Supporting Statement A - OHSEPR Repatriation Revision v3

U.S. Repatriation Program Forms

OMB Information Collection Request

0970 - 0474

Supporting Statement Part A - Justification

April 2022

Submitted By:

Office of Human Services Emergency Preparedness and Response

Administration for Children and Families

U.S. Department of Health and Human Services

1. Circumstances Making the Collection of Information Necessary

The U.S. Repatriation Program (Program) is authorized by Section 1113 of the Social Security Act (42 U.S.C. § 1313) and the assistance provided to mentally ill repatriates found under 24 U.S.C. §§ 321 - 329. This program also provides services for emergency repatriations which are authorized under Section 1113 and by the extension of the Executive Order (E.O.) precedent, E.O. 12656 (53 CFR 47491). Program regulations are in 45 CFR 211 & 212. The information collected through the forms in this request allows the Office of Human Services Emergency Preparedness and Response (OHSEPR) to fulfill its statutory responsibilities to provide temporary assistance to repatriates. OHSEPR needs specific information to determine eligibility for temporary assistance, to grant extensions beyond the 90-day eligibility period, to reimburse states for services provided, to collect repatriation loans from repatriates, and to grant loan waivers and deferrals.

OHSEPR is proposing revisions to all eight forms to ensure the information collected aligns with Program statutes and regulations as well as the purpose and use of the form. Revisions include clarifying statutory authority and general instructions on completing and submitting the forms. These changes make the forms more user friendly.

2. Purpose and Use of the Information Collection

OHSEPR uses the information collected to conduct both emergency and routine repatriation. These forms allow OHSEPR to conduct Program operations regarding: 1) determining a repatriate’s eligibility for temporary assistance 2) granting extensions for temporary assistance beyond the 90-day eligibility period 3) collecting repatriation loans from repatriates and to grant loan waivers and deferrals 4) reimbursing states and service providers for temporary assistance provided to eligible repatriates and 5) pre-approving states’ costs for emergency repatriation.

3. Use of Improved Information Technology and Burden Reduction

All of the forms can be submitted electronically via e-mail. OHSEPR is considering reducing the burden by making the forms fillable online. If OHSEPR determines this change is appropriate and feasible, it will submit a non-substantive change request to reflect the change in data collection mode and any adjustments to estimated time to complete the collections. We do not anticipate this change would impact the content, purpose, or use of the forms.

4. Efforts to Identify Duplication and Use of Similar Information

OHSEPR operates the only U.S. Repatriation Program. Therefore, similar data is not available and there is no duplication of effort.

5. Impact on Small Businesses or Other Small Entities

This information collection does not impact small business or other small entities.

6. Consequences of Collecting the Information Less Frequently

Not collecting this information or collecting the information less frequently would impact the ability of OHSEPR to conduct Program operations in a timely and efficient manner. This would prevent or delay eligibility determinations, extensions for temporary assistance beyond the 90-day eligibility period, loan collections from repatriates, determinations on loan waivers and deferrals, reimbursements to states and service providers for temporary assistance, and pre-approvals for states’ costs for emergency repatriation. Without a repatriate’s signature on the Repatriation Repayment and Privacy Agreement form, OHSEPR cannot provide assistance under the Program.

7. Special Circumstances Relating to the Guidelines of 5 CFR 1320.5

OHSEPR does not have special circumstances relating to these guidelines.

8. Comments in Response to the Federal Register Notice and Efforts to Consult Outside the Agency

In accordance with the Paperwork Reduction Act of 1995 (Pub. L. 104-13) and Office of Management and Budget (OMB) regulations at 5 CFR Part 1320 (60 FR 44978, August 29, 1995), ACF published a notice in the Federal Register announcing the agency’s intention to request an OMB review of this information collection activity. This notice was published on February 4, 2022, Volume 87, Number 24, page 6569 - 6570, and provided a sixty-day period for public comment. During the notice and comment period, no substantive comments were received.

9. Explanation of Any Payment or Gift to Respondents

Respondents do not receive any compensation for completing these forms.

10. Assurance of Confidentiality Provided to Respondents

The Repatriation Repayment and Privacy Agreement form (RR-05) includes a Privacy Act Statement that is in accordance with Program regulations 45 CFR 211.14 and 45 CFR 212.9. The Privacy Act Statement authorizes the Program to collect personally identifiable information (PII) on the RR-05 as well as the following forms: Emergency Repatriation Eligibility Application (RR-01), Loan Waiver and Deferral Application (RR-03), Routine Repatriation Reimbursement Request (RR-04), and Temporary Assistance Extension Request (RR-07).

The Privacy Statement also authorizes the Program to disclose repatriates’ PII to other Federal and state agencies, grantees, service providers, contractors, or private organizations, if necessary for HHS to carry out its responsibilities under 42 U.S.C. 1313 and 24 U.S.C. Sections 321 - 329, or to enable another Federal agency to carry out any functions related to a repatriate’s return from a foreign country to the United States, or as otherwise expressly authorized by appropriate HHS staff.

11. Justification for Sensitive Questions

The Repatriation Repayment and Privacy Agreement (Form RR-05) has voluntary demographic questions regarding race, ethnicity, marital status, gender, primary language, veteran status, disabilities, highest level of education, and annual household income. These questions align with Executive Order 13985 (Advancing Racial Equity and Support for Underserved Communities Through the Federal Government).

Additionally, the Loan Waiver and Deferral Application (RR-03) and Temporary Assistance Extension Request (RR-07) have detailed questions about a repatriate’s financial situation. The questions are necessary for OHSEPR to make eligibility determinations for the Program and to assess a repatriate’s request for an extension of temporary assistance or a loan waiver or deferral.

12. Estimates of Annualized Burden Hours and Costs

Information Collection Title	Total Number of Respondents	Number of Responses Per Respondent	Average Burden Hours Per Response	Annual Burden Hours	Average Hourly Wage	Annual Cost
Emergency Repatriation Eligibility Application	1,000	1	.5	500	$9.58	$4,790
Emergency Repatriation Reimbursement Request	10	1	.3	3	$62.44	$187
Loan Waiver and Deferral Application	100	1	.5	50	$9.58	$479
Routine Repatriation Reimbursement Request	25	10	.3	75	$62.44	$4683
Repatriation Repayment and Privacy Agreement	800	1	.17	136	$9.58	$1,303
Refusal of Temporary Assistance	300	1	.05	15	$9.58	$144
Temporary Assistance Extension Request	25	1	.3	8	$62.44	$499
Emergency Repatriation Request for Cost Approval and Federal Support	5	10	.3	15	$62.44	$937
Estimated Annual Burden Total:				802	Estimated Annual Cost Total:	$13,022

 

The estimated Annual Burden total is 802 hours. This is significantly less than the currently approved annual burden total. The new burden numbers are based on actual numbers of repatriates assisted during routine and emergency repatriations.

The average burden hours per response are estimates based on federal employees’ experience with filling out the forms.

The estimated annual total cost is $13,022.

Repatriates are likely to complete the following four forms listed in the table above: Emergency Repatriation Eligibility Application, Loan Waiver and Deferral Application, Repatriation Repayment and Privacy Agreement, and Refusal of Temporary Assistance. The costs to complete these forms were calculated as follows:

The total number of burden hours to complete the four forms is 701. Some repatriates are employed and many are unemployed. Therefore, their wage is calculated as the average minimum wage among the states in 2021 ($9.58). The cost for repatriates to complete the four forms is $9.58 times 701 or $6716.

Social Workers will complete the following forms: Emergency Repatriation Reimbursement Request, Routine Repatriation Reimbursement Request, Temporary Assistance Extension Request, and Emergency Repatriation Request for Cost Approval and Federal Support. The costs for social workers to complete these four forms is calculated as follows:

The total number of burden hours to complete the four forms is 101.The job code is 21-1029 and wage data from May 2020 is $31.22 per hour. To account for fringe benefits and overhead, the hourly rate ($31.22) is multiplied by two, which is $62.44. The estimate of the annualized cost to respondents for hourly burden is $62.44 times 101 or $6,306.

https://www.bls.gov/oes/current/oes_stru.htm

13. Estimates of Other Total Annual Cost Burden to Respondents and Record Keepers

The total annual cost for recordkeeping is $8,000 for the grantee’s database.

14. Annualized Cost to the Federal Government

The annual cost to the federal government is estimated to be $188,568. This number was estimated using the following calculation:

The January 2022 hourly wage for a GS 14 step 1 employee is $60.49. To account for fringe benefits and overhead, the hourly rate ($60.49) is multiplied by two, which is $120.98. The number of hours for a federal employee to develop the forms and analyze, evaluate, summarize and/or report on the collected information is 766 hours. Therefore, the total for ACF staff is $120.98 times 766 hours or $92,671.

Also, the social workers bill their staff time for filling out the forms (see number 12 - $6,306) to the federal government (the U.S. Repatriation Program).

In addition, the U.S. Repatriation Program grantee assists in the collection of information by helping states and repatriates complete the forms and analyzing information. The average hourly rate for grantee staff is $33.33. To account for fringe benefits and overhead, the hourly rate ($33.33) is multiplied by two, which is $66.66. The annual number of hours the grantee assists in the collection of information is 1344. The total for grantee staff is $66.66 times 1344 which is $89,591.

Therefore, the estimate of annualized cost to the federal government is $92,671 plus $6,306 plus $89,591 or $188,568.

15. Explanation for Program Changes or Adjustments

OHSEPR made changes to all eight forms, as described in section A1. OHSEPR also adjusted the burden and cost estimates to make them more accurate. See section A12 for information about updates to burden estimates.

16. Plans for Tabulation and Publication and Project Time Schedule

The results of the information collection will not be published.

17. Reason(s) Display of OMB Expiration Date is Inappropriate

OHSEPR is not requesting to not display the OMB expiration date.

18. Exceptions to Certification for Paperwork Reduction Act Submissions

No exceptions are necessary for this information collection.