Generic PPR Submission Form - Community Collaborations SAPR Appendix B - Apr 2022 Update

Request for approval under the clearance of the “Generic Performance Progress Report” OMB control Number: 0970-0490 ______________________________________________________________________________

TITLE OF INFORMATION COLLECTION: Community Collaborations to Strengthen and Preserve Families Racial Equity Semi Annual Performance Progress Report

PURPOSE: The Community Collaborations to Strengthen and Preserve Families grant supports the development, implementation, and evaluation of primary prevention strategies to improve the safety, stability, and well-being of families through a continuum of community-based services and supports. Grantees are charged to design and implement highly coordinated and comprehensive family support systems in traditionally underserved areas to mitigate the causes of family vulnerability by enhancing community protective factors and parental protective capacities in racially and culturally appropriate ways. CB believes that communities can create environments and family supports to prevent initial occurrence of child maltreatment and avoid formal involvement with the child welfare system.

The race equity supplement supports the development and/or enhancement of Community Collaboration programs, activities, and services to address racial disparity and promote racial equity and inclusion in child welfare and family systems, especially in underserved communities. Efforts towards developing a shared understanding of the root causes of inequalities in child welfare systems; restructuring policies and practices to incorporate equity to address systemic racism; and institutionalizing program strategies and evaluation activities to support systemic equity advancement are in progress. Funds are used for purposes such as community assessment, training/education, data collection and analysis, and enhancing existing collaboratives with focus on increasing community engagement around equity and improved access.

CB currently collects performance and progress data from grantees through semiannual progress reports (SAPRs), as approved under the Generic Performance Progress Report (ICR Ref. No. 201703-0970-007). CB would like to gather additional performance and progress data from each grantee around a similar set of questions related to the implementation and outcomes from activities conducted through the supplemental funding. The collection of this additional information would be utilized to determine the success of current activities and potential funding opportunities for future related activities, future TA products and/or for planning content for future annual grantees meetings. Data would be collected in conjunction with the currently approved SAPRs.

DESCRIPTION OF RESPONDENTS: (e.g. states or type of non-profit)

Current CB grantees made up of State, county, and tribal governments and non-profits.

CERTIFICATION:

I certify the following to be true:

1. The collection is in compliance with HHS regulations.

2. The collection is non-controversial and does not raise issues of concern to other federal agencies.

3. Information gathered is meant primarily for program improvement and accountability.

Name and Title:____Tracy Fields, Child Welfare Program Specialist ______

To assist OMB review of your request, please provide answers to the following question:

PERSONALLY IDENTIFIABLE INFORMATION:

1. Is personally identifiable information (PII) collected? [ ] Yes [X ] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

BURDEN HOURS

Category of Respondent	No. of Respondents	No. of Responses per Respondent per year	Burden per Response	Annual Burden
State, Local, or Tribal Govt	5	2	13 hours	130 hours
Private Sector	8	2	13 hours	208 hours
Totals				338

FEDERAL COST: The estimated annual cost to the federal government is ____$1,200____

TYPE OF COLLECTION:

How will you collect the information? (Check all that apply)

[ ] Web-based

X ] E-mail

[ ] Paper mail

[X ] Other, Explain – Grantees email the SAPR to the Federal Project Officer and load it to Grant Solutions, an electronic data base for managing grant actions.

Please make sure that all instruments, instructions, and scripts are submitted with the request.

Instructions for completing Request for Approval under the “Generic Performance Progress Report”

____________________________________________________________________________

FORM AND INSTRUCTIONS

• All PPR instruments must display the following required PRA information:

  • OMB Control Number: 0970-0490

Expiration date: 01/31/2023

• The following PRA Burden Statement. The following template can be used. For red text in brackets, choose the best option and delete the other bracketed option(s). Replace highlighted areas with content specific to your collection. 

PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: [Through this information collection, ACF is gathering information to….]/[The purpose of this information collection is to….]. Public reporting burden for this collection of information is estimated to average XX hours per grantee, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This collection of information is required to retain a benefit (cite authority). An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. If you have any comments on this collection of information, please contact….

• Please note the following:

  • The PPR should not request sensitive information

  • All grantees must adhere to 45 CFR § 75.303 (e) to take reasonable measures to safeguard protected personally identifiable information of program participants.

• Submit the data collection form as one individual file and the instruction document as one individual file.

SUBMISSION FORM

TITLE OF INFORMATION COLLECTION: Provide the name of the collection that is the subject of the request.

PURPOSE: Provide a brief description of the purpose of this collection and how it will be used.

DESCRIPTION OF RESPONDENTS: Provide a brief description of the targeted group or groups for this collection of information. These groups must have experience with the program.

CERTIFICATION: Please read the certification carefully. If you incorrectly certify, the collection will be returned as improperly submitted or it will be disapproved.

PERSONALLY IDENTIFIABLE INFORMATION (PII): Provide answers to the questions. Note: Agencies should only collect PII to the extent necessary, and they should only retain PII for the period of time that is necessary to achieve a specific objective.

BURDEN HOURS:

Category of Respondents: Identify who you expect the respondents to be in terms of the following categories: (1) Individuals or Households; (2) Private Sector; (3) State, Local, or Tribal Government; or (4) Federal Government. Only one type of respondent can be selected per row.

No. of Respondents: Provide an estimate of the number of respondents.

No. of Responses per Respondent: Provide the number of responses per respondent per year.

Burden per Response: Provide an estimate of the amount of time (in minutes) required for a response

Burden: Provide the burden hours by multiplying: (# of respondents) x (# or responses) x (burden per response).

FEDERAL COST: Provide an estimate of the annual cost to the federal government.

TYPE OF COLLECTION: Check all that apply. If you are requesting approval of other instruments under the generic, you must complete a form for each instrument.

Submit all instruments, instructions, and scripts with the request.

6