Services Provided to Unaccompanied Alien Children

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form S-26 HS Referral - UC Portal	Form and Instruction	Removed	Available
Form S-26 Home Study Referral (Form S-26)	Form and Instruction	Removed	Missing upstream
Form Form S-27 UAC Case Status	Form and Instruction	Modified	Available
Form Form S-27 UAC Case Status (Form S-27)	Form and Instruction	Modified	Missing upstream
Form S-24 Sponsor Application	Form and Instruction	Removed	Available
Form S-24 Sponsor Application (Form S-24)	Form and Instruction	Removed	Repair queued
Form S-23 Case Manager Call Log and Case Notes	Form and Instruction	Modified	Available
Form S-23 Case Manager Call Log and Case Notes (Form S-23)	Form and Instruction	Modified	Repair queued
Form S-22 Post-Release Service (PRS) Event	Form and Instruction	Removed	Available
Form S-22 Post-Release Service (PRS) Event (Form S-22)	Form and Instruction	Removed	Repair queued
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile	Form and Instruction	Removed	Available
Form S-21D Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	Form and Instruction	Removed	Repair queued
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile	Form and Instruction	Removed	Available
Form S-21C Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction	Removed	Repair queued
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity	Form and Instruction	Removed	Available
Form S-21B Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	Form and Instruction	Removed	Repair queued
Form S-21A HS-PRS Primary Provider Entity	Form and Instruction	Removed	Available
Form S-21A Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	Form and Instruction	Removed	Repair queued
Form S-20 UAC Authorized/ Restricted Call List and Call Log (Form S-20)	Form and Instruction	Modified	Available
Form S-20 UAC Authorized/ Restricted Call List and Call Log (Form S-20)	Form and Instruction	Modified	Repair queued
Form Form S-19 PRS Referral Appendix - PRS Administrative Actions	Form and Instruction	Removed	Available
Form S-19 PRS Referral - UC Portal	Form and Instruction	Removed	Available
Form S-19 Post-Release Service (PRS) Referral (Form S-19)	Form and Instruction	Removed	Repair queued
Form S-18 Admission	Form and Instruction	Modified	Available
Form S-18 Admission (Form S-18)	Form and Instruction	Modified	Repair queued
Form S-15 Child Advocate Recommendation and Appointment	Form and Instruction	Removed	Available
Form S-15 Child Advocate Recommendation and Appointment (Form S-15)	Form and Instruction	Removed	Repair queued
Form S-14 Long Term Foster Care Travel Request - UC Path Version	Form and Instruction	Modified	Available
Form S-14 Foster Care Travel Request (Form S-14)	Form and Instruction	Modified	Available
Form S-13 Individual Service Plan - UC Portal Version	Form and Instruction	Removed	Available
Form S-13 Individual Service Plan - UC Path Version	Form and Instruction	Removed	Available
Form S-13 Individual Service Plan (Form S-13)	Form and Instruction	Removed	Repair queued
Form S-12 UC Case Review - UC Portal Version	Form and Instruction	Removed	Available
Form S-12 UC Case Review - UC Path Version	Form and Instruction	Removed	Available
Form S-12 UC Case Review (Form S-12)	Form and Instruction	Removed	Missing upstream
Form S-11 UC Assessment - UC Portal Version	Form and Instruction	Removed	Available
Form S-11 UC Assessment - UC Path Version	Form and Instruction	Removed	Available
Form S-11 UC Assessment (Form S-11)	Form and Instruction	Removed	Repair queued
Form S-9 Assessment for Risk - UC Portal Version	Form and Instruction	Removed	Available
Form S-9 Assessment for Risk - UC Path Version	Form and Instruction	Removed	Available
Form S-9 Assessment for Risk (Form S-9)	Form and Instruction	Removed	Repair queued
Form S-8 Initial Intakes Assessment - UC Portal Version	Form and Instruction	Removed	Available
Form S-8 Initial Intakes Assessment (Form S-8) - UC Path Version	Form and Instruction	Removed	Available
Form S-8 Initial Intakes Assessment (Form S-8)	Form and Instruction	Removed	Repair queued
Form S-5 Sponsor Assessment - New UC Portal	Form and Instruction	Removed	Available
Form S-7 Adult Contact Profile	Form and Instruction	Removed	Available
Form S-7 Adult Contact Profile (Portal Form S-5; Path Form S-7)	Form and Instruction	Removed	Repair queued
Form S-6 Home Study Assessment - Word Version	Form and Instruction	Removed	Repair queued
Form S-6 Home Study Assessment - UC Path Version	Form and Instruction	Removed	Available
Form S-6 Home Study Assessment (Form S-6)	Form and Instruction	Removed	Repair queued
Form S-5 Sponsor Assessment - New UC Portal	Form and Instruction	Removed	Available
Form S-5 Sponsor Assessment - UC Path Version	Form and Instruction	Removed	Available
Form S-5 Sponsor Assessment (Form S-5)	Form and Instruction	Removed	Repair queued
SSA_0970-0553_Services Provided to Unaccompanied Children_v.4.0_2025.04.07 - OPRE CLEAN.docx	Supporting Statement A	Uploaded 2025-04-14	Repair queued
SSA_0970-0553_Services Provided to Unaccompanied Children_v.4.0_2025.04.07 - OPRE CLEAN.docx	Supporting Statement A	Uploaded 2025-04-14	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
270296	Home Study Referral (Form S-26)	Form and Instruction	Removed	HS Referral - UC Portal
270296	Home Study Referral (Form S-26)	Form and Instruction	Removed
249583	UAC Case Status (Form S-27)	Form and Instruction	Modified	UAC Case Status
249583	UAC Case Status (Form S-27)	Form and Instruction	Modified
249581	Sponsor Application (Form S-24)	Form and Instruction	Removed	Sponsor Application
249581	Sponsor Application (Form S-24)	Form and Instruction	Removed
249580	Case Manager Call Log and Case Notes (Form S-23)	Form and Instruction	Modified	Case Manager Call Log and Case Notes
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	Removed	Post-Release Service (PRS) Event
249579	Post-Release Service (PRS) Event (Form S-22)	Form and Instruction	Removed
249578	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	Form and Instruction	Removed	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile
249578	Home Study/Post-Release Service (HS/PRS) Subcontractor Profile (Form S-21D)	Form and Instruction	Removed
249577	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction	Removed	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile
249577	Home Study/Post-Release Service (HS/PRS) Primary Provider Profile (Form S-21C)	Form and Instruction	Removed
249576	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	Form and Instruction	Removed	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity
249576	Home Study/Post-Release Service (HS/PRS) Subcontractor Entity (Form S-21B)	Form and Instruction	Removed
249575	Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	Form and Instruction	Removed	HS-PRS Primary Provider Entity
249575	Home Study/Post-Release Service (HS/PRS) Primary Provider Entity (Form S-21A)	Form and Instruction	Removed
249574	UAC Authorized/ Restricted Call List and Call Log (Form S-20)	Form and Instruction	Modified	UAC Authorized/ Restricted Call List and Call Log (Form S-20)
249574	UAC 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	Removed	PRS Referral Appendix - PRS Administrative Actions
249573	Post-Release Service (PRS) Referral (Form S-19)	Form and Instruction	Removed	PRS Referral - UC Portal
249573	Post-Release Service (PRS) Referral (Form S-19)	Form and Instruction	Removed
242815	Admission (Form S-18)	Form and Instruction	Modified	Admission
242815	Admission (Form S-18)	Form and Instruction	Modified
242813	Child Advocate Recommendation and Appointment (Form S-15)	Form and Instruction	Removed	Child Advocate Recommendation and Appointment
242813	Child Advocate Recommendation and Appointment (Form S-15)	Form and Instruction	Removed
242812	Foster Care Travel Request (Form S-14)	Form and Instruction	Modified	Long Term Foster Care Travel Request - UC Path Version
242812	Foster Care Travel Request (Form S-14)	Form and Instruction	Modified
242811	Individual Service Plan (Form S-13)	Form and Instruction	Removed	Individual Service Plan - UC Portal Version
242811	Individual Service Plan (Form S-13)	Form and Instruction	Removed	Individual Service Plan - UC Path Version
242811	Individual Service Plan (Form S-13)	Form and Instruction	Removed
242810	UC Case Review (Form S-12)	Form and Instruction	Removed	UC Case Review - UC Portal Version
242810	UC Case Review (Form S-12)	Form and Instruction	Removed	UC Case Review - UC Path Version
242810	UC Case Review (Form S-12)	Form and Instruction	Removed
242809	UC Assessment (Form S-11)	Form and Instruction	Removed	UC Assessment - UC Portal Version
242809	UC Assessment (Form S-11)	Form and Instruction	Removed	UC Assessment - UC Path Version
242809	UC Assessment (Form S-11)	Form and Instruction	Removed
242808	Assessment for Risk (Form S-9)	Form and Instruction	Removed	Assessment for Risk - UC Portal Version
242808	Assessment for Risk (Form S-9)	Form and Instruction	Removed	Assessment for Risk - UC Path Version
242808	Assessment for Risk (Form S-9)	Form and Instruction	Removed
242807	Initial Intakes Assessment (Form S-8)	Form and Instruction	Removed	Initial Intakes Assessment - UC Portal Version
242807	Initial Intakes Assessment (Form S-8)	Form and Instruction	Removed	Initial Intakes Assessment (Form S-8) - UC Path Version
242807	Initial Intakes Assessment (Form S-8)	Form and Instruction	Removed
242806	Adult Contact Profile (Portal Form S-5; Path Form S-7)	Form and Instruction	Removed	Sponsor Assessment - New UC Portal
242806	Adult Contact Profile (Portal Form S-5; Path Form S-7)	Form and Instruction	Removed	Adult Contact Profile
242806	Adult Contact Profile (Portal Form S-5; Path Form S-7)	Form and Instruction	Removed
242805	Home Study Assessment (Form S-6)	Form and Instruction	Removed	Home Study Assessment - Word Version
242805	Home Study Assessment (Form S-6)	Form and Instruction	Removed	Home Study Assessment - UC Path Version
242805	Home Study Assessment (Form S-6)	Form and Instruction	Removed
242804	Sponsor Assessment (Form S-5)	Form and Instruction	Removed	Sponsor Assessment - New UC Portal
242804	Sponsor Assessment (Form S-5)	Form and Instruction	Removed	Sponsor Assessment - UC Path Version
242804	Sponsor Assessment (Form S-5)	Form and Instruction	Removed

ICR Details

OMB Control No: 0970-0553	ICR Reference No: 202504-0970-004
Status: Historical Active	Previous ICR Reference No: 202408-0970-008
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR - UAC Bureau
Title: Services Provided to Unaccompanied Alien Children
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/09/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/30/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2028	36 Months From Approved	06/30/2025
Responses	275,304	0	4,438,452
Time Burden (Hours)	51,900	0	1,206,453
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Refugee Resettlement (ORR) Unaccompanied Alien Children (UAC) Bureau provides care and custody for unaccompanied alien children until they can be safely released to a vetted sponsor, repatriated to their home country, or obtain lawful immigration status. ORR funds residential care provider facilities that provide temporary housing and other services to children in ORR custody. Generally, care provider facilities are State- licensed, except those located in states unwilling to consider them for licensure and temporary Emergency or Influx (EIF) facilities. In both cases, such facilities must meet ORR requirements to ensure a high-level quality of care. Services provided at care provider facilities include, but are not limited to, education, recreation, vocational training, acculturation, nutrition, medical, mental health, legal, and case management. ORR uses several instruments directly related to the care of unaccompanied alien children. The instruments in this information collection allow ORR to provide services to unaccompanied alien children as required by the Homeland Security Act (HSA) (6 U.S.C. 279), the Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA) (8 U.S.C. 1232), the recently published Unaccompanied Children Program Foundational Rule, (45 C.F.R. 410), as well as other ORR regulations (i.e., 45 C.F.R. parts 411 and 412), and the provisions of the Flores Settlement Agreement (No. CV85-4544-RJK (C.D. Cal. 1996)) that still apply to HHS.1 The collection was last approved by OMB on April 21, 2022, and expires on April 30, 2025. The collection currently contains 22 instruments, including 33 alternative versions. Upon completion of this revision request, which removes six forms and the transfers ten forms to two new information collections, this collection will contain 5 unique, revised instruments

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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:
	89 FR 92941	11/25/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 17821	04/29/2025
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

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
Foster Care Travel Request (Form S-14)	S-14	Long Term Foster Care Travel Request - UC Path Version
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
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
UAC Authorized/ Restricted Call List and Call Log (Form S-20)	S-20	UAC Authorized/ Restricted Call List and Call Log (Form S-20)
UAC Case Status (Form S-27)	Form S-27	UAC Case Status
UC Assessment (Form S-11)	S-11, S-11	UC Assessment - UC Path Version ,   UC Assessment - UC Portal Version
UC Case Review (Form S-12)	S-12, S-12	UC Case Review - UC Path Version ,   UC Case Review - UC Portal Version

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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	275,304	4,438,452	0	-4,163,148	0	0
Annual Time Burden (Hours)	51,900	1,206,453	0	-1,154,553	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: Under this application for renewal, ORR proposes revisions to five forms, the removal of six forms, and the transfer of ten forms to two new information collections titled Unaccompanied Alien Children Bureau Assessments of Children and Sponsors (OMB 0970 – NEW) and Home Study and Post-Release Services Provided to Unaccompanied Alien Children (OMB 0970 – NEW), which are detailed separately in concurrent substantive packages. Additionally, on October 24, 2024, ORR submitted a request for revisions to forms approved under the Legal and Advocacy Services for Unaccompanied Alien Children collection (OMB 0970-0565) in which ORR also proposed transferring the Child Advocate Recommendation and Appointment (Form S-15) previously approved under this collection; the request is currently pending a decision before OMB.

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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: 04/30/2025

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