Permanency Innovations Initiative (PII) Evaluation

Forms and Documents

Document Name	Status
SSB IL RISE ORB_5.13.13 FINAL.docx Supporting Statement B	2013-05-22
Attachment D6 RISE Posttest Reminder.docx Supplementary Document	2013-05-22
Attachment D4 RISE ORB Summative Posttest Consent.docx Supplementary Document	2013-05-22
Attachment D2 RISE ORB Summative Pretest BoR and Consent.docx Supplementary Document	2013-05-22
Attachment D1 RISE Research Matrix.docx Supplementary Document	2013-05-22
Attachment C10 DCFS CASI-ACASI Measures and Instruction Screens.docx Supplementary Document	2013-05-22
Attachment C8 DCFS Youth FAQ Letter and Assent Form.docx Supplementary Document	2013-05-22
Attachment C5 DCFS Foster Parent FAQ Letter and Consent Form.docx Supplementary Document	2013-05-22
Attachment C2 DCFS Biological Parent FAQ Letter and Consent Script.docx Supplementary Document	2013-05-22
Attachment C1 DCFS Research Matrix.docx Supplementary Document	2013-05-22
Attachment A1 Research Matrix for Implementation, KS, and Washoe Studies.docx Supplementary Document	2013-05-22
Sample screen shot for web based surveys.JPG Supplementary Document	2012-05-08
SSA IL RISE ORB_5.13.13_FINAL.docx Supporting Statement A	2013-05-29

IC Document Collections

IC ID	Document Title	Status
207124	RISE Staff Post-Test Other-Posttest	New
207123	RISE Staff Pre-Test Other-Survey	New
207122	DCFS Youth Interview Other-Interview	New
207121	DCFS Foster Parent Interview Other-Interview	New
207120	DCFS Youth and Foster Parent Study Contact Form Other-Contact Form	New
207119	DCFS Biological Parent Interview Other-Interview	New
207118	DCFS Biological Parent Study Contact Form Other-Contact Form	New
202195	Washoe Family Assessment Battery Other-Assessment Battery	Modified
202194	Caseworker discussions for NCFAS-Gamp;R completion Other-Discussions	Modified
202193	CAFAS/PECFAS Other-CAFAS/PECFAS	Modified
202192	Family Assessment Battery Other-Assessment Battery	Modified
202191	Caregiver Initial Information Form Other-Info Form	Modified
202190	Fidelity Data (Implementation Quotient Tracker) Other-Quotient Tracker	Modified
202189	Grantee Case Study Protocol Other-Protocol	Modified
202188	Implementation Drivers Web Survey Other-Survey	Modified
202187	Survey of Organization/System Readiness Other-Survey	Modified

ICR Details

OMB Control No: 0970-0408	ICR Reference No: 201305-0970-012
Status: Historical Active	Previous ICR Reference No: 201302-0970-008
Agency/Subagency: HHS/ACF	Agency Tracking No: 19658
Title: Permanency Innovations Initiative (PII) Evaluation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/19/2013
	Date Received in OIRA: 05/30/2013
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2016	36 Months From Approved	08/31/2015
Responses	4,155	0	3,006
Time Burden (Hours)	3,071	0	2,922
Cost Burden (Dollars)	0	0	0

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Abstract: The Administration for Children and Families (ACF), U.S. Department of Health and Human Services (HHS), requests permission to collect data for an evaluation of the Permanency Innovations Initiative (PII). This 5-year initiative, funded by the Children's Bureau (CB) within ACF, will build the evidence base for innovative interventions that enhance well-being and improve permanency outcomes for particular groups of children and youth who are at high risk for long-term foster care and who experience the most serious barriers to timely permanency. A major emphasis of the PII is the design of rigorous evaluations that will provide credible evidence and replicable interventions for achieving faster permanency for children and youth in foster care.

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Authorizing Statute(s): US Code: 42 USC 626 Name of Law: Social Security Act; Research, training, or demonstration projects
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 67651	11/13/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 31941	05/28/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 16

IC Title	Form No.	Form Name
Survey of Organization/System Readiness
Implementation Drivers Web Survey
Grantee Case Study Protocol
Fidelity Data (Implementation Quotient Tracker)
Caregiver Initial Information Form
Family Assessment Battery
CAFAS/PECFAS
Caseworker discussions for NCFAS-Gamp;R completion
Washoe Family Assessment Battery
DCFS Biological Parent Study Contact Form
DCFS Biological Parent Interview
DCFS Youth and Foster Parent Study Contact Form
DCFS Foster Parent Interview
DCFS Youth Interview
RISE Staff Pre-Test
RISE Staff Post-Test

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	4,155	3,006	0	1,149	0	0
Annual Time Burden (Hours)	3,071	2,922	0	149	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This is an additional information collection request under OMB #0970-0408.Already approved information collections continue under this clearance and burden has been updated to reflect information already collected.

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Annual Cost to Federal Government: $1,358,271

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 05/30/2013

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