OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Regional Partnership Grants National Cross-Site Evaluation and Evaluation Technical Assistance

ICR 201612-0970-002 · OMB 0970-0444 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Data Entry for Comparision Study Sites Form and Instruction New Repair queued
Form 1 Review Records and Submit Electonically Form and Instruction New Available
Form 1 Enter Data in Local Database Form and Instruction New Available
Form 1 Report Administrative Data Form and Instruction New Available
Form 1 Obtain Access to Administrative Data Form and Instruction New Available
Form 1 Partner Survey Form and Instruction New Available
Form 1 Staff Survey Form and Instruction New Repair queued
Form 1 Service Log Entries Form and Instruction New Available
Form 1 Case Enrollment Data Form and Instruction New Repair queued
Form 1 Semi-Annual Progress Report Form and Instruction New Repair queued
Form 1 Frontline Staff Individual Interview Form and Instruction New Available
Form 1 Program Manager/Supervisor Individual Interview Form and Instruction New Available
Form 1 Program Manager/Supervisor Group Interview Form and Instruction New Available
Form 1 Program Director Individual Interview Form and Instruction New Available
Form VIIB Household Ros Data entry for comparison study sites - Government Form and Instruction Removed Available
Form VIIB Household Ros Data entry for comparison study sites - Private sector Form and Instruction Removed Available
Form VIB Household Rost Report Administrative data - Government Form and Instruction Removed Available
Form VIB Household Rost Report administrative data - Private Sector Form and Instruction Removed Available
Form VA Partner Survey Partner Survey - Government Form and Instruction Removed Repair queued
Form VA Partner Survey Partner Survey - Private Sector Form and Instruction Removed Available
Form IVA Staff Survey Staff Survey - Government Form Removed Available
Form IVA Staff Survey Staff Survey - Private Sector Form Removed Available
Form IIB Description of Semi-annual progress reports - Government Form and Instruction Removed Available
Form IIB Description of Semi-annual progress reports - Private Sector Form and Instruction Removed Available
Form IA Interview Topic Program Director Individual Interview - Government Form and Instruction Removed Available
Form IA Interview Topic Program Director Individual Interview - Private Sector Form and Instruction Removed Available
supporting statement Part_A 12062016 (4).docx Supporting Statement A Uploaded 2016-12-15 Available
Part_B for OMB March 2020 renewal.docx Supporting Statement B Uploaded 2016-12-07 Available
VII Copy of legislation.pdf Supplementary Document Uploaded 2016-12-07 Available
IIF RPG3 Description of Other Services and Activities.docx Supplementary Document Uploaded 2016-12-07 Available
IIE RPG3 Description of Evidence-Based Practices.docx Supplementary Document Uploaded 2016-12-07 Available
IIC RPG2 Description of Other Services and Activities.docx Supplementary Document Uploaded 2016-12-07 Repair queued
IIB RPG2 Description of Evidence-Based Practices.docx Supplementary Document Uploaded 2016-12-07 Available
IIA RPG2 Semi-Annual Progress Report Form.docx Supplementary Document Uploaded 2016-12-07 Available
RPG OMB references for OMB March 2020 renewal.docx Supplementary Document Uploaded 2016-12-07 Available
IC Document Collections
IC IDCollectionTypeStatusForm
224732 Data Entry for Comparision Study Sites Form and Instruction New
224731 Review Records and Submit Electonically Form and Instruction New
224730 Enter Data in Local Database Form and Instruction New
224729 Report Administrative Data Form and Instruction New
224728 Obtain Access to Administrative Data Form and Instruction New
224727 Partner Survey Form and Instruction New
224726 Staff Survey Form and Instruction New
224725 Service Log Entries Form and Instruction New
224724 Case Enrollment Data Form and Instruction New
224723 Semi-Annual Progress Report Form and Instruction New
224722 Frontline Staff Individual Interview Form and Instruction New
224721 Program Manager/Supervisor Individual Interview Form and Instruction New
224719 Program Manager/Supervisor Group Interview Form and Instruction New
224718 Program Director Individual Interview Form and Instruction New
209841 Data entry for comparison study sites - Government Form and Instruction Removed
209840 Data entry for comparison study sites - Private sector Form and Instruction Removed
209839 Review records and submit data electronically - Government Removed
209838 Review records and submit data electronically - Private Sector Removed
209837 Enter data into local databases - Government Removed
209836 Enter data into local databases - Private Sector Removed
209835 Review and adopt reporting templates - Government Removed
209834 Review and adopt reporting templates - Private Sector Removed
209833 Report Administrative data - Government Form and Instruction Removed
209832 Report administrative data - Private Sector Form and Instruction Removed
209831 Obtain access to administrative data - Government Removed
209830 Obtain Access to Administrative Data - Private Sector Removed
209829 Partner Survey - Government Form and Instruction Removed
209828 Partner Survey - Private Sector Form and Instruction Removed
209827 Staff Survey - Government Form Removed
209826 Staff Survey - Private Sector Form Removed
209825 Service Log Entries - Government Removed
209824 Service log entries - Private Sector Removed
209823 Case Enrollment Data - Government Removed
209822 Case enrollment data - Private Sector Removed
209821 Semi-annual progress reports - Government Form and Instruction Removed
209820 Semi-annual progress reports - Private Sector Form and Instruction Removed
209819 Frontline staff individual interview - Government Other-Interview Topic Guide Removed
209818 Frontline staff individual interview - Private sector Other-Interview Topic Guide Removed
209817 Program manger/supervisor individual interview - Government Other-Interview Topic Guide Removed
209816 Program manger/supervisor individual interview - Private Sector Other-Interview Topic Guide Removed
209815 Program manager/supervisor group interview - Government Other-Interview Topic Guide Removed
209814 Program Manager/Supervisor Group Interview - Private Sector Other-Interview Topic Guide Removed
209813 Program Director Individual Interview - Government Form and Instruction Removed
209812 Program Director Individual Interview - Private Sector Form and Instruction Removed
ICR Details
0970-0444 201612-0970-002
Historical Active 201502-0970-009
HHS/ACF ACYF
Regional Partnership Grants National Cross-Site Evaluation and Evaluation Technical Assistance
Extension without change of a currently approved collection   No
Regular
Approved without change 03/15/2017
Retrieve Notice of Action (NOA) 12/19/2016
  Inventory as of this Action Requested Previously Approved
03/31/2020 36 Months From Approved 03/31/2017
305,623 0 100,814
64,809 0 22,984
0 0 0
Under RPG, CB has issued 21 grants (17 grants under RPG2 and 4 grants under RPG3) to organizations such as child welfare or substance use disorder treatment providers or family court systems to develop interagency collaborations and provide services designed to increase well-being, improve permanency, and enhance the safety of children who are in an out-of-home placement or are at risk of being placed in out-of-home care as a result of a parent’s or caretaker’s substance use disorder. CB required RPG grantees to use evidence-based or evidence-informed programs to deliver services to children, adults, and families. The overall objective of the RPG Cross-Site Evaluation is to plan, develop, and implement a rigorous national cross-site evaluation of the RPG Grant Program, provide legislatively-mandated performance measurement, and furnish evaluation-related technical assistance to the grantees to improve the quality and rigor of their local evaluations. The project will document the programs and activities conducted through the RPG program and assess the extent to which the grants have been successful in addressing the needs of families with substance use disorders who come to the attention of the child welfare system.
PL: Pub.L. 112 - 34 437 Name of Law: Child and Family Services Improvement Act
  
None
Not associated with rulemaking
  81 FR 41310 06/24/2016
81 FR 88688 12/08/2016
No
14
IC Title Form No. Form Name
Program manger/supervisor individual interview - Private Sector IB Site Visit Informant Form IB Site Visit Informant Form
Semi-annual progress reports - Private Sector IIA Semi-Annual Progress Report Form, IIB Description of Evidence-Based Practices, IIC Description of Other Services and Activities, IID Description of Partnerships, IIE Adherence Form IIB Description of Evidence-Based Practices ,   IIC Description of Other Services and Activities ,   IID Description of Partnerships ,   IIE Adherence Form ,   IIA Semi-Annual Progress Report Form
Semi-annual progress reports - Government IIB Description of Evidence-Based Practices, IIA Semi-Annual Progress Report Form, IIC Description of Other Services and Activities, IID Description of Partnerships, IIE Adherence Form IIB Description of Evidence-Based Practices ,   IIA Semi-Annual Progress Report Form ,   IIC Description of Other Services and Activities ,   IID Description of Partnerships ,   IIE Adherence Form
Case enrollment data - Private Sector
Case Enrollment Data - Government
Staff Survey - Private Sector IVA Staff Survey IVA Staff Survey
Program Director Individual Interview - Government IA Interview Topic Guide IA Interview Topic Guide
Program manger/supervisor individual interview - Government IB Site Visit Informant Form IB Site Visit Informant Form
Report Administrative data - Government VIB Household Roster VIB Household Roster
Review and adopt reporting templates - Government
Review records and submit data electronically - Government
Data entry for comparison study sites - Private sector VIIB Household Roster VIIB Household Roster
Program Director Individual Interview 1 Interview Topic Guide
Semi-Annual Progress Report 1 RPG2 Semi-Annual Progress Report Form
Case Enrollment Data 1 Enrollment and Service Log Data Dictionary
Service Log Entries 1 III Enrollment and Service Log Data Dictrionary
Obtain Access to Administrative Data 1 Outcome and Impact Study Information System User Guide and Data Dictionary
Data Entry for Comparision Study Sites 1 Outcome and Impact Study Information System User Guide and Data Dictionary
Partner Survey - Government VA Partner Survey VA Partner Survey
Frontline staff individual interview - Private sector IB Site Visit Informant Form IB Site Visit Informant Form
Frontline staff individual interview - Government IB Site Visit Informant Form IB Site Visit Informant Form
Service log entries - Private Sector
Service Log Entries - Government
Staff Survey - Government IVA Staff Survey IVA Staff Survey
Report administrative data - Private Sector VIB Household Roster VIB Household Roster
Enter data into local databases - Government
Review records and submit data electronically - Private Sector
Data entry for comparison study sites - Government VIIB Household Roster VIIB Household Roster
Program Manager/Supervisor Group Interview 1 Interview Topic Guide
Program Manager/Supervisor Individual Interview 1 Interview Topic Guide
Frontline Staff Individual Interview 1 Interview Topic Guide
Staff Survey 1 Staff Survey
Partner Survey 1 Partner Survey
Program manager/supervisor group interview - Government IB Site Visit Informant Form IB Site Visit Informant Form
Enter data into local databases - Private Sector
Report Administrative Data 1 Outcome and Impact Study Information System User Guide and Data Dicstionary
Enter Data in Local Database 1 Outcome and Impact Study Information System User Guide and Data Dictionary
Review Records and Submit Electonically 1 Outcome and Impact Study Information System User Guide and Data Dictionary
Program Director Individual Interview - Private Sector IA Interview Topic Guide, IB Site Visit Informant Form IA Interview Topic Guide ,   IB Site Visit Informant Form
Partner Survey - Private Sector VA Partner Survey VA Partner Survey
Obtain Access to Administrative Data - Private Sector
Obtain access to administrative data - Government
Review and adopt reporting templates - Private Sector
Program Manager/Supervisor Group Interview - Private Sector IB Site Visit Informant Form IB Site Visit Informant Form
  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 305,623 100,814 0 305,623 -100,814 0
Annual Time Burden (Hours) 64,809 22,984 0 64,809 -22,984 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
For additional grants awarded.
$1,118,315
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Robert Sargis 2026907275
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/19/2016