitator Interview (child burden)	Other-Interview	Modified
211045	B4: RISE CCT Facilitator Interview (facilitator burden)	Other-Interview	Modified
211044	B3: RISE Youth Qualitative Interview (ages 11-19)	Other-Interview	Modified
211043	B2: RISE Youth Interview (ages 11-19)	Other-Interview	Modified
207124	B9b: Revised RISE Staff Post-Test	Other-Posttest	Modified
207123	B9a: Revised RISE Staff Pre-Test	Other-Pretest	Removed
207122	DCFS Youth Interview	Other-Interview	Modified
207121	DCFS Foster Parent Interview	Other-Interview	Modified
207120	DCFS Youth and Foster Parent Study Contact Form	Other-Contact Form	Modified
207119	DCFS Biological Parent Interview	Other-Interview	Modified
207118	DCFS Biological Parent Study Contact Form	Other-Contact Form	Modified
202195	Washoe Family Assessment Battery	Other-Assessment Battery	Modified
202194	Caseworker discussions for NCFAS-G&R completion	Other-Discussions	Modified
202193	CAFAS/PECFAS	Other-CAFAS/PECFAS	Modified
202192	Family Assessment Battery	Other-Assessment Battery	Modified
202191	Caregiver Initial Information Form	Other-Info Form	Modified
202190	Fidelity Data (Implementation Quotient Tracker)	Other-Quotient Tracker	Modified
202189	Grantee Case Study Protocol	Other-Protocol	Modified
202188	Implementation Drivers Web Survey	Other-Survey	Modified
202187	Survey of Organization/System Readiness	Other-Survey	Modified

ICR Details

OMB Control No: 0970-0408	ICR Reference No: 201511-0970-001
Status: Historical Inactive	Previous ICR Reference No: 201410-0970-003
Agency/Subagency: HHS/ACF	Agency Tracking No: 19658
Title: Permanency Innovations Initiative (PII) Evaluation - Phase 4
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn and continue	Conclusion Date: 02/24/2016
	Date Received in OIRA: 11/24/2015
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2017	36 Months From Approved	07/31/2017
Responses	13,355	0	13,355
Time Burden (Hours)	6,863	0	6,863
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. OMB has approved information collection activities for the cross-site implementation study, cost study, and administrative data study and four site-specific impact evaluations. This current request is for another site-specific impact evaluation.

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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:
	79 FR 75556	12/18/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 71809	11/17/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 34

table that charts list of burden

IC Title	Form No.	Form Name
C6: Weekly Supervision Activity Log
C5: Weekly Casework Activity Log
C7: Monthly Management/Administration Log
CAPP Caregiver Questionnaire
B9a: Revised RISE Staff Pre-Test
CAPP Parent-Legal Guardian Questionnaire
DCFS Youth and Foster Parent Study Contact Form
DCFS Foster Parent Interview
DCFS Youth Interview
B9b: Revised RISE Staff Post-Test
B4: RISE CCT Facilitator Interview (facilitator burden)
B4: RISE CCT Facilitator Interview (child burden)
B6: RISE Facilitator submission of CAFAS data
B7: RISE Permanency Resource Interview
B10: RISE Staff Follow-Up Survey
D2: Admin Data file submission, no added fields
B2: RISE Youth Interview (ages 11-19)
B3: RISE Youth Qualitative Interview (ages 11-19)
B8: RISE Current Caregiver Interview
C2: Cost Study Focus Group Preparation
C3: Cost Focus Group Guide
C4: Trial Administration of Logs
D3: Admin Data file submission with added fields
B5: RISE CCT Facilitator Survey
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
DCFS Biological Parent Study Contact Form
DCFS Biological Parent Interview

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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: This request is for additional information collection under 0970-0408, which increases burden under this number. We have also updated current burden to reflect completed data collection.

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Annual Cost to Federal Government: $1,800,000

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: 11/24/2015

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