Fast Track PRA Submission Short Form

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Request for Approval under the “Administration for Children and Families Generic for Information Collections Related to Gatherings”
(OMB Control Number: 0970-0617)


TITLE OF INFORMATION COLLECTION:  Registration for Meeting on Unaccompanied Children & Access to Healthcare in Chicagoland


PURPOSE:  The purpose of this information collection is to gather registration information for an upcoming introductory meeting of ACF Office of Refugee Resettlement (ORR) grant recipients providing Post-Release Services (PRS) to released unaccompanied children and individuals affiliated with the Illinois chapter of the American Academy of Pediatrics. The goal of the meeting is to discuss options and possible coordination to help released unaccompanied children access medical and behavioral healthcare in Chicagoland1.  

Meeting registration information requested would include name, contact information (email address), and organization/affiliation. ORR staff will use this information for planning purposes such as ensuring sufficient seating at the event and the development of presentation materials (ex. affiliation will help understand the makeup of the audience). Contact information will be used to provide attendees information about the meeting, for example if there is any change in the event time/location. 


DESCRIPTION OF RESPONDENTS: The targeted group for this collection of information includes ACF grantees providing PRS to released unaccompanied children and members of the public affiliated with the Illinois chapter of the AAP. ORR federal staff2 attending the meeting may also fill out the registration information.

CERTIFICATION:
I certify the following to be true: 
    1. The collection is voluntary. 
    2. The collection is low-burden for respondents and low-cost for the Federal Government.
    3. The collection is non-controversial and does not raise issues of concern to other federal agencies.
    4. The information collected is not intended to be disseminated to the public3.		
    5. Information gathered will not be used for the purpose of substantially informing influential policy decisions. 

Name and affiliation: Ashley Lippolis Aviles, Policy Analyst, Policy Coordination, UC Policy Unit, Unaccompanied Children Program, Office of Refugee Resettlement, Administration for Children & Families

To assist review, please provide the following information:

BURDEN HOURS 

Instrument Title
Category of Respondent
No. of Respondents
Participation Time
Burden
Microsoft Form:
Unaccompanied Children & Access to Healthcare in Chicagoland
(2) Private Sector;


115
2 minutes
4 hours

FEDERAL COST:  The estimated annual cost to the Federal government is $2,186.38. The total cost estimate considers the time of a step 1 GS-12 in the Washington, DC locality to review registrations.  No additional costs will be incurred by the Federal government.  The hourly rate was multiplied by two to account for fringe benefits and overhead. 

Total Number of Federal Staff  
Total Number of Reviews Per Federal Staff  
Average Burden Hours Per Review 
Total  
Burden Hours  
Average Hourly Wage  
Total Cost  
1
115
.1
4
$47.53
$2,186.38


Administration of the Instrument
    1. How will you collect the information? (Check all that apply)
[X] Web-based or other forms of Social Media 
[  ] Telephone	
[  ] In-person	
[  ] Mail 
[  ] Other, Explain


Please make sure that all instruments, instructions, and scripts are submitted with the request.