Collection of Performance Measures - Personal Responsibility Education Program (PREP)

Forms and Documents

Document Name	Status
Memo - PREP PMAPS NonSub Change Request_07_29_19_final.docx Justification for No Material/Nonsubstantive Change	2019-07-29
Appendix B_Consent letters and forms_clean_FOOTER_030117.docx Supplementary Document	2017-04-03
PMAPS- PM Supp Stat B_012717_clean_UPDATED_071919.docx Supporting Statement B	2019-07-29
PMAPS- PM Supp Stat A_022817_clean_UPDATED_072919_2.docx Supporting Statement A	2019-07-29

IC Document Collections

IC ID	Document Title	Status
223555	Performance Measure Data Report Form (Instrument 4) Other-Data Entry Form	Unchanged
223554	Performance Measures Data Report Form (Instrument 3) Other-Data Entry Form	Modified
223553	Core measures (Instrument 5) Other-Survey	Unchanged
223552	Exit Survey (Instrument 2) Other-Survey	Modified
223549	Entry Survey (Instrument 1) Other-Survey	Modified

ICR Details

OMB Control No: 0970-0497	ICR Reference No: 201907-0970-008
Status: Historical Active	Previous ICR Reference No: 201609-0970-004
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Collection of Performance Measures - Personal Responsibility Education Program (PREP)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/05/2019
	Date Received in OIRA: 07/29/2019
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2020	04/30/2020	04/30/2020
Responses	265,865	0	265,865
Time Burden (Hours)	51,311	0	61,911
Cost Burden (Dollars)	0	0	0

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Abstract: This request is for a nonsubstantive change participant entry and exit surveys for grantees to collect data from participants. We are currently submitting instruments that reflect the following changes compared to the PREP PMAPS Participant Entry and Exit Surveys approved in April 2017: 1) remove sensitive items (by dropping items about oral sex or anal sex, modifying items asking about “vaginal sex” to ask about “sexual intercourse,” and deleting definitions of sexual behaviors); 2) modify and expand existing items related to adulthood preparation subjects; and 3) add items to capture information from youth relevant to the success sequence for poverty prevention. , Additionally, due to the sensitive nature of some of the original questions, the previously approved versions of the surveys required separate versions for middle and high school youth (with not all items administered to middle school youth). Since ACF is proposing to remove the most sensitive questions, separate versions of the surveys are no longer necessary. This request for a nonsubstantive change to the entry and exit surveys decreases the overall burden estimate.

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Authorizing Statute(s): PL: Pub.L. 114 - 10 215 Name of Law: Medicare Access and CHIP Reauthorization Act of 2015
  

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:
	81 FR 21353	04/11/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 63763	09/16/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Entry Survey (Instrument 1)
Exit Survey (Instrument 2)
Performance Measures Data Report Form (Instrument 3)
Performance Measure Data Report Form (Instrument 4)
Core measures (Instrument 5)

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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	265,865	265,865	0	0	0	0
Annual Time Burden (Hours)	51,311	61,911	0	-10,600	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: ACF’s request for a nonsubstantive change to the entry and exit surveys decreases the overall burden estimate. With the changes to questions, we now estimate the entry survey to take 9 minutes (previously estimated to be 8 minutes) and the exit survey to take 8 minutes (previously estimated to be 15 minutes).

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Annual Cost to Federal Government: $285,419

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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: 07/29/2019

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