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COMMENT
Time Remaining
Days
HR
Min
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OMB Control No:
ICR Reference No:
202512-0906-002
Status:
Received in OIRA
Previous ICR Reference No:
Agency/Subagency:
HHS/HRSA
Agency Tracking No:
Title:
Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program Model Eligibility Review Survey
Type of Information Collection:
New collection (Request for a new OMB Control Number)
Common Form ICR:
No
Type of Review Request:
Regular
Date Submitted to OIRA:
12/15/2025
Requested
Previously Approved
Expiration Date
36 Months From Approved
Responses
24
0
Time Burden (Hours)
72
0
Cost Burden (Dollars)
0
0
Abstract:
The MIECHV program supports voluntary, evidence-based home visiting services during pregnancy and to families with young children up to kindergarten entry living in at-risk communities. One key program requirement is that programs deliver services using models that meet HHS criteria for evidence of effectiveness.1 HRSA and ACF define such service delivery models as “evidence-based.” ACF administers the Home Visiting Evidence of Effectiveness (HomVEE) review process to identify early childhood home visiting models that demonstrate evidence of effectiveness.2 However, not all evidence-based service delivery models approved through the HomVEE process meet MIECHV statutory requirements such that they may be used to carry out the MIECHV Program in fidelity to applicable program requirements. This ICR to proposes a survey to identify service delivery models that meet both HHS criteria for evidence of effectiveness, as determined by HomVEE review, and applicable MIECHV statutory requirements, and therefore may be used by eligible entities to provide home visiting services through the MIECHV Program.
Authorizing Statute(s):
PL:
Pub.L. 117 - 328 6101
Name of Law: Consolidated Appropriations Act, 2023
US Code:
42 USC 711(d)(3)(ii-iii)
Name of Law: 42 USC 711: Maternal, infant, and early childhood home visiting programs
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:
90 FR 1508
01/08/2025
30-day Notice:
Federal Register Citation:
Citation Date:
90 FR 57770
12/12/2025
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
MIECHV Program Model Eligibility Review Survey (Private Sector)
1
Model Eligibility Survey
MIECHV Program Model Eligibility Review Survey (State/Local Government)
1
Model Eligibility Survey
ICR Summary of Burden
Total Request
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
24
0
0
24
0
0
Annual Time Burden (Hours)
72
0
0
72
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:
$245,536
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.
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
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:
12/15/2025
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