Office of Refugee Resettlement Unaccompanied Refugee Minors Program Application and the Withdrawal of Application or Declination of Placement Form
OMB Information Collection Request
0970 - 0550
Supporting Statement Part A - Justification
May 2023
Submitted By:
Office of Refugee Resettlement
Administration for Children and Families
U.S. Department of Health and Human Services
Circumstances Making the Collection of Information Necessary
The Refugee Act of 1980, Pub. L. No. 96-212, 8 U.S.C. 1522, amended the Immigration and Nationality Act to create a domestic refugee resettlement program that provides assistance and services to refugees resettling in the United States. With the enactment of this legislation, the Office of Refugee Resettlement (ORR) established comprehensive requirements for a State-administered refugee resettlement program including child welfare services to unaccompanied refugee minors. The Unaccompanied Refugee Minors (URM) Program currently operates in 14 states and the District of Columbia and provides the same range of child welfare benefits and services available to other foster children in those states as well as services required by ORR regulation and policy guidance.
Originally, the URM Program provided services for refugee minors arriving from overseas unaccompanied by a parent or adult relative. Over the years Congress passed laws making other special populations already in the United States eligible for the URM Program. A completed URM Program Application must be submitted to ORR for eligibility determination, initiation of placement efforts, and approval to enter the URM Program.
The current OMB expiration date for this information collection is August 31, 2023. We are requesting approval for a three-year extension with proposed revisions to the information collection. Proposed revisions include additional instructions, a small number of new questions, dropping a few questions, and rephrasing existing questions. See section A15 for additional information.
Purpose and Use of the Information Collection
The URM Program Application is completed on behalf of unaccompanied minors in the United States who are applying for entry into the URM Program. Applications are completed by case managers, attorneys, or other representatives working with minors who are eligible for the URM Program. The application includes biographical data and comprehensive information on the minor and their needs (e.g., placement history, family reunification efforts, medical needs, mental and behavioral health needs, etc.). ORR uses the information collected to determine a minor’s eligibility for the URM Program, and to facilitate placement in the program. The application information is also used to provide a recommendation to ORR leadership to approve the minor to enter the URM Program.
The Withdrawal of Application or Declination of Placement Form is completed when a minor who has applied for the URM Program wishes to withdraw this application before approval to enter the program or if a child is not interested in entering the specific placement they were offered. This form serves as official record for ORR to cease placement efforts or to search for a new placement for the applicant.
Use of Improved Information Technology and Burden Reduction
In May 2019, ORR incorporated the URM Program Application into its secure, web-based data collection system called Refugee Arrivals Data System (RADS), which eliminated the submission of applications via email to ORR. In addition to reducing burden and increasing efficiency to those submitting applications, RADS also provides real-time application status updates and allows all parties to communicate about the case during the application and placement process.
Efforts to Identify Duplication and Use of Similar Information
ORR is the only entity, Federal, State, or local, with authority to determine eligibility for the URM Program and approve minors to enter the program. ORR is responsible for collecting the most complete and accurate picture of the minor’s history and needs to ensure the most appropriate URM placement.
Impact on Small Businesses or Other Small Entities
This information collection does not burden or impact small businesses.
Consequences of Collecting the Information Less Frequently
If the information is not collected, ORR would not have the information necessary to determine a minor eligible for the URM Program, facilitate efforts to place the minor into the program, or recommend to ORR leadership to approve the minor to enter the program.
Special Circumstances Relating to the Guidelines of 5 CFR 1320.5
This proposed information collection will not entail any special handling procedures as indicated in the OMB guidance for Paperwork Reduction Act processing.
Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency
In accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104-13) and Office of Management and Budget (OMB) regulations at 5 CFR Part 1320 (60 FR 44978, August 29, 1995), ACF published a notice in the Federal Register announcing the agency’s intention to request an OMB review of this information collection activity. This notice was published on March 10, 2023, Volume 88, Number 47, page 15039, and provided a sixty-day period for public comment. During the notice and comment period, we did not receive comments.
Explanation of Any Payment or Gift to Respondents
No payment or gift to respondents will be provided.
Assurance of Confidentiality Provided to Respondents
ORR has established a system of records to ensure the level of confidentiality pursuant to the Privacy Act. 5 U.S.C. 552(a). The system used to collect URM Program Applications, ORR’s Refugee Arrivals Data System (RADS), is a Privacy Act System of Records. A System of Records Notice for RADS under 09-80-0325 was published on July 18, 2016 and modified on February 8, 2022.
Justification for Sensitive Questions
The URM Program Application collects sensitive information pertaining to a minor’s history of abuse/abandonment/neglect by family members, history of exploitation or human trafficking, physical and mental health needs, and behavioral issues. The information is necessary in order to find the most appropriate placement in the URM Program that will meet the minor’s needs and arrange necessary services.
Estimates of Annualized Burden Hours and Costs
Annual Burden Estimates
The information collection forms are completed by case managers, attorneys, or other representatives working with minors who are eligible for the URM Program. The below burden estimates provide the anticipated annual number of respondents. The annual number of respondents was estimated by examining historical data and trends in the number of respondents over time. The time estimated per response is based on data collection experience to date and feedback from respondents on the current forms.
Information Collection Title |
Total Number of Respondents |
Total Number of Responses Per Respondent |
Average Burden Hours Per Response |
Total Burden Hours |
Annual Burden Hours |
Average Hourly Wage |
Total Annual Cost |
Unaccompanied Refugee Minors Program Application |
450 |
3 |
1.50 |
2,025 |
675 |
$20.00 x 2 (fringe) = $40.00 |
$27,000 |
Withdrawal of Application or Declination of Placement Form |
50 |
3 |
0.20 |
30 |
10 |
$20.00 x 2 (fringe) = $40.00 |
$400 |
Estimated Annual Burden Total: |
685 |
Estimated Annual Cost Total: |
$27,400 |
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Annual Cost Estimates
The cost to respondents was calculated using the Bureau of Labor Statistics (BLS) job code for Social and Human Services Assistants [21-1093] and wage data from May 2022, which is $20.00 per hour. To account for fringe benefits and overhead the rate was multiplied by two which is $40.00. The estimate of annualized cost to respondents for hour burden is $40.00 times 685 hours or $27,400. https://www.bls.gov/oes/current/oes211093.htm
Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers
There are no monetary costs to respondents and record keepers.
Annualized Cost to the Federal Government
The cost to the Federal Government includes three staff at the GS-12 level reviewing, summarizing, and reporting on the collected information. The cost to the Federal Government was calculated using the 2023 General Schedule (GS) Locality Pay Table annual rate for a GS-12, which is $94,199. Therefore, the estimate of annualized cost to the Federal Government to review the collected information is $282,597.
https://www.opm.gov/policy-data-oversight/pay-leave/salaries-wages/salary-tables/pdf/2023/DCB.pdf
Explanation for Program Changes or Adjustments
The proposed revisions to each form include additional instructions, a small number of new questions, dropping a few questions, and rephrasing existing questions. Proposed changes are expected to improve clarity of questions and lead to stronger information collection, including improved clarity of children’s needs to support placement efforts. This will ultimately reduce the number of clarifications needed and lead to faster processing of URM applications.
The number of anticipated annual respondents has been increased from 350 to 450 for the URM Program Application form and from 30 to 50 for the Withdrawal and Declination form to account for the increase in the number of minors who are eligible for the URM Program. Over time, Congress has granted eligibility for the URM Program to additional populations of youth, leading to an increase in the number of minors eligible and, therefore, an increase in the number of anticipated respondents to this information collection.
Plans for Tabulation and Publication and Project Time Schedule
Applications are received and processed on an ongoing basis, as driven by the need in the field. ORR does not plan to publish the information provided by the respondents.
Reason(s) Display of OMB Expiration Date is Inappropriate
Not applicable; ORR plans to display the expiration date of clearance as set by OMB.
Exceptions to Certification for Paperwork Reduction Act Submissions
No exceptions are necessary for this information collection.
| File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
| Author | Jones, Molly (ACF) |
| File Modified | 0000-00-00 |
| File Created | 2025-06-03 |