Teen Pregnancy Prevention Tier 1B Design and Implementation Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SS_A.doc	Supporting Statement A	Uploaded 2016-06-22	Available
Attachment E_Focus Group Youth Assent_Parent Consent.doc	Supplementary Document	Uploaded 2016-06-21	Available
Attachment C_Confstatement.docx	Supplementary Document	Uploaded 2016-06-21	Available
Attachment D_Introductory_email.docx	Supplementary Document	Uploaded 2016-06-21	Available
SS_B.doc	Supporting Statement B	Uploaded 2016-06-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
222074	Community Advisory Group Members	Other-survey	New
222073	Youth Leadership Council members	Other-survey	New
222072	Partner staff	Other-survey	New
222071	Partner director (telephone)	Other-survey	New
222070	Other grantee staff	Other-survey	New
222068	Grantee director (telephone)	Other-survey	New

ICR Details

OMB Control No: 0990-0451	ICR Reference No: 201604-0990-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Teen Pregnancy Prevention Tier 1B Design and Implementation Study
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 without change	Conclusion Date: 09/22/2016
	Date Received in OIRA: 07/01/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2019	36 Months From Approved
Responses	390	0	0
Time Burden (Hours)	465	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The work of this study includes a descriptive assessment and documentation of how the 50 projects awarded funding under the 2015 Tier 1B grant program are scaling their programs (i.e., the strategies that were planned and implemented to expand the reach of evidence-based programs, mobilize communities, and establish and maintain linkages to youth-friendly health care). More intensive discussion with a subset of grantees, their partners, and constituents will provide detailed information about the implementation and scaling-up experiences of projects that represent the diversity of the grantees in scale-up strategies and settings.

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Authorizing Statute(s): PL: Pub.L. 113 - 76 3547 Name of Law: Title II of the Consolidated Appropriations Act, 2014
   PL: Pub.L. 113 - 164 101 Name of Law: Continuing Resolution thus far for 2015
  

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:
	81 FR 22983	04/19/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 41556	06/27/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Other grantee staff
Partner director (telephone)
Partner staff
Grantee director (telephone)
Youth Leadership Council members
Community Advisory Group Members

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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	390	0	0	390	0	0
Annual Time Burden (Hours)	465	0	0	465	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: New collection

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Annual Cost to Federal Government: $480,478

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: 07/01/2016

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