Services Provided to Unaccompanied Children

Forms and Documents

Document Name	Status
Form S-26 Home Study Referral (Form S-26) Form and Instruction	New
Form S-26 Home Study Referral (Form S-26) Form and Instruction	New
Form 1 UC Case Status Form and Instruction	Modified
Form 1 UC Case Status Form and Instruction	Modified
Form S-24 Sponsor Application (Form S-24) 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	Modified
Form S-23 Case Manager Call Log and Case Notes (Form S-23) Form and Instruction	Modified
Form S-22 Post-Release Service (PRS) Event (Form S-22) 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	Modified
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction	Modified
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction	Modified
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction	Modified
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) 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-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	Modified
Form S-20 UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction	Modified
Form S-19 Post-Release Service (PRS) Referral (Form S-19) Form and Instruction	Modified
Form S-19 Post-Release Service (PRS) Referral (Form S-19) Form and Instruction	Modified
Form S-18 Admission (Form S-18) Form and Instruction	Modified
Form S-18 Admission (Form S-18) Form and Instruction	Modified
Form S-15 Child Advocate Recommendation and Appointment (Form S-15) 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	Modified
Form S-14 Long Term Foster Care Travel Request (Form S-14) Form and Instruction	Modified
Form S-13 Individual Service Plan (Form S-13) Form and Instruction	Modified
Form S-13 Individual Service Plan (Form S-13) Form and Instruction	Modified
Form S-12 UC Case Review (Form S-12) Form and Instruction	Unchanged
Form S-12 UC Case Review (Form S-12) Form and Instruction	Unchanged
Form S-11 UC Assessment (Form S-11) Form and Instruction	Unchanged
Form S-11 UC Assessment (Form S-11) Form and Instruction	Unchanged
Form S-9 Assessment for Risk (Form S-9) Form and Instruction	Unchanged
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	Modified
Form S-8 Initial Intakes Assessment (Form S-8) Form and Instruction	Modified
Form S-7 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction	Unchanged
Form S-7 Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction	Unchanged
Form S-6 Home Study Assessment (Form S-6) Form and Instruction	Modified
Form S-6 Home Study Assessment (Form S-6) Form and Instruction	Modified
Form S-5 Sponsor Assessment (Form S-5) Form and Instruction	Unchanged
Form S-5 Sponsor Assessment (Form S-5) Form and Instruction	Unchanged
Nonsub Memo Appendix A_0970-0553_Services_010_2024 08 20.xlsx Justification for No Material/Nonsubstantive Change	2024-08-21
Nonsub Memo Appendix A_0970-0553_Services_010_2024 08 20.xlsx Justification for No Material/Nonsubstantive Change	2024-08-21
Nonsub Memo_0970-0553_Services_010_2024 08 20.docx Justification for No Material/Nonsubstantive Change	2024-08-21
Nonsub Memo_0970-0553_Services_010_2024 08 20.docx Justification for No Material/Nonsubstantive Change	2024-08-21
Nonsub Memo_0970-0553_Services_009_2023 09 271.docx Justification for No Material/Nonsubstantive Change	2024-02-22
Nonsub Memo_0970-0553_Services_009_2023 09 271.docx Justification for No Material/Nonsubstantive Change	2024-02-22
Nonsub Memo_0970-0553_Services_007 _2023 10 26.docx Justification for No Material/Nonsubstantive Change	2023-10-26
Nonsub Memo_0970-0553_Services_007 _2023 10 26.docx Justification for No Material/Nonsubstantive Change	2023-10-26
Nonsub Memo_0970-0553_Services_008 _2023 09 25.docx Justification for No Material/Nonsubstantive Change	2023-09-25
Nonsub Memo_0970-0553_Services_008 _2023 09 25.docx Justification for No Material/Nonsubstantive Change	2023-09-25
Nonsub Memo_0970-0553_Services_006 _2023 07 25.docx Justification for No Material/Nonsubstantive Change	2023-07-25
Nonsub Memo_0970-0553_Services_006 _2023 07 25.docx Justification for No Material/Nonsubstantive Change	2023-07-25
Appendix B - S-5 Sponsor Assessment - Flags Section Mockup.pdf Supplementary Document	2023-07-25
Appendix B - S-5 Sponsor Assessment - Flags Section Mockup.pdf Supplementary Document	2023-07-25
Appendix A - Proposed Revisions for S-5 Sponsor Assessment - Flags Section.xlsx Supplementary Document	2023-07-25
Appendix A - Proposed Revisions for S-5 Sponsor Assessment - Flags Section.xlsx Supplementary Document	2023-07-25
0970-0553_Services_NonSub Change Request _UC Case Status_2022 05 23.docx Justification for No Material/Nonsubstantive Change	2022-06-09
0970-0553_Services_NonSub Change Request _UC Case Status_2022 05 23.docx Justification for No Material/Nonsubstantive Change	2022-06-09
0970-0553 NonSub Change Request Memo (04.21.22).docx Justification for No Material/Nonsubstantive Change	2022-04-22
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 Attachment A_0970-0553_Services_003_2022 04 20.docx Supplementary Document	2022-04-20
SSA_0970-0553_Services_003_2022 4 22 (updated 08.21.24) v3 CLEAN.docx Supporting Statement A	2024-08-21
SSA_0970-0553_Services_003_2022 4 22 (updated 08.21.24) v3 CLEAN.docx Supporting Statement A	2024-08-21

IC Document Collections

IC ID	Document Title	Status
270296	Home Study Referral (Form S-26) Form and Instruction	New
270296	Home Study Referral (Form S-26) Form and Instruction	New
249583	UC Case Status Form and Instruction	Modified
249583	UC Case Status Form and Instruction	Modified
249581	Sponsor Application (Form S-24) 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	Modified
249580	Case Manager Call Log and Case Notes (Form S-23) Form and Instruction	Modified
249579	Post-Release Service (PRS) Event (Form S-22) 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	Modified
249578	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D) Form and Instruction	Modified
249577	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction	Modified
249577	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C) Form and Instruction	Modified
249576	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B) 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
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	Modified
249574	UC Authorized/Restricted Call List and Call Log (Form S-20) Form and Instruction	Modified
249573	Post-Release Service (PRS) Referral (Form S-19) Form and Instruction	Modified
249573	Post-Release Service (PRS) Referral (Form S-19) Form and Instruction	Modified
242815	Admission (Form S-18) Form and Instruction	Modified
242815	Admission (Form S-18) Form and Instruction	Modified
242813	Child Advocate Recommendation and Appointment (Form S-15) 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	Modified
242812	Long Term Foster Care Travel Request (Form S-14) Form and Instruction	Modified
242811	Individual Service Plan (Form S-13) Form and Instruction	Modified
242811	Individual Service Plan (Form S-13) Form and Instruction	Modified
242810	UC Case Review (Form S-12) Form and Instruction	Unchanged
242810	UC Case Review (Form S-12) Form and Instruction	Unchanged
242809	UC Assessment (Form S-11) Form and Instruction	Unchanged
242809	UC Assessment (Form S-11) Form and Instruction	Unchanged
242808	Assessment for Risk (Form S-9) Form and Instruction	Unchanged
242808	Assessment for Risk (Form S-9) Form and Instruction	Unchanged
242807	Initial Intakes Assessment (Form S-8) Form and Instruction	Modified
242807	Initial Intakes Assessment (Form S-8) Form and Instruction	Modified
242806	Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction	Unchanged
242806	Adult Contact Profile (Portal Form S-5; Path Form S-7) Form and Instruction	Unchanged
242805	Home Study Assessment (Form S-6) Form and Instruction	Modified
242805	Home Study Assessment (Form S-6) Form and Instruction	Modified
242804	Sponsor Assessment (Form S-5) Form and Instruction	Unchanged
242804	Sponsor Assessment (Form S-5) Form and Instruction	Unchanged

ICR Details

OMB Control No: 0970-0553	ICR Reference No: 202408-0970-008
Status: Active	Previous ICR Reference No: 202402-0970-011
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
OIRA Conclusion Action: Approved without change	Conclusion Date: 09/03/2024
	Date Received in OIRA: 08/22/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2025	04/30/2025	04/30/2025
Responses	4,438,452	0	4,438,452
Time Burden (Hours)	1,206,453	0	1,218,699
Cost Burden (Dollars)	0	0	0

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Abstract: The Services Provided to Unaccompanied Children information collection contains 22 instruments that allow the Office of Refugee Resettlement (ORR) to collect information necessary to provide services to unaccompanied children as required by the Homeland Security Act (6 U.S.C. 279), the Trafficking Victims Protection Reauthorization Act of 2008 (8 U.S.C. 1232), and the Flores Settlement Agreement (No. CV85-4544-RJK (C.D. Cal. 1996)).  The collection was last approved by OMB on April 21, 2022, and expires on April 30, 2025. ORR is proposing changes to one form in this collection, the Home Study/Post-Release Service (HS/PRS) Referral (Form S-19). The currently approved version of the HS/PRS Referral (Form S-19) was developed for UC Path, an alternative case management system that ORR has not rolled out and therefore does not align with existing forms in the UC Portal, its current case management system. Approval of a UC Portal version will allow ORR to come into compliance with Paperwork Reduction Act (PRA) requirements. Additionally, ORR solicited feedback and completed testing activities, as approved under the “Feedback for Post-Release Service (PRS) Solution Development and Iteration” information collection (0970-0401) and has identified improvements to improve user experience.

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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 Referral (Form S-26)	S-26	HS Referral - UC Portal
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) 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
Post-Release Service (PRS) Referral (Form S-19)	S-19, Form S-19	PRS Referral - UC Portal ,   PRS Referral Appendix - PRS Administrative Actions
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
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, 1b	UC Case Status ,   Location of Child

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ICR Summary 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	4,438,452	4,438,452	0	0	0	0
Annual Time Burden (Hours)	1,206,453	1,218,699	0	-12,246	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: ORR is proposing nonsubstantive changes that will: 1. Align the HS/PRS Referral with the existing version in the UC Portal system. The form will be split into two separate forms – PRS Referral (Form S-19) and Home Study Referral (Form S-26). 2. Create an appendix to the PRS Referral (Form S-19) that will improve user experience and create efficiencies for completing administrative actions needed to process PRS cases. Additionally, the supporting statement A burden table was updated

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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: 08/22/2024

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