Title V State Sexual Risk Avoidance Education

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Performance Progress Report	Form	New	Available
Form 1 State Plan	Form and Instruction	New	Available
SRAE Supporting Statement.05.26.20.docx	Supporting Statement A	Uploaded 2020-05-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
242038	Performance Progress Report	Form	New
242037	State Plan	Form and Instruction	New
241985	Application	Other-Application	New

ICR Details

OMB Control No: 0970-0551	ICR Reference No: 202005-0970-016
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: FYSB
Title: Title V State Sexual Risk Avoidance Education
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: 08/19/2020
	Date Received in OIRA: 06/01/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2023	36 Months From Approved
Responses	197	0	0
Time Burden (Hours)	4,720	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Administration on Children, Youth and Families' (ACYF) Family and Youth Services Bureau (FYSB) published a new funding opportunity announcement to solicit applications from states and territories for the development and implementation of the Title V State Sexual Risk Avoidance Education (SRAE) Program. States and territories are expected to submit plans for the implementation of sexual risk avoidance education that normalizes the optimal health behavior of avoiding non-marital sexual activity, with a focus being on the future health, psychological wellbeing, and economic success of youth. Further, the plans must address the social, psychological, and health gains to be realized by refraining from non-marital sexual activity and engaging in healthy relationships. OMB approval is requested for the Application, State Plan and Performance Progress Report documents related to funding states and territories to develop and implement State Sexual Risk Avoidance Education Programs.

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Authorizing Statute(s): US Code: 42 USC 710 Name of Law: Section 510 of the Social Security Act, as amended
  

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:
	85 FR 16948	03/25/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 33159	06/01/2020
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Application
State Plan	1	TitleV SRAE State Plan
Performance Progress Report	1	TitleV SRAE PPR

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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	197	0	0	197	0	0
Annual Time Burden (Hours)	4,720	0	0	4,720	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 information collection request.

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Annual Cost to Federal Government: $13,333

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? No

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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: 06/01/2020

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