1 MIECHV Needs Assessment Data Summary_Table 7

At-Risk Counties	The county is served, in whole or in part, by at least one home visiting program (Yes or No or Not Sure)	The county is served, in whole or in part, by at least one home visiting program that implements evidence-based home visiting service delivery models eligible for implementation by MIECHV (Yes or No or Not Sure)	The county is served, in whole or in part, by home visiting programs which are    funded by MIECHV (Yes or No or Not Sure)	Estimated number of families served by a home visiting program located in the county in the most recently completed program fiscal year	Author: If the at-risk community is smaller than a county, how will it be reflected - e.g. census tracts? Optional: Alternate estimated need of eligible families in the county as defined by the awardee	Optional: In home visiting programs located in the county, percentage of home visitor positions that were vacant in the most recently completed program fiscal year
							OMB No: 0915-XXXX
							Expiration Date: XX/XX/XXXX
Public Burden Statement: The purpose of this data collection is to gather updated data and the list of communities identified as at-risk in the awardee needs assessment. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB control number for this information collection is 0915/0906-XXXX and it is valid until XX/XX/202X. This information collection is voluntary. Public reporting burden for this collection of information is estimated to average 30 hours per response, including the time for reviewing instructions, searching existing data sources, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to HRSA Information Collection Clearance Officer, 5600 Fishers Lane, Room 14N39, Rockville, Maryland, 20857 or [email protected]. Please see https://www.hrsa.gov/about/508-resources for the HRSA digital accessibility statement.