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OMB Control No: 0906-0017	ICR Reference No: 202603-0906-002
Status: Received in OIRA	Previous ICR Reference No: 202503-0906-001
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: Maternal, Infant, and Early Childhood Home Visiting Program Performance Measurement Information System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular	Date Submitted to OIRA: 03/13/2026

	Requested	Previously Approved
Expiration Date	36 Months From Approved	09/30/2027
Responses	280	56
Time Burden (Hours)	73,416	43,736
Cost Burden (Dollars)	0	0

Abstract: The Maternal, Infant, and Early Childhood Home Visiting (MIECHV) Program is administered by the Maternal and Child Health Bureau (MCHB) within HRSA in partnership with the Administration for Children and Families. MIECHV provides support to all 56 states and jurisdictions, as well as tribes and tribal organizations. State and jurisdiction MIECHV funding recipients report annual demographic and performance data to HRSA through: Form 1 – Demographic Performance Measures; Form 2 – Benchmark Performance Measures. MIECHV funding recipients also report program information on a quarterly basis through Form 4 – Quarterly Data Collection, currently approved under OMB No. 0906-0016. This ICR will now include Forms 1, 2, and 4, so all the components of data collection for the MIECHV Program in one request. OMB No. 0906-0016 will be discontinued after OMB approval of this ICR. The forms will not be renumbered because MIECHV used to have Form 3 and that is no longer part of the data collection. MCHB decided not to renumber the forms because this has been well recognized by all awardees that it’s the quarterly form and renaming to Form 3 might be more confusing at this time.

Authorizing Statute(s): PL: Pub.L. 117 - 328 6101 Name of Law: Consolidated Appropriations Act, 2023
US Code: 42 USC 701, section 511 Name of Law: Social Security Act, Sct 511

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 59844	12/22/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 12431	03/13/2026
Did the Agency receive public comments on this ICR? Yes

ICR Summary of Burden

	Total Request	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	280	56	224
Annual Time Burden (Hours)	73,416	43,736	29,680
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: Changes have been made to MIECHV Forms 1, 2 and 4. Forms 1 and 2 are included in the currently approved package for OMB No. 0906-0017). Form 4 was approved through a separate ICR: OMB No. 0906-0016. HRSA is seeking to combine all information collection forms through a single ICR in this revision package. However, rather than reflecting a true increase in burden, the updated burden estimate reflects actual burden data more accurately for each form. As stated above in Section 12A, HRSA conducted a survey under OMB No. 0906-0094 in summer 2024 where awardees reported approximate actual burden hours to complete information collection. We are not adjusting the number of the forms to avoid confusion from respondents.

Annual Cost to Federal Government: $882,628

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

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