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View ICR - OIRA Conclusion

OMB Control No: 0906-0042	ICR Reference No: 202501-0906-003
Status: Active	Previous ICR Reference No: 202404-0906-002
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: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/12/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/22/2025
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2028	36 Months From Approved	04/30/2025
Responses	14,500	0	17,584
Time Burden (Hours)	3,155	0	3,481
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	14,500	17,584	-3,084
Annual Time Burden (Hours)	3,155	3,481	-326
Annual Cost Burden (Dollars)	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The estimated annual burden in this revision package is 3,155 hours, a decrease from the previously estimated 3,481 hours in ICR 202404-0906-002. Although the total number of interviews has increased, the burden hours have declined due to two factors: (1) survey timings have been adjusted to reflect actual survey times from the three completed rounds of data collection, rather than prior estimates, and (2) eligibility assumptions and response rates have been updated based on actual results from the same three rounds of data collection experience.

Annual Cost to Federal Government: $1,189,364

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? No

Agency Contact: Laura Cooper 301 443-2126 lcooper@hrsa.gov