Maternal Health Portfolio Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Supporting Statement A_2023.docx	Supporting Statement A	Uploaded 2024-01-10	Repair queued
Supporting Statement B_2023.docx	Supporting Statement B	Uploaded 2024-01-10	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
244129	Web-Based Data Collection Tool Question Pool	Other-Survey	Modified
244128	Partnership Survey	Other-Survey	Modified
244127	Interview Protocol for HRSA MH Portfolio Grantees	Instruction	Modified
244126	Interview Protocol for HRSA POs	Instruction	Modified

ICR Details

OMB Control No: 0906-0059	ICR Reference No: 202401-0906-001
Status: Active	Previous ICR Reference No: 202010-0906-003
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Maternal Health Portfolio Evaluation
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: 02/25/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/12/2024
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2027	36 Months From Approved	02/29/2024
Responses	224	0	387
Time Burden (Hours)	121	0	167
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this project is to gather credible evidence on the activities and impact of the HRSA Maternal Health Portfolio, which can be used to assess how programs were designed and implemented and evaluate their associated outcomes. These findings will be used for future decision making on efforts to address maternal mortality and severe maternal morbidity. Respondents include HRSA Project Officers, MH grantees, and grantee partners.

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Authorizing Statute(s): PL: Pub.L. 115 - 245 501(1)(2) and 701(a)(2) Name of Law: SSA Title V
   US Code: 42 USC 912(b)(5)) Section 711(b)(5) Name of Law: SSA
  

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:
	88 FR 63965	09/18/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 86910	12/15/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
Interview Protocol for HRSA MH Portfolio Grantees
Interview Protocol for HRSA POs
Partnership Survey
Web-Based Data Collection Tool Question Pool

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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	224	387	0	-163	0	0
Annual Time Burden (Hours)	121	167	0	-46	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden has been reduced from the burden shown in the current inventory because only 12 grantees were included in the data collection activities instead of 15. Additionally, the current inventory overestimated the burden of the partnership survey (it reflected that the survey will be fielded annually) so the revised burden was reduced to reflect that the survey is administered biannually (twice total). We also changed the average burden per respondent for interviews with the grantee staff from 1 to 1.125 because interviews are supposed to be 90 minutes in the final year (compared to 60 minutes in other years). Because the total number of grantees interviewed changed from 15 to 12, adjusting the average burden per respondent for the interviews with grantee staff did not increase the overall burden for this data collection instrument (it actually decreased). .

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Annual Cost to Federal Government: $975,221

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]? 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? No

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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: 01/12/2024

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