Family Level Assessment and State of Home Visiting (FLASH-V) Outreach and Recruitment Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement A.docx	Supporting Statement A	Uploaded 2020-09-18	Repair queued
Supporting Statement B.docx	Supporting Statement B	Uploaded 2020-09-18	Repair queued
Appendix K_Interview Consent Form.docx	Supplementary Document	Uploaded 2020-09-18	Repair queued
Appendix J_Interview Topics and Sub-Topics.docx	Supplementary Document	Uploaded 2020-09-18	Repair queued
Appendix I_Email Templates Providing Interview Information Confirmation and Thank You.docx	Supplementary Document	Uploaded 2020-09-18	Repair queued
Appendix H_Email Templates to LIAs Requesting Interview.docx	Supplementary Document	Uploaded 2020-09-18	Missing upstream
Appendix G_Project Description.docx	Supplementary Document	Uploaded 2020-09-18	Missing upstream
Appendix F_Email Templates to LIAs Requesting Survey Participation.docx	Supplementary Document	Uploaded 2020-09-18	Repair queued
Appendix E_FLASH-V Study Design Changes in Response to Public Comments.docx	Supplementary Document	Uploaded 2020-09-18	Repair queued
Appendix D_60 Day FRN Public Comment 3.pdf	Supplementary Document	Uploaded 2020-09-18	Missing upstream
Appendix C_60 Day FRN Public Comment 2.pdf	Supplementary Document	Uploaded 2020-09-18	Repair queued
Appendix B_60 Day FRN Public Comment 1.pdf	Supplementary Document	Uploaded 2020-09-18	Missing upstream
Appendix A_60 Day FRN.pdf	Supplementary Document	Uploaded 2020-09-18	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
243696	Instrument 3: LIA Interview Protocol	Other-LIA Interview Protocol	New
243695	Instrument 2: LIA Survey	Other-LIA Survey	New
243694	Instrument 1: Request for LIA Contact Information from MIECHV Leads	Other-Request for LIA Contact Information from MIECHV Lead	New

ICR Details

OMB Control No:	ICR Reference No: 202009-0970-008
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: OPRE
Title: Family Level Assessment and State of Home Visiting (FLASH-V) Outreach and Recruitment Study
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/22/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	24 Months From Approved
Responses	478	0
Time Burden (Hours)	247	0
Cost Burden (Dollars)	0	0

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Abstract: This is a request to use surveys and semi-structured telephone interviews to gather information about how Maternal, Infant, and Early Childhood Home Visiting (MIECHV) state and territory local implementing agencies (LIAs) and tribal grantees (hereafter referred to collectively as MIECHV funded LIAs) recruit families for program participation and work with their community referral partners to recruit families. The request also includes collection of select MIECHV funded LIAs’ outreach and recruitment materials to gather information on the content and messages contained within. We do not intend for this information to be used as the principal basis for public policy decisions. The request is for a descriptive study with the purpose of understanding challenges programs may face in reaching caseload capacity to help identify ways programs can reach more families who could benefit from home visiting.

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Authorizing Statute(s): US Code: 42 USC 711 Name of Law: Social Security Act, Maternal and Child Health Services Block Grant
  

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 3922	01/23/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 59318	09/21/2020
Did the Agency receive public comments on this ICR? Yes

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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
Instrument 1: Request for LIA Contact Information from MIECHV Leads
Instrument 2: LIA Survey
Instrument 3: LIA Interview Protocol

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	478	0	0	478	0	0
Annual Time Burden (Hours)	247	0	0	247	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.

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Annual Cost to Federal Government: $460,030

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: 09/22/2020

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