The third cohort_Pregnancy Assistance Fund (PAF) Performance, FY2017-FY2019

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990-NEW OAH Memo Request to reduce the number of measures collected.docx	Supplementary Document	Uploaded 2017-09-21	Repair queued
Attachment J PAF Performance Data System Screenshots.docx	Supplementary Document	Uploaded 2017-05-16	Available
Attach_A_PAF_AuthorizingLegislation.pdf	Supplementary Document	Uploaded 2017-05-16	Available
30-day Federal Register, Volume 82 Issue 91 (Friday, May 12, 2017).htm	Supplementary Document	Uploaded 2017-05-16	Available
60-day Federal Register, Volume 82 Issue 20 (Wednesday, February 1, 2017).htm	Supplementary Document	Uploaded 2017-05-16	Available
0990-NEW SSB_PAF_PM_FY17_FY19_91717.docx	Supporting Statement B	Uploaded 2017-09-21	Available
0990- NEW SSA_PAF PM_FY17_FY19-clean_91417.docx	Supporting Statement A	Uploaded 2017-09-21	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226863	Core Services	Other-services	New
226862	Reach and Demographics	Other-Reach Demo	New
226860	Partnerships and Sustainability	Other-form	New
226859	Training Forms	Other-survey	New

ICR Details

OMB Control No: 0990-0460	ICR Reference No: 201701-0990-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: The third cohort_Pregnancy Assistance Fund (PAF) Performance, FY2017-FY2019
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: 10/02/2017
	Date Received in OIRA: 05/16/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2020	36 Months From Approved
Responses	76	0	0
Time Burden (Hours)	438	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Collection of annual performance data will benefit grantees by assisting PAF administrators with ongoing program monitoring and continuous quality improvement of their individual projects. The collection of annual performance data will assist OAH in gathering uniform demographic information on all funded grantees, assessing progress across all PAF projects and providing timely technical assistance to grantees, as necessary. OAH will use the performance data to inform planning and resource allocation decisions; identify training, technical assistance, and evaluation needs; and provide Congress, OMB, and the general public with information about the individuals who participate in PAF-funded activities and the range and scope of services they receive.

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Authorizing Statute(s): PL: Pub.L. 103 - 62 2 Name of Law: 1993 Government Performance and Results Act
   PL: Pub.L. 111 - 148 10104 Name of Law: Affordable Care 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:
	82 FR 8941	02/01/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 22147	05/12/2017
Did the Agency receive public comments on this ICR? Yes

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

table that charts list of burden

IC Title	Form No.	Form Name
Reach and Demographics
Core Services
Training Forms
Partnerships and Sustainability

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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	76	0	0	76	0	0
Annual Time Burden (Hours)	438	0	0	438	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 for the third PAF cohort (FY2017-FY2019).

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Annual Cost to Federal Government: $52,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Yes

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: 05/16/2017

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