View Information Collection Request (ICR) Package
Skip to main content
An official website of the United States government
The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.
The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.
Search:
Agenda
Reg Review
ICR
This script is used to control the display of information in this page.
Display additional information by clicking on the following:
All
Brief and OIRA conclusion
Abstract/Justification
Legal Statutes
Rulemaking
FR Notices/Comments
IC List
Burden
Misc.
Common Form Info.
Certification
View Information Collection (IC) List
View Supporting Statement and Other Documents
Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0970-0523
ICR Reference No:
201807-0970-016
Status:
Historical Active
Previous ICR Reference No:
Agency/Subagency:
HHS/ACF
Agency Tracking No:
Title:
Childhood & Family Experiences
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved with change
Conclusion Date:
02/25/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
07/25/2018
Terms of Clearance:
OMB is approving this information collection request for a period of one year during which time the agency will request approval to extend or revise the collection if the agency seeks to continue the information collection activity beyond the period approved under this action.
Inventory as of this Action
Requested
Previously Approved
Expiration Date
02/29/2020
12 Months From Approved
Responses
215
0
0
Time Burden (Hours)
161
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
The Administration for Children and Families (ACF) at the U.S. Department of Health and Human Services (HHS) seeks approval for data collection activities for a study that will examine the perspectives and lived experiences of children and families living in poverty. ACF seeks OMB approval for four data collection instruments that will be used as part of the site selection process and field interviews: - Phone Screener for Prospective Families (Appendix A) - Adult Interview Guide (Appendix B) - Adolescent Interview Guide (Ages 12-17) (Appendix C) - Child Interview Guide (Ages 7-11) (Appendix D) The proposed data collection activities will collect qualitative data about how children describe their lives materially; what children understand about their families’ economic circumstances; what children know about any public benefits that their families receive or do not receive; how children feel about any public benefits that their families receive or do not receive; how children interact with public assistance offices and workers; what the most salient aspects of families’ interactions with public assistance offices are; and how parents perceive their economic circumstances and/or benefit receipt as impacting their family and children. This justification provides supporting statements for each of the eighteen points outlined in Part A of the OMB guidelines.
Authorizing Statute(s):
PL:
Pub.L. 115 - 31 413
Name of Law: Social Security Act, as amended by the FY 2017 Consolidated Appropriations Act, 2017
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
83 FR 2996
01/22/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 35275
07/25/2018
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Appendix A - Phone Screener for Prospective Families
Appendix B - Adult Interview Guide
Appendix C - Adolescent Interview Guide (Ages 12-17)
Appendix D - Child Interview Guide (Ages 7-11)
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
215
0
0
215
0
0
Annual Time Burden (Hours)
161
0
0
161
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:
No
Burden Reduction Due to:
Short Statement:
This is a new collection.
Annual Cost to Federal Government:
$277,280
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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
Agency Contact:
Molly Buck 202 205-4724 mary.buck@acf.hhs.gov
Common Form ICR:
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:
(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:
07/25/2018