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View ICR - OIRA Conclusion

OMB Control No: 0906-0042	ICR Reference No: 202404-0906-002
Status: Historical Active	Previous ICR Reference No: 202211-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Maternal and Child Health Jurisdictional Survey Instrument for the Title V MCH Block Grant Program
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: 04/12/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 04/10/2024
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2025	04/30/2025	04/30/2025
Responses	17,584	0	7,303
Time Burden (Hours)	3,481	0	2,002
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	17,584	7,303	10,281
Annual Time Burden (Hours)	3,481	2,002	1,479
Annual Cost Burden (Dollars)	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: The proposed non-substantive adjustment as outlined below will increase the survey’s sample size in Puerto Rico, Guam, US Virgin Islands, and the Republic of Marshall Islands. An increase in sample size will improve the precision of the data in all Jurisdictions. Many of the estimates for the National Outcome and National Performance Measures in the first two rounds of data collection maintained large confidence intervals, which means the estimates are not precise and must be interpreted with caution. An increase in sample size would help to remedy the problem.

Annual Cost to Federal Government: $1,273,954

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. No

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? Yes

Agency Contact: Tierra Moore 301 443-0496 tmoore@hrsa.gov