Attachment B: Previously approved submission form (2021)

Request for Approval under the clearance of the “Generic for ACF Program Office Monitoring Activities” Office of Management and Budget (OMB) Control Number: 0970-0558

TITLE OF INFORMATION COLLECTION: Office of Head Start Disaster Recovery Improper Payment Reviews

PURPOSE: This information collection will help the Office of Head Start (OHS) examine grantee use of federal funds related to disaster relief in accordance with the Improper Payments Information Act 2002. More specifically, OHS will review expenditures equal to the sum-total of charged payments to Disaster Relief Act subaccounts in the Payment Management System to determine if there are improper payments among Head Start grantees who received Disaster Relief Act funding for the hurricanes of FY 2017 and natural disasters of FY 2018/2019. ACF will use the reviews to determine if sampled items are supported by adequate documentation and are reasonable, allocable, and necessary to the objective of the Disaster Relief Act funds, and terms and conditions of the Notice of Awards.

DESCRIPTION OF RESPONDENTS: Respondents include current Head Start grantees who were awarded federal funding related to relief and recovery from natural disasters.

The FY2017 grantees had necessary expenses directly related to the consequences of Hurricanes Harvey, Irma and Maria. The FY2017 grantees are non-profits or local governments located in Georgia, Florida, Kentucky, Puerto Rico, South Carolina, Texas and the US Virgin Islands.

The FY2018 and 2019 grantees had necessary expenses directly related to the consequences of Hurricanes Florence and Michael, Typhoon Mangkhut, Super Typhoon Yutu, and wildfires and earthquakes occurring in calendar year 2018 and tornadoes and floods occurring in calendar year 2019 in those areas for which a major disaster or emergency has been declared under section 401 or 501 of the Robert T. Stafford Disaster Relief and Emergency Assistance Act. The FY2018 and 2019 grantees are non-profits, state agencies or universities located in Alaska, California, Florida, Georgia, Kentucky, Louisiana, Mississippi, Nebraska, North Carolina, Northern Mariana Islands, Ohio, and Tennessee.

There are 48 private sector agencies awarded a total of 88 grants. There are 32 public sector agencies awarded a total of 119 grants.

CERTIFICATION:

I certify the following to be true:

1. The collection is in compliance with U.S. Health and Human Services regulations.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

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

4. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

Name: Stefanie Gordon, Grants Management Officer, Office of Grants Management

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 [X] No

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

BURDEN HOURS

We estimate that responses will take respondents anywhere from 15 minutes to 4 hours to complete. We have estimated an average time to complete as 1 hour.

Category of Respondent	No. of Respondents	No. of Responses per Respondent per year	Burden per Response	Annual Burden
Private Sector	48	1	1 hour	48
State, Local, or Tribal Governments	32	1	1 hour	32
Totals	80	1	1 hour	80 hours

FEDERAL COST: The estimated annual cost to the Federal Government is $39,980.

TYPE OF COLLECTION:

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

[x] Web-based

[ ] E-mail

[ ] Paper mail

[ ] Other, Explain

Please make sure to submit all instruments, instructions, and scripts with the request.

Included is:

Attachment A: Disaster Supplement Payment Management System Reconciliation Example

Attachment B1: 2017 disaster recovery funds improper payment reviews notification letter

Attachment B2: 2017 disaster recovery funds improper payment reviews notification letter in Spanish

Attachment C: 2018-19 disaster recovery funds improper payment reviews notification letter

3