Services Provided to Unaccompanied Children

Forms and Documents

Document Name	Status
Form 1 UC Case Status Form and Instruction	Unchanged
Form S-24 Sponsor Application (Form S-24) Form and Instruction	Unchanged
Form S-23 Case Manager Call Log and Case Notes (Form S-23) Form and Instruction	Unchanged
Form S-22 Post-Release Service (PRS) Event (Form S-22) Form and Instruction	Unchanged
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction	Unchanged
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction	Unchanged
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) Form and Instruction	Unchanged
Form S-21A Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A) Form and Instruction	Unchanged
Form S-20 UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction	Unchanged
Form S-19 Home Study/Post-Release Service (HS/PRS) Referral (Form S-19) Form and Instruction	Unchanged
Form S-18 Admission (Form S-18) Form and Instruction	Unchanged
Form S-16 Thirty Day Restrictive Placement Case Review (Form S-16) Form and Instruction	Unchanged
Form S-15 Child Advocate Recommendation and Appointment (Form S-15) Form and Instruction	Unchanged
Form S-14 Long Term Foster Care Travel Request (Form S-14) Form and Instruction	Unchanged
Form S-13 Individual Service Plan (Form S-13) Form and Instruction	Unchanged
Form S-12 UC Case Review (Form S-12) Form and Instruction	Modified
Form S-11 UC Assessment (Form S-11) Form and Instruction	Modified
Form S-9 Assessment for Risk (Form S-9) Form and Instruction	Unchanged
Form S-8 Initial Intakes Assessment (Form S-8) Form and Instruction	Unchanged
Form S-7 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction	Modified
Form S-6 Home Study Assessment (Form S-6) Form and Instruction	Unchanged
Form S-5 Sponsor Assessment (Form S-5) Form and Instruction	Modified
0970-0553 NonSub Change Request Memo (04.21.22).docx Justification for No Material/Nonsubstantive Change	2022-04-22
SSA Attachment A_0970-0553_Services_003_2022 04 20.docx Supplementary Document	2022-04-20
SSA_0970-0553_Services_003_2022 4 22 UPDATED.docx Supporting Statement A	2022-04-22

IC Document Collections

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

ICR Details

OMB Control No: 0970-0553	ICR Reference No: 202204-0970-015
Status: Received in OIRA	Previous ICR Reference No: 202109-0970-020
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR
Title: Services Provided to Unaccompanied Children
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 04/22/2022

	Requested	Previously Approved
Expiration Date	04/30/2025	04/30/2025
Responses	4,439,457	4,439,457
Time Burden (Hours)	1,219,453	1,219,453
Cost Burden (Dollars)	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. This nonsubstantive change request is ORR is proposing revisions to the following four instruments contained in this information collection: • Sponsor Assessment (Form S-5) – This is a Word form used to conduct an in-depth suitability assessment of a potential sponsor to ensure a safe release for the UC. • New Sponsor (Form S-7) – This form is located within UC Portal (ORR’s case management system) and is used to link a potential sponsor to a UC and enter basic information about the potential sponsor and their household. • UC Assessment (Form S-11) – This UC Portal form is used to conduct an in-depth assessment that is used to inform provision of services, screen for trafficking or other safety concerns, and identify special needs. This form also contains a section that documents information about the potential sponsor. • UC Case Review (Form S-12) – This UC Portal form is used to document new information obtained after completion of the UC Assessment. The form also contains a section that documents information about the potential sponsor. All four of these forms contain information about the potential sponsor. ORR proposes consolidating all sponsor-related fields into one location in UC Portal. The New Sponsor form and Sponsor Assessment will be merged into one Sponsor Assessment form in UC Portal. In addition, sponsor-related fields in the UC Assessment and UC Case Review will be moved into the new UC Portal Sponsor Assessment. ORR also made revisions to the new UC Portal Sponsor Assessment.

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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

IC Title	Form No.	Form Name
Admission (Form S-18)	S-18	Admission
Adult Contact Profile (Portal Form S-5; Path Form S-7)	S-7, S-5	Adult Contact Profile ,   Sponsor Assessment - New UC Portal
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 - New UC Portal
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

	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	4,439,457	4,439,457	0	0	0	0
Annual Time Burden (Hours)	1,219,453	1,219,453	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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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: 04/22/2022

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