Tribal Maternal, Infant, and Early Childhood Home Visiting Program Performance Reporting Form 2

ICR 201705-0970-005

OMB: 0970-0500

Federal Form Document

IC Document Collections
ICR Details
0970-0500 201705-0970-005
Historical Active
HHS/ACF
Tribal Maternal, Infant, and Early Childhood Home Visiting Program Performance Reporting Form 2
New collection (Request for a new OMB Control Number)   No
Regular
Approved without change 08/03/2017
Retrieve Notice of Action (NOA) 05/19/2017
  Inventory as of this Action Requested Previously Approved
08/31/2020 36 Months From Approved
20 0 0
10,000 0 0
0 0 0

Social Security Act, Title V, Section 511 (42 U.S.C. §711), as amended by the Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015 (Public Law (Pub.L.) 114-10) created the Maternal, Infant, and Early Childhood Home Visiting Program (MIECHV) and authorized the Secretary of HHS (in Section 511(h)(2)(A)) to award grants to Indian tribes (or a consortium of Indian tribes), tribal organizations, or urban Indian organizations to conduct an early childhood home visiting program, through 3 percent of the total MIECHV program appropriation (authorized in Section 511(j)) for grants to tribal entities. The implementation of the program is a collaborative endeavor between Health Resources Services Administration (HRSA) and the Administration for Children and Families (ACF). HRSA administers the State MIECHV program while ACF administers the Tribal MIECHV program. The goal of the Tribal MIECHV program is to support the development of happy, healthy, and successful American Indian and Alaska Native (AIAN) children and families through a coordinated home visiting system. Tribal MIECHV grants, to the greatest extent practicable, are to be consistent with the requirements of the MIECHV grants to states and jurisdictions (authorized in Section 511(c)), and include conducting a needs assessment and establishing quantifiable, measurable benchmarks. The proposed Tribal MIECHV Form 2 (Appendix 1) will be used by Tribal MIECHV grantees to annually report their benchmark performance measures. As stipulated in the MIECHV legislation, the Tribal MIECHV grantees, like their State counterparts, must meet the required reporting of benchmark areas. The Tribal MIECHV Form 2 will be used by Tribal MIECHV grantees to begin collecting performance data in October 2017 (pending OMB approval) and then reporting performance data in October 2018 on an annual basis thereafter. The Tribal MIECHV Form 2 is new to the MIECHV Program information system and is somewhat similar to the currently-approved Tribal MIECHV Form 3 (OMB #0915-0357 Expiration: 07/31/17). The creation of Tribal MIECHV Form 2 is due to the added level of specificity and revised performance reporting requirements for grantees to report benchmarks data.

US Code: 44 USC 711 Name of Law: Social Security Act, Title V, Section 511
   PL: Pub.L. 114 - 10 511(h)(2)(A) Name of Law: Medicare Access and Children's Health Insurance Program (CHIP) Reauthorization Act of 2015
  
None

Not associated with rulemaking

  82 FR 7836 01/23/2017
82 FR 23008 05/19/2017
Yes

  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 20 0 0 20 0 0
Annual Time Burden (Hours) 10,000 0 0 10,000 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
The Tribal MIECHV Form 2 is new to the MIECHV Program information system. The creation of Tribal MIECHV Form 2 is due to the added level of specificity and revised performance reporting requirements for grantees to report benchmarks data.

$480,000
No
No
No
No
No
Uncollected
Molly Buck 202 205-4724 mary.buck@acf.hhs.gov

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
05/19/2017


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