Center for States Evaluation Ancillary Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Annual Assessment Update	Form and Instruction	Modified	Available
CenterforStatesEvaluationAncillaryDataCollection_SSB_Final.docx	Supporting Statement B	Uploaded 2020-08-07	Available
CenterforStatesEvaluationAncillaryDataCollection_SSA_Final.docx	Supporting Statement A	Uploaded 2020-08-07	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226795	Annual Assessment Update (8 systematic questions)	Other-Systematic Quesitons	Modified
226795	Annual Assessment Update (8 systematic questions)	Form and Instruction	Modified	Annual Assessment Update
226794	Assessment and Service Delivery State Lead Interviews-Supplemental Questions	Other-Supplemental Questions	Modified
226793	Service Delivery and Tracking and Adjustment Observation-Group Debrief	Other-Group Debrief	Modified
226792	Assessment Observation-Group Debrief	Other-Group Debrief	Modified
226791	Tailored Services Practice Model Survey	Other-Model Survey	Modified
226790	Child Welfare Virtual Conference Exit Survey	Other-Exit Survey	Modified
226788	Child Welfare Virtual Conference Registration Form	Other-Registration Form	Modified
226787	Child Welfare Virtual Conference Interview Guide	Other-Virtual Interview Guide	Modified
226786	Child Welfare Virtual Conference Focus Group Guide	Other-Focus Group Guide	Modified
226785	Child Welfare Virtual Conference Session Surveys	Other-Session Surveys	Modified

ICR Details

OMB Control No: 0970-0501	ICR Reference No: 202008-0970-004
Status: Historical Active	Previous ICR Reference No: 201705-0970-004
Agency/Subagency: HHS/ACF	Agency Tracking No: ACYF
Title: Center for States Evaluation Ancillary Data Collection
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/17/2020
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/14/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2023	36 Months From Approved	09/30/2020
Responses	4,319	0	7,431
Time Burden (Hours)	390	0	672
Cost Burden (Dollars)	0	0	0

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Abstract: The Evaluation of the Child Welfare Capacity Building Collaborative, Center for States is sponsored by the Children's Bureau, Administration for Children and Families of the U.S. Department of Health and Human Services. The purpose of this evaluation is to respond to a set of cross-cutting evaluation questions posed by the Children's Bureau. This existing information collection is an ancillary part of a larger data collection effort being conducted for the evaluation of the Child Welfare Capacity Building Collaborative. This notice details a group of instruments that are specific only to the Center for States. The instruments focus on (1) evaluating an innovative approach to engaging professionals in networking and professional development through virtual conferences, (2) understanding fidelity to and effectiveness of the Center for States' Capacity Building Model, and (3) capturing consistent information during the updated annual assessment process focused on related contextual issues impacting potential service delivery such as implementation of new legislation. This is time sensitive request because the Center for States anticipates the need to collect information immediately after the expiration of the existing collection (August 31, 2020). Registration for the Child Welfare Virtual Conference (Child Welfare Virtual Conference Registration Form) will begin in June 2020 and will continue through the date of the conference on September 24, 2020. The other information collection forms associated with this conference will also be used once the conference begins.

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Authorizing Statute(s): PL: Pub.L. 93 - 247 5106 Name of Law: Child Abuse Prevention and Treatment 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:
	85 FR 30710	05/20/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 48704	08/12/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Annual Assessment Update (8 systematic questions)	1	Annual Assessment Update
Assessment Observation-Group Debrief
Assessment and Service Delivery State Lead Interviews-Supplemental Questions
Child Welfare Virtual Conference Exit Survey
Child Welfare Virtual Conference Focus Group Guide
Child Welfare Virtual Conference Interview Guide
Child Welfare Virtual Conference Registration Form
Child Welfare Virtual Conference Session Surveys
Service Delivery and Tracking and Adjustment Observation-Group Debrief
Tailored Services Practice Model Survey

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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	4,319	7,431	0	-3,112	0	0
Annual Time Burden (Hours)	390	672	0	-282	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Burden decrease due to lower than expected response rates for most instruments during the previous administration of the instruments.

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Annual Cost to Federal Government: $46,485

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? 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: 08/14/2020

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