State Maternal Health Innovation (State MHI) Maternal Health Annual Report (MHAR)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Maternal Health Annual Report (MHAR)	Form	New	Repair queued
Supporting_Statement_A_CLEAN.docx	Supporting Statement A	Uploaded 2024-09-27	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
271241	Maternal Health Annual Report (MHAR)	Instruction	New
271240	Maternal Health Annual Report (MHAR)	Form	New

ICR Details

OMB Control No:	ICR Reference No: 202409-0906-002
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: State Maternal Health Innovation (State MHI) Maternal Health Annual Report (MHAR)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/30/2024

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	30	0
Time Burden (Hours)	360	0
Cost Burden (Dollars)	0	0

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Abstract: The State Maternal Health Innovation (MHI) program aims to reduce maternal mortality and severe maternal morbidity (SMM) by improving access to comprehensive and continuous, culturally congruent, and high-quality preconception, prenatal, labor and delivery, and/or postpartum care for those populations with the highest unmet needs (as justified by state level data); enhancing state maternal health surveillance and data capacity; and advancing equity and reducing disparities in maternal health through improving social determinants of health (SDOH), workforce, training, and other appropriate means. The State MHI program is authorized by 42 U.S.C. § 701(a)(2) (Title V, § 501(a)(2) of the Social Security Act), which authorizes awards for special projects of regional and national significance (SPRANS) in maternal and child health. SPRANS projects support HRSA’s mission to improve the health and well-being of America’s mothers, children, and families. HRSA directly funds states to implement maternal health innovation projects. The Maternal Health Annual Report (MHAR) will be completed by all grantees who receive funding under the program. This information will be used to monitor grantees’ progress in accessing, analyzing, and using state-level maternal health data and to summarize the data focused work that grantees accomplish.

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Authorizing Statute(s): US Code: 42 USC 701(a)(2) Name of Law: Social Security Act
  

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:
	89 FR 55950	07/08/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 79296	09/27/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Maternal Health Annual Report (MHAR)	1	Finalized_Instrument_MHAR Data Table Template
Maternal Health Annual Report (MHAR)	1	Finalized_Instrument_MHAR Data Table Template

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	30	0	0	30	0	0
Annual Time Burden (Hours)	360	0	0	360	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: No

Burden Reduction Due to:

Short Statement: This is a new collection.

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Annual Cost to Federal Government: $5,086

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: 09/30/2024

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