Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 1: Demographic and Service Utilization Data

OMB 0970-0389

OMB 0970-0389

The purpose of this information collection request is to renew and revise the existing approval under OMB No.: 0970-0389 (expires 8/31/19) to remove the Tribal Maternal, Infant, and Early Childhood Home Visiting Program Implementation Plan Guidance and only include Form 1: Demographic and Service Utilization Data. The Implementation Plan Guidance was specifically created to assist Tribal MIECHV Development and Implementation, and Implementation and Expansion grantees who originally received awards in FY2016 to develop their implementation plans (a requirement of their grant). These grantees successfully submitted their plans in 2018 and the guidance is no longer necessary. The Form 1 data are used to help ACF better understand the population receiving services from Tribal MIECHV grantees, the degree to which they are using services, as well as staffing data to better understand the Tribal MIECHV workforce. This includes data such as numbers of newly enrolled and continuing participants, educational level and poverty status of participants, gender and ethnicity of staff, and number of home visits. Overall, this information collection will provide valuable information to HHS that will guide understanding of Tribal MIECHV grantees and the provision of technical assistance needed to support the Tribal MIECHV Program. There are only minor changes proposed to the previously approved Form 1. Changes are meant to provide clearer guidance and refine some definitions. The data fields have not changed.

The latest form for Tribal Maternal, Infant, and Early Childhood Home Visiting Program Form 1: Demographic and Service Utilization Data expires 2022-06-30 and can be found here.

OMB Details

Tribal Maternal, Infant, and Early Childhood Home Visiting Implementation Plan Guidance

Federal Enterprise Architecture: Community and Social Services - Social Services


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