Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System

Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System

OMB: 0906-0017

IC ID: 219429

Information Collection (IC) Details

View Information Collection (IC)

Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System
 
No Modified
 
Required to Obtain or Retain Benefits
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 DEMOGRAPHIC, SERVICE UTILIZATION, AND SELECT CLINICAL INDICATORS Appendix A. Form 1 09092024.docx Yes Yes Fillable Fileable
Form and Instruction 2 PERFORMANCE AND SYSTEMS OUTCOME MEASURES Appendix B. Form 2 09092024.docx Yes Yes Fillable Fileable

Health Health Care Services

 

56 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 56 0 0 0 0 56
Annual IC Time Burden (Hours) 43,736 0 -1,064 0 0 44,800
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

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