Services Provided to Unaccompanied Children

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 UC Case Status	Form and Instruction	New	Available
Form S-24 Sponsor Application	Form and Instruction	New	Available
Form S-24 Sponsor Application (Form S-24)	Form and Instruction	New	Repair queued
Form S-23 Case Manager Call Log and Case Notes	Form and Instruction	New	Available
Form S-23 Case Manager Call Log and Case Notes (Form S-23)	Form and Instruction	New	Repair queued
Form S-22 Post-Release Service (PRS) Event	Form and Instruction	New	Repair queued
Form S-22 Post-Release Service (PRS) Event (Form S-22)	Form and Instruction	New	Repair queued
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile	Form and Instruction	New	Available
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	Form and Instruction	New	Repair queued
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile	Form and Instruction	New	Available
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction	New	Repair queued
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity	Form and Instruction	New	Available
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	Form and Instruction	New	Repair queued
Form S-21A HS-PRS Primary Provider Entity	Form and Instruction	New	Available
Form S-21A Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	Form and Instruction	New	Repair queued
Form S-20 UC Authorized-Restricted Call List and Call Log - UC Path Version	Form and Instruction	New	Available
Form S-20 UC Authorized/Restricted Call List and Call Log (Form S-20)	Form and Instruction	New	Repair queued
Form S-19 HS-PRS Referral - UC Path Version	Form and Instruction	New	Available
Form S-19 Home Study/Post-Release Service (HS/PRS) Referral (Form S-19)	Form and Instruction	New	Repair queued
Form S-18 Admission	Form and Instruction	Modified	Available
Form S-18 Admission (Form S-18)	Form and Instruction	Modified	Repair queued
Form S-16 Thirty Day Restrictive Placement Case Review	Form and Instruction	Modified	Available
Form S-16 Thirty Day Restrictive Placement Case Review (Form S-16)	Form and Instruction	Modified	Repair queued
Form S-15 Child Advocate Recommendation and Appointment	Form and Instruction	Modified	Available
Form S-15 Child Advocate Recommendation and Appointment (Form S-15)	Form and Instruction	Modified	Repair queued
Form S-14 Long Term Foster Care Travel Request - UC Portal Version	Form and Instruction	Modified	Available
Form S-14 Long Term Foster Care Travel Request - UC Path Version	Form and Instruction	Modified	Available
Form S-14 Long Term Foster Care Travel Request (Form S-14)	Form and Instruction	Modified	Repair queued
Form S-13 Individual Service Plan - UC Portal Version	Form and Instruction	Modified	Available
Form S-13 Individual Service Plan - UC Path Version	Form and Instruction	Modified	Available
Form S-13 Individual Service Plan (Form S-13)	Form and Instruction	Modified	Repair queued
Form S-12 UC Case Review - UC Portal Version	Form and Instruction	Modified	Available
Form S-12 UC Case Review - UC Path Version	Form and Instruction	Modified	Available
Form S-12 UC Case Review (Form S-12)	Form and Instruction	Modified	Repair queued
Form S-11 UC Assessment - UC Portal Version	Form and Instruction	Modified	Available
Form S-11 UC Assessment - UC Path Version	Form and Instruction	Modified	Available
Form S-11 UC Assessment (Form S-11)	Form and Instruction	Modified	Repair queued
Form S-9 Assessment for Risk - UC Portal Version	Form and Instruction	Modified	Available
Form S-9 Assessment for Risk - UC Path Version	Form and Instruction	Modified	Available
Form S-9 Assessment for Risk (Form S-9)	Form and Instruction	Modified	Repair queued
Form S-8 Initial Intakes Assessment - UC Portal Version	Form and Instruction	Modified	Repair queued
Form S-8 Initial Intakes Assessment (Form S-8) - UC Path Version	Form and Instruction	Modified	Available
Form S-8 Initial Intakes Assessment (Form S-8)	Form and Instruction	Modified	Repair queued
Form S-7 Adult Contact Profile	Form and Instruction	Modified	Available
Form S-7 Adult Contact Profile (Form S-7)	Form and Instruction	Modified	Repair queued
Form S-6 Home Study Assessment - Word Version	Form and Instruction	Modified	Available
Form S-6 Home Study Assessment - UC Path Version	Form and Instruction	Modified	Available
Form S-6 Home Study Assessment (Form S-6)	Form and Instruction	Modified	Repair queued
Form S-5 Sponsor Assessment - Word Version	Form and Instruction	Modified	Repair queued
Form S-5 Sponsor Assessment - UC Path Version	Form and Instruction	Modified	Available
Form S-5 Sponsor Assessment (Form S-5)	Form and Instruction	Modified	Repair queued
SSA Attachment A_0970-0553_Services_002_2021 09 27 FINAL.docx	Supplementary Document	Uploaded 2021-09-29	Repair queued
SSA_0970-0553_Services_002_2021 09 27 FINAL.docx	Supporting Statement A	Uploaded 2021-09-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
249583	UC Case Status	Form and Instruction	New	UC Case Status
249583	Ohio Youth Assessment System (OYAS) Reentry Tool	Other-Copyrighted Tool	New
249581	Sponsor Application (Form S-24)	Form and Instruction	New	Sponsor Application
249581	Sponsor Application (Form S-24)	Form and Instruction	New
249580	Case Manager Call Log and Case Notes (Form S-23)	Form and Instruction	New	Case Manager Call Log and Case Notes
249580	Case Manager Call Log and Case Notes (Form S-23)	Form and Instruction	New
249579	Post-Release Service (PRS) Event (Form S-22)	Form and Instruction	New	Post-Release Service (PRS) Event
249579	Post-Release Service (PRS) Event (Form S-22)	Form and Instruction	New
249578	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	Form and Instruction	New	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile
249578	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	Form and Instruction	New
249577	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction	New	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile
249577	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction	New
249576	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	Form and Instruction	New	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity
249576	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	Form and Instruction	New
249575	Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	Form and Instruction	New	HS-PRS Primary Provider Entity
249575	Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	Form and Instruction	New
249574	UC Authorized/Restricted Call List and Call Log (Form S-20)	Form and Instruction	New	UC Authorized-Restricted Call List and Call Log - UC Path Version
249574	UC Authorized/Restricted Call List and Call Log (Form S-20)	Form and Instruction	New
249573	Home Study/Post-Release Service (HS/PRS) Referral (Form S-19)	Form and Instruction	New	HS-PRS Referral - UC Path Version
249573	Home Study/Post-Release Service (HS/PRS) Referral (Form S-19)	Form and Instruction	New
242815	Admission (Form S-18)	Form and Instruction	Modified	Admission
242815	Admission (Form S-18)	Form and Instruction	Modified
242814	Thirty Day Restrictive Placement Case Review (Form S-16)	Form and Instruction	Modified	Thirty Day Restrictive Placement Case Review
242814	Thirty Day Restrictive Placement Case Review (Form S-16)	Form and Instruction	Modified
242813	Child Advocate Recommendation and Appointment (Form S-15)	Form and Instruction	Modified	Child Advocate Recommendation and Appointment
242813	Child Advocate Recommendation and Appointment (Form S-15)	Form and Instruction	Modified
242812	Long Term Foster Care Travel Request (Form S-14)	Form and Instruction	Modified	Long Term Foster Care Travel Request - UC Portal Version
242812	Long Term Foster Care Travel Request (Form S-14)	Form and Instruction	Modified	Long Term Foster Care Travel Request - UC Path Version
242812	Long Term Foster Care Travel Request (Form S-14)	Form and Instruction	Modified
242811	Individual Service Plan (Form S-13)	Form and Instruction	Modified	Individual Service Plan - UC Portal Version
242811	Individual Service Plan (Form S-13)	Form and Instruction	Modified	Individual Service Plan - UC Path Version
242811	Individual Service Plan (Form S-13)	Form and Instruction	Modified
242810	UC Case Review (Form S-12)	Form and Instruction	Modified	UC Case Review - UC Portal Version
242810	UC Case Review (Form S-12)	Form and Instruction	Modified	UC Case Review - UC Path Version
242810	UC Case Review (Form S-12)	Form and Instruction	Modified
242809	UC Assessment (Form S-11)	Form and Instruction	Modified	UC Assessment - UC Portal Version
242809	UC Assessment (Form S-11)	Form and Instruction	Modified	UC Assessment - UC Path Version
242809	UC Assessment (Form S-11)	Form and Instruction	Modified
242808	Assessment for Risk (Form S-9)	Form and Instruction	Modified	Assessment for Risk - UC Portal Version
242808	Assessment for Risk (Form S-9)	Form and Instruction	Modified	Assessment for Risk - UC Path Version
242808	Assessment for Risk (Form S-9)	Form and Instruction	Modified
242807	Initial Intakes Assessment (Form S-8)	Form and Instruction	Modified	Initial Intakes Assessment - UC Portal Version
242807	Initial Intakes Assessment (Form S-8)	Form and Instruction	Modified	Initial Intakes Assessment (Form S-8) - UC Path Version
242807	Initial Intakes Assessment (Form S-8)	Form and Instruction	Modified
242806	Adult Contact Profile (Form S-7)	Form and Instruction	Modified	Adult Contact Profile
242806	Adult Contact Profile (Form S-7)	Form and Instruction	Modified
242805	Home Study Assessment (Form S-6)	Form and Instruction	Modified	Home Study Assessment - Word Version
242805	Home Study Assessment (Form S-6)	Form and Instruction	Modified	Home Study Assessment - UC Path Version
242805	Home Study Assessment (Form S-6)	Form and Instruction	Modified
242804	Sponsor Assessment (Form S-5)	Form and Instruction	Modified	Sponsor Assessment - Word Version
242804	Sponsor Assessment (Form S-5)	Form and Instruction	Modified	Sponsor Assessment - UC Path Version
242804	Sponsor Assessment (Form S-5)	Form and Instruction	Modified

ICR Details

OMB Control No: 0970-0553	ICR Reference No: 202109-0970-020
Status: Historical Active	Previous ICR Reference No: 202107-0970-001
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR
Title: Services Provided to Unaccompanied Children
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: 04/21/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/30/2021
Terms of Clearance: We thank the agency for agreeing to remove the OYAS Tool from this information collection, which we agree would not be appropriate for use in this setting. Any prior use of this instrument without a valid OMB control number will be documented in OMB's annual report to Congress. We further thank the agency for inserting age skips for sensitive questions regarding sexual behavior in S-9 to reflect that these questions would not be asked of young children. Finally, we agree with the agency’s decision to remove additional proposed questions related to gang affiliation in response to public comment and to rephrase related questions on the Home Study Assessment.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2025	36 Months From Approved	04/30/2022
Responses	4,439,457	0	888,622
Time Burden (Hours)	1,219,453	0	384,209
Cost Burden (Dollars)	0	0	0

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Abstract: ORR’s UC Program provides care and custody for UC until they can be safely released to a sponsor, repatriated to their home country, or obtain legal status. ORR funds residential care provider facilities that provide temporary housing and other services to UC in ORR custody. Care provider facilities are State licensed, with the exception of temporary influx care facilities, and must meet ORR requirements to ensure a high-level quality of care. Services provided at care provider facilities include, but are not limited to, education, recreation, vocational training, acculturation, nutrition, medical, mental health, legal, and case management. The instruments included in this information collection are directly relate to the care of UC for processing pursuant to the Paperwork Reduction Act. These instruments allow ORR to provide services to UC as required by statute and ORR policy.

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Authorizing Statute(s): US Code: 6 USC 279 Name of Law: Homeland Security Act (HSA)
   US Code: 8 USC 1232 Name of Law: Trafficking Victims Protection Reauthorization Act of 2008
  

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:
	86 FR 11537	02/25/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 54202	09/30/2021
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 22

table that charts list of burden

IC Title	Form No.	Form Name
Admission (Form S-18)	S-18	Admission
Adult Contact Profile (Form S-7)	S-7	Adult Contact Profile
Assessment for Risk (Form S-9)	S-9, S-9	Assessment for Risk - UC Path Version ,   Assessment for Risk - UC Portal Version
Case Manager Call Log and Case Notes (Form S-23)	S-23	Case Manager Call Log and Case Notes
Child Advocate Recommendation and Appointment (Form S-15)	S-15	Child Advocate Recommendation and Appointment
Home Study Assessment (Form S-6)	S-6, S-6	Home Study Assessment - UC Path Version ,   Home Study Assessment - Word Version
Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	S-21A	HS-PRS Primary Provider Entity
Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	S-21C	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile
Home Study/Post-Release Service (HS/PRS) Referral (Form S-19)	S-19	HS-PRS Referral - UC Path Version
Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	S-21B	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity
Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	S-21D	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile
Individual Service Plan (Form S-13)	S-13, S-13	Individual Service Plan - UC Path Version ,   Individual Service Plan - UC Portal Version
Initial Intakes Assessment (Form S-8)	S-8, S-8	Initial Intakes Assessment (Form S-8) - UC Path Version ,   Initial Intakes Assessment - UC Portal Version
Long Term Foster Care Travel Request (Form S-14)	S-14, S-14	Long Term Foster Care Travel Request - UC Path Version ,   Long Term Foster Care Travel Request - UC Portal Version
Post-Release Service (PRS) Event (Form S-22)	S-22	Post-Release Service (PRS) Event
Sponsor Application (Form S-24)	S-24	Sponsor Application
Sponsor Assessment (Form S-5)	S-5, S-5	Sponsor Assessment - UC Path Version ,   Sponsor Assessment - Word Version
Thirty Day Restrictive Placement Case Review (Form S-16)	S-16	Thirty Day Restrictive Placement Case Review
UC Assessment (Form S-11)	S-11, S-11	UC Assessment - UC Path Version ,   UC Assessment - UC Portal Version
UC Authorized/Restricted Call List and Call Log (Form S-20)	S-20	UC Authorized-Restricted Call List and Call Log - UC Path Version
UC Case Review (Form S-12)	S-12, S-12	UC Case Review - UC Path Version ,   UC Case Review - UC Portal Version
UC Case Status	1	UC Case Status

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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	4,439,457	888,622	0	3,550,835	0	0
Annual Time Burden (Hours)	1,219,453	384,209	0	835,244	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: ORR revised 11 instruments currently approved under OMB #0970-0553 and added 11 new instruments to this collection. All instruments will be incorporated into ORR’s new case management system, UC Path. In addition, ORR plans to remove one currently approved instrument from this collection. Finally, ORR replaced the term “unaccompanied alien child (UAC)” with “unaccompanied child (UC)” throughout the instruments in this collection. Note that the screenshots of UC Path instruments attached to this package do not reflect this change because it has not yet been developed in the system. However, the revision in terminology will be made before the system is launched. ORR removed the term “alien” from the title of this information collection and revise it to read “Services Provided to Unaccompanied Children.” ORR intends to conduct a phased rollout of the UC Path system. Beginning Fall 2021, ORR plans to roll the UC Path system out to a small group of care provider programs. ORR will gradually expand use of the system to other programs and expects all care provider programs will be using UC Path by Spring 2022. To ensure continuity of operations, care provider programs will need the ability to continue using instruments in the UC Portal system and in other formats (e.g., PDF, Excel) while they are waiting to transition over to the UC Path system. Therefore, ORR requests OMB’s approval to continue use of as detailed in A15 of the Supporting Statement. Although all care providers are expected to be using UC Path by Spring 2022, ORR requests approval to continue using these instruments for up to one year to account for any unexpected technical issues that may arise during rollout. These versions were last approved by OMB on March 10, 2021.

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Annual Cost to Federal Government: $1,531,207,125

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.     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.     Yes

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? Yes

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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: 09/30/2021

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