Information Collection Request

Healthy Marriage and Responsible Fatherhood Performance Measures and Additional Data Collection

ICR 202102-0970-014 · OMB 0970-0566 · Received in OIRA

⚠️ Notice: This information collection may be outdated. More recent filings for OMB 0970-0566 can be found here:

Forms and Documents

Document	Type	Status	Availability
Form HM 6: Quarterly Performance Report (QPR)	Form and Instruction	New	Repair queued
Form HM 5: Semi-annual Performance Progress Report (PPR)	Form and Instruction	New	Missing upstream
Attachment D_Assumptions for Calculations of Burden Estimates.docx	Supplementary Document	Uploaded 2021-02-25	Repair queued
Attachment C_IRB Exemption for ACF-Sponsored Analysis of Performance Measures.pdf	Supplementary Document	Uploaded 2021-02-25	Repair queued
Attachment B_60-Day FRN_HMRF nFORM_2020-26266.pdf	Supplementary Document	Uploaded 2021-02-25	Repair queued
Attachment_A_Legislative Authority_Claims Res Act_SSA_Title IV_Part A_Section 403_HMRF grants.pdf	Supplementary Document	Uploaded 2021-02-25	Repair queued
HMRF_2020cohort_OMB_Part_B_2.25.21_Final.docx	Supporting Statement B	Uploaded 2021-02-25	Repair queued
HMRF_2020cohort_OMB_Part_A_2.25.21_Final.docx	Supporting Statement A	Uploaded 2021-02-25	Available

IC Document Collections

IC ID	Collection	Type	Status
246012	7: CQI Plan	Other-Template	New
246011	6: Quarterly Performance Report (QPR)	Form and Instruction	New
246010	5: Semi-annual Performance Progress Report (PPR)	Form and Instruction	New
246008	4: Entrance and Exit Surveys - Program staff (entrance and exit on paper)	Other-HM Adult Entrance Survey	New
246007	4: Entrance and Exit Surveys - Program clients (exit)	Other-HM Adult Exit Survey	New
246006	4: Entrance and Exit Surveys - Program clients (entrance)	Other-HM Adult Entrance Survey	New
246005	3: Service Delivery Data	Other-Reporting System	New
246004	2: Program Operations	Other-Survey	New
246003	1: Applicant Characteristics - Program Staff	Other-Survey	New
246002	1: Applicant Characteristics - Program Applicants	Other-Survey	New

ICR Details

OMB Control No:	ICR Reference No: 202102-0970-014
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: OPRE
Title: Healthy Marriage and Responsible Fatherhood Performance Measures and Additional Data Collection
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: 03/01/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	447,093	0
Time Burden (Hours)	140,177	0
Cost Burden (Dollars)	0	0

Abstract: The Administration for Children and Families (ACF) requires that each cohort of Healthy Marriage and Responsible Fatherhood (HMRF) grantees collect data and report on a comprehensive set of performance measures as part of their grants. The 2015 cohort of grantees used data collection and reporting instruments approved by the Office of Management and Budget under approval number 0970-0490. This new information collection request (ICR) covers the performance measures data collection and reporting instruments for the 2020 cohort. For the 2020 cohort, the instruments used by the 2015 cohort were revised by ACF to reflect its current priorities, better align the data with the characteristics of HMRF programs and clients, and improve the grantee user experience.

Authorizing Statute(s): US Code: 42 USC 603 Name of Law: Sec. 403; Social Security Act

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:
	85 FR 76580	11/30/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 12006	03/01/2021
Did the Agency receive public comments on this ICR? No

Number of Information Collection (IC) in this ICR: 10

IC Title	Form No.	Form Name
2: Program Operations
3: Service Delivery Data
4: Entrance and Exit Surveys - Program clients (entrance)
4: Entrance and Exit Surveys - Program clients (exit)
4: Entrance and Exit Surveys - Program staff (entrance and exit on paper)
5: Semi-annual Performance Progress Report (PPR)	HM, RF	HM PPR , RF PPR
6: Quarterly Performance Report (QPR)	HM, RF	HM QPR , RF QPR
7: CQI Plan
1: Applicant Characteristics - Program Applicants
1: Applicant Characteristics - Program Staff

ICR Summary of Burden

	Total Request	Change Due to Agency Discretion
Annual Number of Responses	447,093	447,093
Annual Time Burden (Hours)	140,177	140,177
Annual Cost Burden (Dollars)	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 information collection request.

Annual Cost to Federal Government: $2,584,978

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. Yes

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: Molly Buck 202 205-4724 [email protected]

Common Form ICR: No