OPRE OMB Clearance Manual

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Tribal Home Visiting Continuous Quality Improvement Collaboratives

Formative Data Collections for Program Support

0970 – 0531


Supporting Statement
Part A - Justification
April  2026

Submitted By:
Office of Early Childhood Development
Administration for Children and Families 
U.S. Department of Health and Human Services

4th Floor, Mary E. Switzer Building
330 C Street, SW
Washington, D.C. 20201








A1. Necessity for the Data Collection
The Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services (HHS) seeks approval to collect information from Tribal Maternal, Infant, and Early Childhood Home Visiting (Tribal MIECHV) grant recipients participating in the 2026 Tribal Home Visiting Continuous Quality Improvement Collaborative (CQIC). 

Background 
The Tribal MIECHV Program supports the delivery of culturally relevant, evidence-based home visiting services to American Indian and Alaska Native families. Continuous quality improvement (CQI) is a core component of Tribal MIECHV, aimed at strengthening program implementation and improving outcomes for children and families. The Tribal MIECHV CQIC uses a structured, time-limited approach to support grant recipients in testing and refining strategies to improve practice, including the use of Plan-Do-Study-Act (PDSA) cycles.

The proposed information collection is needed to support implementation of the 2026 Tribal CQIC. Structured information on grant recipient activities, progress, and staff experiences is necessary for ACF and its training and technical assistance (T/TA) providers to provide targeted T/TA, monitor progress toward collaborative aims, and facilitate shared learning across participating grant recipients. Existing data sources do not capture rapid-cycle improvement efforts, real-time progress on collaborative measures, or staff perceptions of capacity and practice change. The information collected will be used for program support purposes only and is not intended to be generalizable or used as the principal basis for federal policy decisions.

Legal or Administrative Requirements that Necessitate the Collection 
There are no legal or administrative requirements that necessitate the collection. ACF is undertaking the collection at the discretion of the agency.

A2. Purpose of Survey and Data Collection Procedures
Overview of Purpose and Use
The purpose of this information collection is to support the implementation of the 2026 Tribal CQIC and to inform ACF’s provision of T/TA to participating Tribal MIECHV grant recipients. Through this collaborative, grant recipient teams will test and refine strategies to strengthen culturally responsive, relationship-based home visiting practices using CQI methods.

Information will be collected using three instruments: (1) a PDSA Planning Tool, (2) a CQIC Family of Measures (FoM) Quarterly Reporting Template, and (3) a CQIC Survey administered to program staff. These instruments will provide ACF and its T/TA providers with timely, structured data on grant recipient activities, progress, and staff experiences. Data will be used to provide targeted T/TA, identify common challenges and successful strategies, monitor progress toward collaborative aims, facilitate shared learning across participating grant recipients, and inform summary materials describing lessons learned from the CQIC.

This proposed information collection meets the following goals of ACF’s generic clearance for formative data collections for program support (0970-0531): 
    • Delivery of TA related to program implementation.
        ◦ Information from the PDSA Planning Tool and Quarterly Reporting Template will be used by T/TA providers to offer individualized feedback to grant recipients and to identify areas where additional support is needed.
    • Obtaining feedback about processes and/or practices to inform ACF program development or support. 
        ◦ Information from all three instruments, including staff responses to the CQIC Survey, will provide insight into grant recipient experiences implementing CQI approaches and culturally responsive practices.
    • Use of rapid-cycle testing activities to strengthen programs.
        ◦ The PDSA Planning Tool will support grant recipients in documenting and reflecting on rapid-cycle tests of change, which will inform ongoing improvements in home visiting services.

Processes for Information Collection 
Information will be collected from Tribal MIECHV grant recipients and their staff participating in the 12-month CQIC using structured templates and web-based surveys.

At the grant recipient level, each participating grant recipient will designate a staff member (e.g., program lead or CQI lead) to complete and submit two instruments: (1) the PDSA Planning Tool, a structured Word-based template used to document rapid-cycle tests of change, and (2) the CQIC FoM Quarterly Reporting Template, a structured reporting form administered via a web-based platform (e.g., Qualtrics) used to submit data on key measures and implementation progress. 
    • The PDSA Planning Tool will be completed multiple times throughout the collaborative as grant recipients conduct tests of change and will be submitted electronically (e.g., via secure file sharing or email) to ACF’s contracted T/TA providers. 
    • The FoM Quarterly Reporting Template will be completed and submitted four times over the course of the collaborative via the web-based platform.

At the individual staff level, up to five staff members per grant recipient (e.g., program leads and home visitors) will complete the CQIC Survey independently. The Survey is a brief, web-based survey administered via Qualtrics and will be completed at three time points: at the beginning of the collaborative, around the mid-point CQIC learning session, and at the end of the collaborative. The additional mid-point administration will provide timely information on staff experiences and implementation progress during the collaborative, allowing ACF and its contracted T/TA providers to identify emerging needs and provide responsive support before the end of the CQIC.

ACF’s contracted T/TA providers will collect and review all submitted information, provide feedback to grant recipients, and summarize information across participants to inform ongoing T/TA and collaborative activities.

A3. Improved Information Technology to Reduce Burden
ACF will use information technology to minimize respondent burden and facilitate efficient data collection. The PDSA Planning Tool will be completed electronically using a structured template and submitted electronically (e.g., via secure file sharing or email) to ACF’s contracted T/TA providers. The CQIC FoM Quarterly Reporting Template and the CQIC Survey will be administered electronically via a web-based platform (e.g., Qualtrics).

These approaches reduce burden by allowing respondents to complete and submit information using familiar tools and web-based forms that include structured fields and built-in validation. The use of a web-based platform for the Quarterly Reporting Template and Survey supports consistent data entry, reduces data entry errors, and eliminates the need for respondents to manage separate files or formats, thereby minimizing duplicative reporting processes

A4. Efforts to Identify Duplication
ACF has made efforts to minimize duplication and leverage existing data sources where possible. Some data elements included in the CQIC FoM Quarterly Reporting Template may overlap with data collected through other information collections, such as the Tribal Engagement and Capacity Monthly Snapshot (TECS) (OMB #0970-0490). However, this information collection is distinct in purpose, timing, and use. For example, existing data collections, including TECS, are designed for program monitoring and reporting and do not capture the rapid-cycle quality improvement processes central to the CQIC. The proposed information collection is specifically designed to support continuous quality improvement and includes additional context needed for this purpose, such as documentation of PDSA cycles, integration of data with collaborative aims, and structured reflections to inform T/TA.

In addition, this collection includes information not available through existing sources, including detailed documentation of rapid-cycle tests of change and staff perspectives on capacity and practice change collected through the CQIC Family of Measures Survey. The frequency and structure of data collection are also tailored to support timely feedback and learning within the collaborative.

Therefore, while some data elements may align with existing reporting, the proposed information collection does not duplicate existing efforts and is necessary to meet the specific needs of the CQIC.

A5. Involvement of Small Organizations
No small businesses will be involved with this information collection.

A6. Consequences of Less Frequent Data Collection
The proposed information collection is designed to support an ongoing, iterative CQI process within the Tribal Home Visiting CQIC. Data are collected at multiple points throughout the 12-month collaborative to enable timely feedback, support rapid-cycle testing, and inform ongoing technical assistance.

Collecting this information less frequently or using a less structured approach would limit ACF’s ability to monitor progress, identify challenges, and provide responsive technical assistance to grant recipients. It would also reduce opportunities for grant recipients to reflect on and refine their improvement efforts and would limit shared learning across participants.

Because CQI relies on regular data collection and feedback to guide improvement efforts, less frequent data collection would reduce the utility of the information for program support purposes.

A7. Special Circumstances
There are no special circumstances for the proposed data collection efforts.

A8. Federal Register Notice and Consultation
Federal Register Notice and Comments
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 request to extend approval of the umbrella generic with minor changes. The notice was published on April 28, 2025, (90 FR 17603), and provided a sixty-day period for public comment. ACF did not receive any comments on the first notice. A second notice was published, allowing a thirty-day period for public comment (90 FR 42248), in conjunction with submission of the request to OMB. ACF did not receive any comments on the second notice.

Consultation with Outside Experts
ACF consulted with contracted TA providers, including James Bell Associates and Zero To Three, as well as subject matter experts with expertise in CQI and culturally responsive early childhood practices. These subject matter experts, who are independent of the contracted providers and include university faculty and evaluators working with Tribal communities, contributed to the design of the CQIC and the development and refinement of data collection instruments. These consultations helped ensure that the information collection is appropriate, feasible, and aligned with the cultural and community contexts of Tribal MIECHV grant recipients.

A9. Tokens of Appreciation for Respondents
No tokens of appreciation for respondents are proposed for this information collection.

A10. Privacy of Respondents
Information collected will be kept private to the extent permitted by law. Respondents will be informed of all planned uses of data, that their participation is voluntary, and that their information will be kept private. 


A11. Sensitive Questions
There are no sensitive questions in this data collection.

A12. Estimation of Information Collection Burden
Burden Estimates
Estimated burden is based on prior experience with Tribal Home Visiting CQIC data collections (information collection activities approved under OMB #0970-0531), including the 2020-2022 CQIC, as well as input from TA providers involved in the design of the 2026 CQIC. Estimates reflect the expected level of effort required for grant recipients and their staff to complete each instrument, including time to review instructions, compile information, and submit responses.

The burden estimates account for the number of respondents, the number of responses per respondent, and the average time required to complete each instrument. 

Grant recipient-level instruments include the PDSA Planning Tool and the CQIC FoM Quarterly Reporting Template. Each are completed by one designated staff member per grant recipient. The PDSA Planning Tool will be completed approximately 6 over the 12 month period, reflecting the expected cadence of rapid-cycle testing activities conducted by grant recipients. FoM Quarterly Reporting Template will be completed 4 times of the 12 month period. 

The CQIC Survey will be completed by up to five staff per grant recipient at three time points.

Cost Estimates
The cost to respondents was calculated using the Bureau of Labor Statistics (BLS) job code for Social and Human Service Assistants [21-1093] and wage data from May 2024, which is $22.64 per hour. To account for fringe benefits and overhead the rate was multiplied by two which is $45.28  https://www.bls.gov/oes/current/oes_stru.htm 

Instrument
Total Number of Respondents
Total Number of Responses Per Respondent
Average Burden Hours Per Response
Total
Burden Hours
Average Hourly Wage
Total Annual Cost
PDSA Planning Tool
41
6
2
492
$45.28
$22,277.76
CQIC FoM Quarterly Reporting Template
41
4
1
164
$45.28
$7,425.92
CQIC Survey
205
3
.17
104.6
$45.28
$4,734.02
Total Burden and Cost Estimates: 
246
-
-
760.6
$45.28
$34,437.70


A13. Cost Burden to Respondents or Record Keepers
There are no additional costs to respondents.

A14. Estimate of Cost to the Federal Government
The total cost for the data collection activities under this request will be $30,000. These costs include contractor support for instrument development and refinement, data collection and management, analysis of submitted information, and the provision of ongoing TA to participating grant recipients.

A15. Change in Burden
This is for an individual information collection under the umbrella formative generic clearance for program support (0970-0531).

A16. Plan and Time Schedule for Information Collection, Tabulation and Publication
Data collection will occur over the 12-month Tribal CQIC period following OMB approval. During this time, participating grant recipients will complete and submit the PDSA Planning Tool on an ongoing basis as they conduct rapid-cycle tests of change, the CQIC FoM Quarterly Reporting Template four times over the course of the collaborative, and the CQIC Survey at three time points: at the beginning of the collaborative, around the mid-point CQIC learning session, and at the end of the collaborative.

ACF and its contracted T/TA providers will review submitted information on a rolling basis to inform ongoing T/TA, identify trends, and support shared learning across participating grant recipients. Summary information may be compiled periodically throughout the collaborative and at its conclusion to inform program support activities.

Under this umbrella generic information collection, information is meant to inform ACF activities and will primarily be used to support technical assistance and shared learning among ACF staff, participating grant recipients, and T/TA providers. Summary information may also be incorporated in presentations, briefs, or other materials that describe lessons learned from the CQIC and support program improvement efforts.

Any information shared will be presented in aggregate or summary form and will not include identifying information about individual grant recipients. 
In sharing findings, ACF will describe the methods and limitations of the data, including that the information is not generalizable and is not intended to be used as the principal basis for policy decisions. 

A17. Reasons Not to Display OMB Expiration Date
All instruments will display the expiration date for OMB approval.

A18. Exceptions to Certification for Paperwork Reduction Act Submissions
No exceptions are necessary for this information collection.	





Attachments

Instrument 1: Plan-Do-Study-Act (PDSA) Planning Tool
Instrument 2: CQIC Family of Measures (FoM) Quarterly Reporting Template
Instrument 3: CQIC Survey