Plan for Foster Care, Prevention and Permanency—Title IV–E

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
pi1906.pdf	Supplementary Document	Uploaded 2019-10-04	Available
Supporting statement 10-04-2019.docx	Supporting Statement A	Uploaded 2019-10-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
238002	Title IV-E Kinship Navigator Program	Instruction	New
238001	Title IV-E Prevention Services Plan	Instruction	New
10180	State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act	Instruction	Unchanged

ICR Details

OMB Control No: 0970-0433	ICR Reference No: 201910-0970-002
Status: Active	Previous ICR Reference No: 201812-0970-005
Agency/Subagency: HHS/ACF	Agency Tracking No: ACYF
Title: Plan for Foster Care, Prevention and Permanency—Title IV–E
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/26/2019
	Date Received in OIRA: 10/09/2019
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2022	36 Months From Approved	04/30/2022
Responses	92	0	17
Time Burden (Hours)	467	0	272
Cost Burden (Dollars)	0	0	0

---

Abstract: A title IV-E plan is required by section 471, part IV-E of the Social Security Act (the Act) for each public child welfare agency requesting Federal funding for foster care, adoption assistance and guardianship assistance under the Act. Section 479B of the Act provides for an Indian tribe, tribal organization or tribal consortium (Tribe) to operate a title IV-E program in the same manner as a State with minimal exceptions. The Tribe must have an approved title IV-E Plan. The title IV-E plan provides assurances the programs will be administered in conformity with the specific regulatory, or policy references and citations for each requirement as well as supporting documentation. The plan must include all applicable State or Tribal statutory, regulatory, or policy references and citations for each requirement as well as supporting documentation. A title IV-E agency may use the pre-print format prepared by the Children’s Bureau of the Administration for Children and Families or a different format, on the condition that the format used includes all of the title IV-E plan requirements of the law. The FFPSA authorized new optional title IV–E funding for time-limited (one year) prevention services for mental health/substance abuse and in-home parent skill-based programs for: (1) A child who is a candidate for foster care (as defined in section 475(13) of the Act), (2) pregnant/parenting foster youth, and (3) the parents/kin caregivers of those children and youth (sections 471(e), 474(a)(6), and 475(13) of the Act). Title IV–E prevention services must be rated as promising, supported, or well supported in accordance with HHS criteria and be approved by HHS (section 471(e)(4)(C) of the Act) as part of the title IV–E Prevention Services Clearinghouse (section 476(d)(2) of the Act). A state or tribal title IV–E agency electing to participate in the program must submit a five-year title IV–E prevention program plan that meets the statutory requirements. (See Program Instructions ACYF–CB–PI–18–09 and ACYF–CB–PI–18–10 for more information.) The FFPSA also amended Section 474(a)(7) of the Act to reimburse state and tribal IV–E agencies for a portion of the costs of operating kinship navigator programs that meet certain criteria. To qualify for funding under the title IV– E Kinship Navigator program, the program must meet the requirements of a kinship navigator program described in section 427(a)(1) of the Act. The kinship navigator program must also meet practice criteria of promising, supported, or well-supported in accordance with HHS criteria and be approved by HHS (section 471(e)(4)(C) of the Act). To begin participation in the title IV–E Kinship Navigator Program, a title IV–E agency must submit an attachment to its title IV–E plan that specifies the Kinship Navigator model it has chosen to implement, the date on which the provision of program services began or will begin, and that provides an assurance that the model meets the requirements of section 427(a)(1) of the Act as well as a brief narrative describing how the program will be operated. (Please see Program Instruction ACYF–CB–PI–18–11 for additional information.) In addition, as stated in the Transitional Payments for the Title IV-E Prevention and Family Services and Programs program instructions (ACYF-CB-PI-19-06) a state must complete and submit the checklist in Attachment B of the PI, with all required documentation, to request transitional payments for a title IV-E prevention program or service which has not yet been rated by the Clearinghouse. This request for a revision includes the addition of the title IV-E prevention services plan and the title IV-E plan attachment for the title IV-E kinship navigator program to the title IV-E plan information collection. There are no changes to the previously approved information collection.

---

Authorizing Statute(s): US Code: 42 USC 671, 427(a), and 474(a)(7) Name of Law: Social Security Act
  

Citations for New Statutory Requirements: PL: Pub.L. 115 - 123 50711 and 50713 Name of Law: Title IV

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 35391	07/23/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 54153	10/09/2019
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Title IV-E Kinship Navigator Program
State Plan for Foster Care and Adoption Assistance: Title IV-E of the Social Security Act
Title IV-E Prevention Services Plan

---

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	92	17	75	0	0	0
Annual Time Burden (Hours)	467	272	195	0	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: Changing Regulations

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

Burden Reduction Due to:

Short Statement: This information collection was last re-authorized 04/02/2019. Since then, changes to title IV–E necessitated by passage of Public Law 115–123, which included the Family First Prevention Services Act (FFPSA) and requires the addition of the title IV-E prevention services plan and the title IV-E plan attachment for the title IV-E kinship navigator program to the title IV-E plan information collection.

---

Annual Cost to Federal Government: $32,690

Does this IC contain surveys, censuses, or employ statistical methods? No

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]? 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

---

Common Form ICR:  No

---

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: 10/09/2019

---