National Survey of Child and Adolescent Well-Being Second Cohort (NSCAW III): Data Collection (Phase II)

Forms and Documents

Document	Type	Status	Availability
OMB request for nonsubstantive change_NSCAW_7-26-19_fin.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-07-30	Repair queued
OMB request for nonsubstantive changes_NSCAW_opre 4.15.19_clean.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2019-04-15	Available
Appx A_NSCAW III_Summary of Interviews_clean 4.19.17v1.docx	Supplementary Document	Uploaded 2017-04-20	Available
Appx I_HIPAA Authorization Forms_clean.docx	Supplementary Document	Uploaded 2017-02-17	Available
Appx H_Data Linkage Forms_clean.docx	Supplementary Document	Uploaded 2017-02-17	Repair queued
Appx G_Consent and Assent Forms_clean.docx	Supplementary Document	Uploaded 2017-02-17	Repair queued
Appx F_Lead Letters and Fact Sheets_clean.docx	Supplementary Document	Uploaded 2017-02-17	Available
SSB_Phase II_NSCAW III_2017_clean.docx	Supporting Statement B	Uploaded 2017-02-17	Repair queued
SSA_Phase II_NSCAW III_2017_clean_NonSub July 2019_clean.docx	Supporting Statement A	Uploaded 2019-07-30	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
225756	Caseworking Interview - 18-month follow-up	Other-Interviews	Unchanged
225755	Caregiver Interview - 18-month follow-up	Other-Interviews	Unchanged
225754	Child Interview - 18-month follow-up	Other-Interviews	Modified
225753	Caseworking Interview - Baseline	Other-Interviews	Unchanged
225752	Caregiver Interview - Baseline	Other-Interviews	Unchanged
225751	Child Interview - Baseline	Other-Interviews	Unchanged
221807	Child welfare agency staff monthly sample file generation and transmission	Other-Email - Monthly sample file	Unchanged
221806	Visit or call with agency staff explaining the sample file process	Other-Specifications Monthly Submissions	Unchanged
221805	In-person visit with agency staff	Other-Checklist/Discussion Guide	Unchanged
221804	Initial call with agency staff	Other-Checklist/Discussion Guide	Unchanged
221803	Information package for child welfare agency administrators	Other-Prenotification Letter	Unchanged

ICR Details

OMB Control No: 0970-0202	ICR Reference No: 201907-0970-009
Status: Historical Active	Previous ICR Reference No: 201904-0970-004
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: National Survey of Child and Adolescent Well-Being Second Cohort (NSCAW III): Data Collection (Phase II)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2019
	Date Received in OIRA: 07/30/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	07/31/2020	07/31/2020
Responses	8,941	0	8,941
Time Burden (Hours)	11,222	0	11,222
Cost Burden (Dollars)	0	0	0

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Abstract: This memorandum requests approval for a non-substantive change to the information collection (IC) effort approved under OMB Control Number 0970-0202. The purpose of this request is to make the following changes to the 18-month follow-up data collection (Wave 2): 1. Expand the child age range for the Go/No-Go assessment of executive functioning, and 2. Remove the Dimensional Change Card Sort Task. Information about child executive functioning is not a new topic for this IC. The minor change requested would expand the age range of children administered the assessment from the age of 5 or older to 4 or older. Further, due to feasibility issues around implementation and costs, we are unable to administer the Dimensional Change Card Sort Task as planned. We do not anticipate any changes to the number of respondents in the IC approved under OMB Control Number 0970-0202 because the child cohort size for 5 years and older is lower than anticipated.

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Authorizing Statute(s): US Code: 42 USC 626 Name of Law: Social Security Act Section 426
  

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 85572	11/28/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 11470	02/23/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 11

IC Title	Form No.	Form Name
Initial call with agency staff
Information package for child welfare agency administrators
In-person visit with agency staff
Visit or call with agency staff explaining the sample file process
Child welfare agency staff monthly sample file generation and transmission
Child Interview - Baseline
Caregiver Interview - Baseline
Caregiver Interview - 18-month follow-up
Caseworking Interview - Baseline
Child Interview - 18-month follow-up
Caseworking Interview - 18-month follow-up

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ICR Summary 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	8,941	8,941	0	0	0	0
Annual Time Burden (Hours)	11,222	11,222	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is an additional information collection request under OMB No. 0970-0202.

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Annual Cost to Federal Government: $5,797,906

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.     Yes

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]? 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: 07/30/2019

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