Information Collection

Tribal Home Visiting Continuous Quality Improvement Collaboratives

IC 280092 under ICR 202606-0970-005 · OMB 0970-0531.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0531 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
THV PDSA Journey Tool.docx	Other-PDSA Journey Tool
THV CQIC FoM Quarterly Indicators_June update - CLEAN.docx	Other-CQIC FoM Quarterly Reporting T
THV CQIC FoM Survey_June update - CLEAN.docx	Other-CQIC Survey
Generics Supporting Statement A Tribal MIECHV CQIC_FNL 4.28.26_CLEAN.docx SSA Prog Supp GenIC - Tribal Home Visiting Continuous Quality Improvement Collaboratives	IC Document
CQIC Change Request Memo_OMB 0970-0531_2026-06-01_fnl.docx NonSub - Tribal HV CQIC - Survey timepoint updates	IC Document
CQIC Change Request Memo_OMB 0970-0531_Admin Fields_2026-06-05_fnl.docx NonSub - Tribal HV Continuous Quality Improvement Collaboratives	IC Document

IC Title:

Tribal Home Visiting Continuous Quality Improvement Collaboratives

Agency IC Tracking Number:

ECD

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-PDSA Journey Tool	Yes	Yes	Fillable Fileable
Other-CQIC FoM Quarterly Reporting Template	Yes	Yes	Fillable Fileable
Other-CQIC Survey	Yes	Yes	Fillable Fileable

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 246

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Requested	Previously Approved
Annual Number of Responses for this IC	1,279	1,279
Annual IC Time Burden (Hours)	761	761
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
SSA Prog Supp GenIC - Tribal Home Visiting Continuous Quality Improvement Collaboratives		06/02/2026
NonSub - Tribal HV CQIC - Survey timepoint updates		06/02/2026
NonSub - Tribal HV Continuous Quality Improvement Collaboratives		06/08/2026

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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