Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System	Form and Instruction	Modified	Repair queued
Attachment E - 60 Day FRN.pdf	Supplementary Document	Uploaded 2021-04-16	Repair queued
MIECHV_ Supporting Statement A_030820.docx	Supporting Statement A	Uploaded 2021-04-16	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
219429	Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System	Form and Instruction	Modified

ICR Details

OMB Control No: 0906-0017	ICR Reference No: 202104-0906-005
Status: Received in OIRA	Previous ICR Reference No: 201805-0906-002
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/19/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved	07/31/2021
Responses	56	56
Time Burden (Hours)	44,800	42,560
Cost Burden (Dollars)	0	0

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Abstract: HRSA is seeking to revise annual performance measurement information collected from MIECHV Program awardees. Performance information is used to demonstrate program accountability and to continuously monitor and provide oversight to MIECHV Program awardees. The information will be used to provide quality improvement guidance and technical assistance and to help inform the development of early childhood systems. The respondents will be state and territorial governments and eligible non-profit organizations.

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Authorizing Statute(s): US Code: 42 USC 701 section 511 Name of Law: Social Security Act, Sct 511
  

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 82490	12/18/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 20372	04/19/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System	1, 2	Attachment A - DEMOGRAPHIC, SERVICE UTILIZATION, AND SELECT CLINICAL INDICATORS ,   Attachment B - PERFORMANCE AND SYSTEMS OUTCOME MEASURES

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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	56	56	0	0	0	0
Annual Time Burden (Hours)	44,800	42,560	0	2,240	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: The increase is due to a burden reevaluation for Form # 2, Performance Indicators and System Outcome Measures.

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Annual Cost to Federal Government: $520,459

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: 04/19/2021

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