Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 1: Demographic and Service Utilization Data

ICR 202204-0970-021

OMB: 0970-0389

Federal Form Document

Forms and Documents
Document
Name
Status
Form and Instruction
Modified
Justification for No Material/Nonsubstantive Change
2022-04-29
Justification for No Material/Nonsubstantive Change
2022-04-05
Supplementary Document
2022-03-31
Supporting Statement A
2022-03-31
IC Document Collections
ICR Details
0970-0389 202204-0970-021
Received in OIRA 202204-0970-002
HHS/ACF OCC
Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 1: Demographic and Service Utilization Data
No material or nonsubstantive change to a currently approved collection   No
Regular 05/02/2022
  Requested Previously Approved
04/30/2025 04/30/2025
23 23
11,500 11,500
0 0

Section 511 of the Social Security Act, created the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and authorized the Secretary of the Department of Health and Human Services (HHS) (in Section 511(h)(2)(A)) to award grants to Indian tribes (or a consortium of Indian tribes), tribal organizations, or urban Indian organizations to conduct an early childhood home visiting program. The legislation set aside 3 percent of the total MIECHV program appropriation for grants to tribal entities. Tribal MIECHV grants, to the greatest extent practicable, are to be consistent with the requirements of the MIECHV grants to states and jurisdictions and include conducting a needs assessment and establishing quantifiable, measurable benchmarks. In Years 2-5 when Tribal MIECHV grantees are implementing home visiting services, they must submit to ACF Form 1: Demographic and Service Utilization Data to satisfy the legislative requirements of the program. Overall, this information collection provides valuable information to HHS that will guide understanding of Tribal MIECHV grantees and the provision of technical assistance (TA) needed to support the Tribal MIECHV Program. The Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 1: Demographic and Service Utilization Data (OMB #0970-0389) was renewed on April 1, 2022. The categories of staff listed under the recently approved Instructions and Definitions of Key Terms include 4 categories: Home Visitors, Project Directors/Managers/Coordinators, Data/Evaluation Staff and Project Support Staff. After submitting a nonsubstantive change request, category fields were added to the actual form to match the approved Instructions and Definitions of Key Terms. Further analysis of costs associated with modifying and adding the Data/Evaluation Staff and Project Support Staff fields in the Tribal Home Visiting Reporting System (THVRS) to match the Form 1 nonsubstantive change is not the best value to the Government at this time. The data has been determined not to be necessary for the overall purpose/use of the data collection. The change request is to eliminate rows in Form 1 that cover the 2 staff categories (Data/Evaluation Staff and Project Support Staff) that are included in the approved Instructions and Definitions of Key Terms portion of the information collection under Section B Program Staff Characteristics. The change request is minor and ensures accurate reporting. A sentence has been added in the Instructions and Definitions of Key Terms appendix to assist grantees when reporting in the system under Section B Program Staff Characteristics.

PL: Pub.L. 115 - 123 511(h)(2)(A) Name of Law: The Bipartisan Budget Act of 2018; Title V of SSA
  
None

Not associated with rulemaking

  86 FR 66314 11/22/2021
87 FR 5823 02/02/2022
No

1
IC Title Form No. Form Name
Tribal MIECHV Form 1: Demographic and Service Utilization Data and Service 1 Demographic and Service Utilization Data and Service

  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 23 23 0 0 0 0
Annual Time Burden (Hours) 11,500 11,500 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$93,000
No
    No
    No
No
No
No
No
Molly Buck 202 205-4724 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/02/2022


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