The Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Updated Attachment A _MIECHV Form 4 Revised Updates 11-22-21.docx	Form and Instruction	Modified	Available
Form 1 MIECHV Form 4 Revised CLEAN.docx	Form and Instruction	Modified	Available
Form 1 Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report	Form and Instruction	Modified	Repair queued
Attachment B_60 Day FRN_Form 4 Revision.pdf	Supplementary Document	Uploaded 2021-10-04	Repair queued
Supporting Statement A 0906-0016 Revision.docx	Supporting Statement A	Uploaded 2021-10-04	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
218304	Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report	Form and Instruction	Modified	Attachment A _MIECHV Form 4 Revised Updates 11-22-21.docx
218304	Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report	Form and Instruction	Modified	MIECHV Form 4 Revised CLEAN.docx
218304	Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report	Form and Instruction	Modified
218304	Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report	Other-Tracked Changes	Modified

ICR Details

OMB Control No: 0906-0016	ICR Reference No: 202110-0906-001
Status: Historical Active	Previous ICR Reference No: 201812-0906-002
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: The Maternal, Infant, and Early Childhood Home Visiting Program Quarterly Performance Report
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: 12/02/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/12/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2024	36 Months From Approved	02/28/2022
Responses	488	0	264
Time Burden (Hours)	18,752	0	13,376
Cost Burden (Dollars)	0	0	0

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Abstract: This clearance request is for continued approval of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Quarterly Performance Report. The MIECHV Program, administered by HRSA in partnership with the Administration for Children and Families, supports voluntary, evidence-based home visiting services during pregnancy and to parents with young children up to kindergarten entry. HRSA is seeking to revise quarterly 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. MIECHV Program awardees that are states, territories, and, where applicable, nonprofit organizations receiving MIECHV funding to provide home visiting services within states.

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Authorizing Statute(s): US Code: 42 USC 701, Section 511 Name of Law: Bipartisan Budget Act of 2018
  

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 35809	07/07/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 56279	10/08/2021
Did the Agency receive public comments on this ICR? No

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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 Quarterly Performance Report	1, 1 Updated	MIECHV Form 4 Revised CLEAN.docx ,   Attachment A _MIECHV Form 4 Revised Updates 11-22-21.docx

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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	488	264	0	224	0	0
Annual Time Burden (Hours)	18,752	13,376	0	5,376	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: Burden increase due to an increase in the frequency of data collection for Form 4, section A from 4 responses to 8 per year.

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Annual Cost to Federal Government: $284,645

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]? Yes

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: 10/12/2021

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