Submission for Office of Management and Budget (OMB) Review; Monitoring and Compliance for ORR Care Provider Facilities (OMB #: 0970-0564), 34858-34865 [2023-11487]
Download as PDF
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commercial property such as patentable
material, and personal information
concerning individuals associated with
the grant applications, the disclosure of
which would constitute a clearly
unwarranted invasion of personal
privacy.
Agenda items for this meeting are
subject to change as priorities dictate.
Dated: May 24, 2023.
Marquita Cullom,
Associate Director.
[FR Doc. 2023–11498 Filed 5–30–23; 8:45 am]
BILLING CODE 4160–90–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Refugee Cash and Medical
Assistance Federal Financial Report
ORR–2 Supplemental Data Collection
(OMB #: 0970–0510)
Office of Refugee Resettlement,
Administration for Children and
Families, U.S. Department of Health and
Human Services.
ACTION: Request for public comments.
AGENCY:
The Administration for
Children and Families’ (ACF) Office of
Refugee Resettlement (ORR) plans to
submit a generic information collection
(GenIC) request under the following
umbrella generic: Generic Clearance for
Financial Reports used for ACF
Mandatory Grant Programs (0970–0510).
SUMMARY:
This request is to include instructions
for ORR Refugee Cash and Medical
Assistance (CMA) grant recipients to
provide supplemental financial
information when submitting the
already required ORR–2 Financial
Report, which is approved under Office
of Management and Budget (OMB)
number 0970–0407.
DATES: Comments due within 14 days of
publication. In compliance with the
requirements of the Paperwork
Reduction Act of 1995, ACF is soliciting
public comment on the specific aspects
of the information collection described
above and below.
ADDRESSES: Copies of the proposed
collection of information can be
obtained and comments may be
forwarded by emailing infocollection@
acf.hhs.gov. All requests should be
identified by the title of the information
collection.
SUPPLEMENTARY INFORMATION:
Description: ACF programs require
detailed financial information from their
grantees that allows ACF to monitor
various specialized cost categories
within each program to closely manage
program activities and to have sufficient
financial information to enable periodic
thorough and detailed audits. The
Generic Clearance for Financial Reports
used for ACF Mandatory Grant
Programs allows ACF programs to
efficiently develop and receive approval
for financial reports that are tailored to
specific funding recipients and the
associated needs of the program. For
more information about the umbrella
generic, see: https://www.reginfo.gov/
public/do/PRAViewICR?ref_
nbr=202303-0970-002.
This specific GenIC request applies to
all ORR Refugee Cash and Medical
Assistance grantees awarded traditional
base funding as well as funding received
under the Afghanistan Supplemental
Appropriations Act, 2022 (ASA), and
the Ukraine Supplemental
Appropriations Act, 2022, and other
appropriations as communicated. All
grantees must complete reporting in
accordance with statute. Currently,
grantees use the ORR–2 (OMB #: 0970–
0407) to report federal expenditures by
program categories such as refugee cash
assistance and refugee medical
assistance. The ORR–2 requests grantees
to report on the various program
categories totaling expenditures,
unliquidated obligations, and
unobligated balances. ORR is proposing
to request that grantees break out
unobligated balances reported on the
final ORR–2 financial report by funding
source (base, ASA, Ukraine) and
financial account number as referenced
on the Notice of Award as a Word or
Excel attachment to upload (with the
ORR–2 report) in the Online Line Data
Collection via the designated link. This
final report is due September 30th. The
proposed supplemental instructions
will provide guidance and assist
grantees with submitting the additional
detail about Federal expenditure data
reported on the ORR–2. The analysis of
this data would further support
adherence to program requirements.
Respondents: States, State Agency
Grantee Designees.
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ANNUAL BURDEN ESTIMATES
Title of information collection
Number of
respondents
Annual
frequency
of responses
Hourly
burden per
response
Annual
hourly burden
RSS SF–425 Supplemental Data Collection ...................................................
66
1
1.67
110
Comments: The Department
specifically requests comments on (a)
whether the proposed collection of
information is necessary for the proper
performance of the functions of the
agency, including whether the
information shall have practical utility;
(b) the accuracy of the agency’s estimate
of the burden of the proposed collection
of information; (c) the quality, utility,
and clarity of the information to be
collected; and (d) ways to minimize the
burden of the collection of information
on respondents, including through the
use of automated collection techniques
or other forms of information
technology. Consideration will be given
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to comments and suggestions submitted
within 14 days of this publication.
Authority: Section 412(c)(1)(A) of the
Immigration and Nationality Act (8
U.S.C. 1522(c)(1)(A)).
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Mary B. Jones,
ACF/OPRE Certifying Officer.
Submission for Office of Management
and Budget (OMB) Review; Monitoring
and Compliance for ORR Care Provider
Facilities (OMB #: 0970–0564)
[FR Doc. 2023–11479 Filed 5–30–23; 8:45 am]
BILLING CODE 4184–89–P
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Administration for Children and
Families
Office of Refugee Resettlement,
Administration for Children and
Families, U.S. Department of Health and
Human Services.
AGENCY:
ACTION:
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Request for public comments.
31MYN1
Federal Register / Vol. 88, No. 104 / Wednesday, May 31, 2023 / Notices
The Office of Refugee
Resettlement (ORR), Administration for
Children and Families (ACF), U.S.
Department of Health and Human
Services (HHS), is inviting public
comments on the proposed collection.
The request consists of several forms
that allow the ORR Unaccompanied
Children (UC) Program to enhance
monitoring efforts at care provider
facilities that are not licensed by the
State, as well as continue standard
monitoring activities that ensure its care
provider facilities are in compliance
with Federal and State laws and
regulations, licensing and accreditation
standards, ORR policies and procedures,
and child welfare standards. This notice
is specific to forms that were recently
approved through emergency approval
for 180 days and additional proposed
forms.
DATES: Comments due within 30 days of
publication. OMB must make a decision
about the collection of information
between 30 and 60 days after
publication of this document in the
Federal Register. Therefore, a comment
is best assured of having its full effect
if OMB receives it within 30 days of
publication.
ADDRESSES: Written comments and
recommendations for the proposed
information collection should be sent
within 30 days of publication of this
notice to www.reginfo.gov/public/do/
PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. You can also obtain
copies of the proposed collection of
information by emailing infocollection@
acf.hhs.gov. Identify all emailed
requests by the title of the information
collection.
SUPPLEMENTARY INFORMATION:
SUMMARY:
Description
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Current Proposed Revisions
Quarterly Unlicensed Facility Site Visits
• Unlicensed Facility
Unaccompanied Child Case File
Checklist (Form M–8A–UF)
Æ Admission Documents
D Inventory of Property and Cash:
Corrected timeframe to align with
policy. The inventory log should be
completed ‘‘within 2 hours of
admission’’ not 24 hours.
D Clothing and Supplies: Added
language to clarify what is covered
under this item.
Æ Orientation Documents—Added
new item checking for compliance with
ORR’s access to reproductive health care
policy (also known as the Garza policy).
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Æ Legal Information
D Acknowledgement of Receiving
Legal Resource Guide: Changed ‘‘within
24 hours’’ to ‘‘within 24 hours of
admission’’ to clarify the policy
requirement.
D EOIR Docs: Corrected name
Executive Office for Immigration
Review (‘‘Review’’ was missing)
Æ Medical Documents
D Authorization for Medical, Dental,
and Mental Health Care: Changed
‘‘within 24 hours’’ to ‘‘within 24 hours
of admission’’ to clarify the policy
requirement.
D Documentation of Initial Medical
Exam: Added ‘‘within 48 hours of
admission’’ to clarify policy
requirement. Updated form expiration
dates referenced. Added reminder that
completion of the exam form is
mandatory.
D Dental Exam Form: Updated form
expiration dates referenced. Added
reminder that completion of the form is
mandatory.
D Supplemental TB Screening Form:
Updated form expiration dates
referenced. Added reminder that
completion of the form is mandatory.
D Prescriptions: Changed ‘‘log’’ to
‘‘record/log’’ for clarity.
D Split Medical and Mental Health
Records into two separate line items and
added language to clarify the policy
requirements.
Æ Assessments
D Unaccompanied Child Case Review:
In first bullet point, clarified that it’s the
initial case review that is continuously
updated until 30 calendar days after
admission. In second bullet point,
changed ‘‘Every 30 calendars days . . .’’
to ‘‘Subsequently every 30 calendar
days . . .’’ for clarity.
D Sponsor Assessment: Updated form
expiration dates referenced. Changed
‘‘Within 5 days’’ to ‘‘Must be initiated
within 5 days’’ for clarity.
D Individual Service Plan: Changed
‘‘Within 5 days’’ to ‘‘Initial must be
done within 5 days’’ for clarity.
Æ Case Management—Recreation/
Leisure: Changed ‘‘log’’ to ‘‘plan/log’’ for
clarity. Removed ‘‘Effective 3/20/20—
avoid community outing due to COVID–
19’’ since this is no longer applicable.
Æ Clinical Services—Added
‘‘Disclosure Notice’’ to reflect new
policy requirement.
Æ Discharge
D Removed ‘‘CDC Covid–19 Fact
Sheet and Symptoms Sheet (Effective: 3/
13/20)’’—the revised sponsor letter has
replaced that fact sheet.
D Added ‘‘Post-18 Plan (if
applicable)’’ to align with policy and
procedures.
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D Family Reunification Packet:
Updated form expiration dates
referenced.
Æ Post-Discharge—Health Follow-Up
Call: Updated effective dates for related
guidance and added language clarify
requirements.
• Unlicensed Facility Staff Secure
Addendum to Case File Checklist (Form
M–8D–UF)—Made minor edits for more
precise language and changed
formatting to bullet point lists for
several items.
• Unlicensed Facility Personnel File
Checklist (Form M–10A–UF)
Æ Removed Training Directive per
ORR Management section because it is
no longer a requirement. This
requirement was related to a specific
webinar series on the topic of traumainformed care. It was removed because
it is duplicative of the requirements in
the cooperative agreement that require
training on strength-based behavior
management and trauma-informed care
approaches.
Æ Annual Trainings—Removed
‘‘Hover for additional comments’’ and
corresponding comment that read ‘‘How
does the employee confirm
comprehension of a training? i.e., quiz/
test score or signature confirming
comprehension’’ because respondents
reported the comments were unhelpful.
Æ Trainings Every Two Years per
Cooperative Agreement—
D Medication Management: Added
‘‘must also receive medication
administration training’’
D Removed ‘‘Hover for additional
comments’’ and corresponding
comment that read ‘‘How does the
employee confirm comprehension of a
training? i.e., quiz/test score or signature
confirming comprehension’’ because
respondents reported the comments
were unhelpful.
D Rephrased ‘‘Strength-based
behavior management . . .’’ to
‘‘Strength-based behavior management
and trauma-informed care approaches’’
to reflect current cooperative agreement
requirements.
Reinstated the following forms as the
number of respondents has increased to
more than nine respondents.
• Unlicensed Facility LTFC
Monitoring Notes (Form M–6C–UF)
• Unlicensed Facility LTFC UC Case
File Checklist (Form M–8B–UF)
• Unlicensed Facility Staff Secure
Addendum to Case File Checklist (Form
M–8D–UF)
• Unlicensed Facility Foster Home
Onsite Monitoring Checklist (M–9B–UF)
Quarterly Influx Care Facility Site Visits
Added the below-listed alternate
version of a form that was previously
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approved by OMB but was removed
from the information collection due to
the number of respondents. Differences
between the previously approve version
and the alternate version are noted
below.
• Influx Care Facility (ICF)
Monitoring Notes (Form M–6E)
Æ Instructs monitors to review the
facility’s contract and statement of work
(as opposed to the grant application and
cooperative agreement) to reflect the
funding method used for ICFs.
Æ Removes the following sections that
are specific to grants.
D Fiscal year budget
D Key positions approved by the
Project Officer
Æ Instructs monitors to review
Serious Incident Reports (SIRs) from the
past three months (as opposed to six
months for shelters). This revision does
not represent a reduction in SIR review,
rather it reflects the ongoing SIR review
process that occurs for ICFs. Monitors
are performing site visits within the first
three months of an ICR opening, which
means that there would only be three
months’ worth of SIRs available during
the initial site visit. Thereafter, three
months will cover review of all SIRs
since the last site visit. For example, if
an ICF opened at the start of January,
the initial site visit would occur by the
end of March and SIRs generated from
January through March would be
reviewed. The next site visit would then
occur at the end of June and during that
visit SIRs generated April through June
would be review. There would be no
need to review six months’ worth of
SIRs at that time because the SIRs
generated January through March would
have already been reviewed. This
pattern of quarterly reviews would
continue while the ICF is operational.
Æ Reworded questions under the
staffing plan section to be more specific
to contracts.
Æ Added instruction for monitors to
ensure that the facility is following their
supervision plan (as reported in the ICF
Site Visit Guide) for any staff whose
relevant background checks are still
pending. All staff must pass a public
records criminal background check
before hire. Staff with direct access to
children must also pass an FBI
fingerprint check and child abuse and
neglect check (CA/N). However, staff
may be hired provisionally before FBI or
CA/N check results are received if at all
times prior to receipt of results the staff
member is within the sight and under
the supervision of a staff member whose
background checks are complete.
Æ Removed questions on State
licensing.
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Æ Removed section on mosquito
control inspections. These inspections
were originally established to address
concerns with the Zika virus and are no
longer performed.
Added the below-listed alternate
versions of forms already approved
under this information collection.
Differences between the already
approved versions and the alternate
versions are as noted below.
• ICF Monitoring Site Visit Guide
(Form M–7G)—Revisions were made to
develop a more in-depth guide to reflect
the size and complexity of influx sites.
ORR plans to pilot this revised guide at
ICFs and later decide on whether some
or all of these revisions should be made
to site visit guides for other levels of
care. ORR will seek OMB approval for
any future revision to other versions of
the site visit guide.
Æ Reorganized and grouped questions
under different sections, as well as
rewording questions and instructions
for clarity.
Æ Added text boxes and tables to
make clear where the ICF should enter
information.
Æ Added areas for the ICF to provide
a brief overview of their site operations
and list of subcontractors and their
respective scopes of work.
Æ Expanded the list of facility points
of contact requested.
Æ Added areas for the ICF to share
any innovative and/or best practices
implemented at the site and for the ICF
to describe know deficiencies and/or
areas for improvement.
Æ Added a table in the stakeholders
section to prompt the ICF to provide
more detail information about the
frequency and type of collaboration as
well as areas in need of improvement.
Æ Expanded section on personnel to
include questions about personnel
evaluation practices, whistleblower
policies, and significant staffing
changes, vacancies, deficiencies, and/or
barriers to personnel capacity.
Æ In addition to providing copies of
internal procedures, ICFs are asked to
document information about the
personnel responsible for internal
reviews, protocols for responding to
noncompliance, and how the ICF
protects child privacy and
confidentiality.
Æ Expands the question asking for the
program’s video monitoring policies and
procedures to include all perimeter and
internal security mechanisms.
Æ In addition to providing copies of
emergency and evacuation plans,
programs are asked to describe related
procedures and provide information on
emergency drills and after-action
reviews.
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Æ Added area for programs to
describe their safety inspection
practices and related drills, as well as an
area to note concerns/deficiencies
related to safety and security.
Æ Added questions on the program’s
procedures for staffing cases, case status
updates, and how case managers
coordinate with other discipline (e.g.,
clinical).
Æ Split the question asking for the
programs discharge procedures into
several questions that prompt the
program to specifically provide
information about their procedures for
transfers, age redetermination cases, and
managing age outs.
Æ Added question that requests the
program’s procedures on facilitating
visits among children in care.
Æ Added question asking the program
to note any complex or especially
vulnerable cases that required
specialized service coordination.
Æ Added question asking the program
to note any concerns/deficiencies
related to case management.
Æ Added new section on child
supervision that asks for program’s
procedures on supervision plans and
direct care staffing ratios, determining
room/bed assignments, accurately
monitoring the location of the child, and
behavior management.
Æ Expanded the section that asks for
a description of ancillary services to
include recreational/leisure, religious,
languages access, and phone call,
visitation, and mail services (in addition
to education and transportation).
Æ In addition to requesting copies of
nutritional services procedures, adds a
section for programs to describe these
services. This includes food storage and
safety protocols, how child dietary
needs are meet, how cultural and
religious preferences are meet, and any
concerns/deficiencies.
Æ Expands the medical services
section to add questions asking the
program to describe their medical
intakes procedures, onsite medical
services, medication administration
protocols, medical records system, the
process for referring a child for offsite
medical services, and vaccination
procurement and administration
protocols.
Æ Expands the mental health services
section to add questions asking the
program to describe their mental health
intake procedures and onsite mental
health services.
Æ In addition to requesting copies of
prevention of sexual abuse procedures
and related materials, asks the program
to describe several specific aspects of
their procedures.
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Æ Breaks the general question asking
the program to describe their SIR
procedures into several more specific
questions on who the responsible
parties are for submitting reports,
follow-up/addendums, and notification/
coordination with external entities.
Æ Adds a new question asking the
program how long it took to complete
the form.
Æ Updates the type of background
check documentation requested to align
with background check requirements
specific to influx care facilities.
• ICF Personnel File Checklist (Form
M–10E)
Æ Pre-Service Trainings—Removed
‘‘State licensed required trainings’’
because ICF are not State-licensed.
Æ Removed Training Directive per
ORR Management section because it is
no longer a requirement. This
requirement was related to a specific
webinar series on the topic of traumainformed care. It was removed because
it is duplicative of a new item added to
the annual trainings section that
monitors for training on strength-based
behavior management and traumainformed care approaches.
Æ Annual Trainings—Added
‘‘Strengths-based behavior management
approaches and trauma-informed care
approaches, such as using conflict
resolution, problem solving skills, using
rewards and consequences, deescalation techniques and helping
children and youth learn accountability
and self-control.’’
Æ Removed Trainings Every Two
Years per Cooperative Agreement
section because ICFs are funded through
contracts and not grants.
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Prevention of Sexual Abuse (PSA)
Audits
ORR is seeking approval to add eight
new instruments that will allow ORR to
audit its care provider programs for
compliance with the IFR on Standards
to Prevent, Detect, and Respond to
Sexual Abuse and Sexual Harassment
Involving Unaccompanied Children (45
CFR Subpart L). These instruments are
currently in use without OMB approval;
this request will allow ORR to comply
with the Paperwork Reduction Act
requirements. The proposed new
instruments are:
• Preaudit Questionnaire and Audit
Documentation Requested Checklist
(Form M–17A)
• Instructions for Site Visit and
Facility Tour (Form M–17B)
• Interview Guide: Random Sample
of Staff Interview (Form M–17C)
• Interview Guide: Program Director
(Form M–17D)
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• Interview Guide: Prevention of
Sexual Abuse (PSA) Compliance
Manager (Form M–17E)
• Interview Guide: Specialized Staff
(Form M–17F)
• Interview Guide: Unaccompanied
Child (Form M–17G)
• PSA Audit Corrective Action Report
(Form M–17H)
Revisions to Existing Forms
The below noted revisions were made
to existing forms in this collection to
better align with ORR policies and
procedures and strengthen monitoring
protocols.
• FFS Compliance and Safety Site
Visit Report (Form M–3A)
Æ Converted the original Excel
version into a web-based format.
Æ Removed the following items that
are best practices but not explicitly
required in ORR policy/procedures:
D Client’s rights are posted in
language unaccompanied child
understands
D Daily schedule is posted in
language unaccompanied child
understands
Æ Added the following fields
D ORR Region
D Please note the number of children
in the group being interviewed
D Please note the estimate age range of
the group of children you interviewed
Æ Renamed field ‘‘FFS Name’’ to
‘‘ORR Representative Name’’
Æ Consolidated separate questions
regarding compliance with staffing
ratios into two questions (‘‘Is the
program compliant with all ORR staffing
ratios?’’ and ‘‘Are there staffing
concerns?’’) and added field ‘‘If Yes,
please confirm you elevated this to the
Project Officer for resolution or to
address UC capacity.’’
• PSA Unaccompanied Child
Incident Review (Form M–5A)—
Corrected typo in the When did the
incident occur? field dropdown options,
changing ‘‘pm’’ to ‘‘am.’’
• PSA Adult Incident Review (Form
M–5B)—Corrected typo in the When did
the incident occur? field dropdown
options, changing ‘‘pm’’ to ‘‘am.’’
• Site Visit Guide (Form M–7A)
Æ Under Child Protection—Added
requirement for program to provide link
to mandatory reporting laws/rules and
specify who is classified as a mandatory
reported in the State in which the
program is located.
Æ Under Background Checks—
Clarified that information on foster
parents is also required.
Æ Removed reference to mosquito
control inspections. These inspections
were originally established to address
concerns with the Zika virus and are no
longer performed.
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Æ Added Personnel and Volunteer
List as a supplemental tool to use with
this instrument. This list directly
corresponds to the information
requested in the Background Checks
section of the guide.
• Foster Care Site Visit Guide (Form
M–7C)
Æ Retitled form ‘‘Foster Care Site Visit
Guide.’’ The former title was ‘‘Long
Term Foster Care Site Visit Guide.’’
Æ Under Program Management—
Added requirement to describe internal
policies and procedures related to
referral and placement.
Æ Under Child Protection—Rephrased
question 3 from ‘‘Describe the State’s
licensing child maltreatment reporting
requirements. (Provide state link to
licensing requirements for reporting
requirements.)’’ to ‘‘Describe the State’s
child maltreatment reporting
requirements. (Provide a link to the
state’s mandatory reporting laws/rules.
Also, include who classifies as a
mandatory reporter in your state.)’’
Æ Under Facility, Foster Homes, and
Food Services
D Retitled ‘‘Facility, Foster Homes,
and Food Services section to ‘‘Foster
Homes.’’
D Moved the two questions unrelated
to foster homes into their own section
titled ‘‘Facility and Food Services’’ and
added additional instructions to clarify
what programs are expected to include
in their description of the facility space.
Æ Under Case Management—Clarified
what programs must provide related to
their procedures on post-18 planning.
Æ Under Background Checks—
Reordered and rephrased some of the
questions.
Æ Under Health Services—Added
examples of communicable diseases.
Æ Under Problems Encountered—
Removed requirement to provide list of
commonly used partnerships and
services.
Æ In the list of requested materials
D Added educational curriculum and
weekly class schedule
D Reformatted the item requesting
various policies and procedures into a
bullet point list
Æ Added a note clarifying that ORR
will request foster parent
documentation for foster homes that are
visited during the site visit.
• Personnel File Checklist (Form M–
10A)
Æ Removed Training Directive per
ORR Management section because it is
no longer a requirement. This
requirement was related to a specific
webinar series on the topic of traumainformed care. It was removed because
it is duplicative of the requirements in
the cooperative agreement that require
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training on strength-based behavior
management and trauma-informed care
approaches.
Æ Annual Trainings—Removed
‘‘Hover for additional comments’’ and
corresponding comment that read ‘‘How
does the employee confirm
comprehension of a training? i.e. quiz/
test score or signature confirming
comprehension’’ because respondents
reported the comments were unhelpful.
Æ Trainings Every Two Years per
Cooperative Agreement—
D Medication Management: Added
‘‘must also receive medication
administration training’’
D Removed ‘‘Hover for additional
comments’’ and corresponding
comment that read ‘‘How does the
employee confirm comprehension of a
training? i.e. quiz/test score or signature
confirming comprehension’’ because
respondents reported the comments
were unhelpful.
D Rephrased ‘‘Strength-based
behavior management . . .’’ to
‘‘Strength-based behavior management
and trauma-informed care approaches’’
to reflect current cooperative agreement
requirements.
• Foster Parent Checklist (Form M–
10D)
Æ Under General Documentation—
Added requirement for monitors to
check for completed foster home study
assessments/inspections.
Æ General Documentation
D Foster Home License: Added
‘‘(Effective: 2022; please reference the
program-specific Cooperative
Agreement)’’ to clarify requirements in
the current cooperative agreement.
D Added new item ‘‘Completed Foster
Home Study Assessments/Inspections
(Effective: 2022; please reference the
program-specific Cooperative
Agreement)’’ to align with requirements
in the current cooperative agreement.
D Added new item ‘‘Foster Parent
Agreement (signed; Effective: 2022;
please reference the program-specific
Cooperative Agreement)’’ to align with
requirements in the current cooperative
agreement.
Æ Pre-Service Trainings—ORR
Standards to Prevent, Detect, and
Respond to SA and SH involving
unaccompanied children: Removed
‘‘New employees must complete
training before hire.’’ to align with
current guidance that allows hire (but
no interaction with children) before
training.
• Foster Parent Questionnaire (Form
M–11O)
Æ Added instructions on the first
page.
Æ Reordered some questions.
Æ Clarified that when asking the
foster parent what information they
VerDate Sep<11>2014
17:32 May 30, 2023
Jkt 259001
received on the child, that ORR is
asking about information on the child’s
individual services needs and provided
examples (education, health, dietary,
religious, etc.).
Æ Added example of independent
living to question asking what types of
activities the child participates in.
• Unaccompanied Child
Questionnaire—Ages 6–12 Years Old
(Form M–12As)—Updated Spanish
translation to match currently-approved
English version.
• Unaccompanied Child
Questionnaire—Ages 13 and Older
(Form M–12Bs)—Updated Spanish
translation to match currently-approved
English version.
ORR is requesting that the following
instruments be removed from this
information collection:
• Remote Monitoring Site Visit Guide
(Form M–7B)—Remove from
information collection. This instrument
was created for use during the height of
the COVID–19 pandemic. Monitors have
resumed in-person site visits and the
instrument is no longer needed.
• Long Term Foster Care Remote Site
Visit Guide (Form M–7D)—Remove
from information collection. This
instrument was created for use during
the height of the COVID–19 pandemic.
Monitors have resumed in-person site
visits and the instrument is no longer
needed.
Voluntary Agency Site Visit Guide
(Form M–7F)—Remove from
information collection. This instrument
is completed by less than 10
respondents and therefore not subject to
PRA.
Revisions Approved Under Emergency
Approval
Added Interpreter Questionnaire
(Form M–11P), which is currently
approved under OMB #0970–0558, to
this information collection.
Quarterly Unlicensed Facility Site Visits
Added the following forms that were
previously approved by OMB but were
removed from the information
collection due to the number of
respondents. Differences between the
previously approved versions and the
current versions that will be used by
contractor monitors are as noted below.
• Monitoring Notes (Form M–6A–UF)
Æ Directions added to top of form.
• UC Case File Checklist (Form M–
8A–UF)
Æ Added a Read Me tab with
directions.
Æ Added a summary tab that autosums data from other tabs.
Æ Revised the formatting of the UC
Services tab.
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Frm 00041
Fmt 4703
Sfmt 4703
• On Site Monitoring Checklist (M–
9A–UF)
Æ Removed section on mosquito
control. These inspections were
originally established to address
concerns with the Zika virus and are no
longer performed.
Æ Under Documents that Should be
Posted—Removed reference to two
discontinued items.
Æ Under Other—Removed reference
to mosquito repellant.
Æ Under Logs/Schedules—Removed
reference to the discontinued UC
Temperature Tracker.
Added the below-listed alternate
versions of forms already approved
under this information collection.
Differences between the already
approved versions and the alternate
versions are as noted below. Unlicensed
programs will continue to receive
comprehensive biennial monitoring
visits pursuant to UC Policy Guide
section 5.5.1 during which the full
original versions of these forms will be
used. Quarterly monitoring visits will
mainly focus on health and safety. To
align with that purpose and help
streamline forms that will be
administered more often than their full
version counterparts, adjustments made
to the alternate versions removed some
items related to program management.
Other adjustments were made for clarity
or to align with current ORR policy and
procedures. Quarterly monitoring visits
will continue to monitor the same areas
related to child welfare practices and
provision of services as biennial
monitoring visits.
• Site Visit Guide (Form M–7A–UF)
Æ Under Child Protection—Added
requirement for program to provide link
to mandatory reporting laws/rules and
specify who is classified as a mandatory
reported in the State in which the
program is located.
Æ Under Background Checks—
Clarified that information on foster
parents is also required.
Æ Removed reference to mosquito
control inspections. These inspections
were originally established to address
concerns with the Zika virus and are no
longer performed.
• Personnel File Checklist (Form M–
10A–UF)
Æ Under General Documentation—
Removed job description; employment
application; personal and professional
references; educational records;
professional licensure; and I–9
documents.
• Program Director Questionnaire
(Form M–11A–UF)
Æ Removed question on what changes
the program director envisions for the
program in the next year.
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Æ Modified the question on how the
program incorporates input from others
to assess the program to only ask about
how input from minors and staff is
used. Previously, the question asked
how input from minors, staff, program
partners, legal services providers, and
sponsor is used.
• Clinician Questionnaire (Form M–
11C–UF)
Æ Removed question on what system
the clinician uses to document clinical
sessions.
Æ Removed question asking clinician
to describe their relationship with their
supervisor.
• Case Manager Questionnaire (Form
M–11E–UF)
Æ Removed question asking case
manager to describe their relationship
with their supervisor.
• Education Staff Questionnaire
(Form M–11G–UF)
Æ No modifications made.
• Medical Coordinator Questionnaire
(Form M–11I–UF)
Æ Removed question asking medical
coordinator to describe their
relationship with their supervisor.
• Youth Care Worker Questionnaire
(Form M–11J–UF)
Æ Removed question on access to UC
Portal.
Æ Removed question on how often
staff meetings are held.
Æ Removed question asking youth
care worker to describe their
relationship with their supervisor.
• Prevention of Sexual Abuse
Compliance Manager Staff
Questionnaire (Form M–11K–UF)
Æ No modifications made.
• Interpreter Questionnaire (Form M–
11P–UF)
Æ No modifications made.
• UC Questionnaire—Ages 6–12
Years Old (Forms M–12A–UF and M–
12As–UF)
Æ Under Communication with
Family—Added question on how often
and how long the child speaks with
their family.
Æ Removed placeholder sections on
meetings with case management and
clinical staff, which are not asked of
children ages 6–12.
• UC Questionnaire—Ages 13 and
Older (Forms M–12B–UF and M–12Bs–
UF)
Æ Under Admission/Orientation—
Removed question asking what the child
remembers about documents signed/
received during the first couple days.
Æ Under Communication with
Family—Added question on how often
and how long the child speaks with
their family. Removed question on
sending/receiving mail and email.
• UC Questionnaire—Ages 5 and
Under (Form M–12E–UF and M–12Es–
UF)
Æ No modifications made.
• Legal Service Provider
Questionnaire (Form M–13C–UF)
Æ Reworded questions on ability to
perform Know Your Rights and legal
screenings.
Æ Removed question on with which
program staff members legal service
providers regularly interact.
Æ Removed questions method used to
inform legal service providers of
incidents affecting the child’s legal case.
• Case Coordinator Questionnaire
(Form M–13E–UF)
Æ No modifications made.
For information about all currently
approved forms under this OMB
number, see: https://www.reginfo.gov/
public/do/PRAViewICR?ref_
nbr=202108-0970-016.
Respondents: ORR grantee and
contractor staff; foster parents; and UC.
Annual Burden Estimates:
Note: These burden estimates include
burden related to the revisions
described above and currently approved
forms for which we are not proposing
any changes.
ESTIMATED BURDEN HOURS FOR RESPONDENTS
Annual
number of
respondents
lotter on DSK11XQN23PROD with NOTICES1
Information collection title
Corrective Action Report (Form M–1) .............................................................
FFS Compliance and Safety Site Visit Report (Form M–3A) ..........................
Out-of-Network Site Visit Report (Form M–3B) ...............................................
Checklist for a Child-Friendly Environment (Form M–4) .................................
Incident Reviews (Forms M–5A to M–5B) .......................................................
Site Visit Guide (Forms M–7A) ........................................................................
LTFC Site Visit Guide (Forms M–7C) .............................................................
Home Study and Post-Release Services Site Visit Guide (Form M–7E) .......
ICF Monitoring Site Visit Guide (Form M–7G) ................................................
Unlicensed Facility Site Visit Guide (Form M–7A–UF) ...................................
Unlicensed Facility UC Case File Checklist (Form M–8A–UF) .......................
Unlicensed Facility LTFC UC Case File Checklist (Form M–8B–UF) .............
Unlicensed Facility Staff Secure Addendum Case File Checklist (Form M–
8B–UF) .........................................................................................................
Program Staff Questionnaires (Forms M–11A to M–11K) ..............................
Secure Detention Officer Questionnaire (Form M–11L) ..................................
Long Term Foster Care Home Finder Questionnaire (Form M–11M) ............
Long Term Foster Care Independent Living Life Skills Staff Questionnaire
(Form M–11N) ..............................................................................................
Long Term Foster Care Foster Parent Questionnaire (Form M–11O) ...........
Interpreter Questionnaire (Form M–11P) ........................................................
Unlicensed Facility Program Staff Questionnaires (Forms M–11A–UF to M–
11K–UF) .......................................................................................................
Unlicensed Facility Interpreter Questionnaire (Form M–11P–UF) ..................
UC Questionnaires (Forms M–12A to M–12B & M–12E) ...............................
Long Term Foster Care Client Questionnaire (Form M–12C) ........................
Secure Client Questionnaire (Form M–12D) ...................................................
Unlicensed Facility UC Questionnaires (Forms M–12A–UF to M–12B–UF &
M–12E–UF) ..................................................................................................
Home Study and Post-Release Services Director Questionnaire (Form M–
13A) ..............................................................................................................
VerDate Sep<11>2014
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Frm 00042
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Annual
number of
responses per
respondent
Average
burden hours
per response
Annual total
burden hours
262
262
24
262
262
114
18
30
3
56
56
1
0.4
12.0
5.0
12.0
0.3
1.0
1.0
1.0
1
4.0
20.0
20
5.00
1.00
1.00
0.25
1.50
13.00
6.00
6.00
15.00
1.00
1.00
1.00
524.00
3,144.00
120.00
786.00
117.90
1,482.00
108.00
180.00
45.00
224.00
1,120.00
20.00
2
917
1
18
20
1.0
1.0
1.0
1.00
1.00
1.00
1.00
40.00
917.00
1.00
18.00
18
35
115
1.0
1.0
2.0
1.00
0.75
0.50
18.00
26.25
115.00
56
56
563
88
5
32.0
4.0
1.0
1.0
1.0
1.00
0.50
0.50
0.50
0.50
1,792.00
112.00
281.50
44.00
2.50
1,120
1.0
0.50
560.00
30
1.0
1.00
30.00
E:\FR\FM\31MYN1.SGM
31MYN1
34864
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ESTIMATED BURDEN HOURS FOR RESPONDENTS—Continued
Annual
number of
responses per
respondent
Annual
number of
respondents
Information collection title
Home Study and Post-Release Services Caseworker Questionnaire (Form
M–13B) .........................................................................................................
Legal Service Provider Questionnaire (Form M–13C) ....................................
Long Term Foster Care Legal Service Provider Questionnaire (Form M–
13D) ..............................................................................................................
Case Coordinator Questionnaire (Form M–13E) .............................................
Unlicensed Facility Legal Service Provider Questionnaire (Form M–13C–
UF) ...............................................................................................................
Unlicensed Facility Case Coordinator Questionnaire (Form M–13E–UF) ......
Preaudit Questionnaire and Audit Documentation Requested Checklist
(Form M–17A) ..............................................................................................
Instructions for Site Visit and Facility Tour (Form M–17B) .............................
Interview Guide: Random Sample of Staff Interview (Form M–17C) ..............
Interview Guide: Program Director (Form M–17D) .........................................
Interview Guide: PSA Compliance Manager (Form M–17E) ..........................
Interview Guide: Specialized Staff (Form M–17F) ..........................................
Interview Guide: Unaccompanied Child (Form M–17G) .................................
PSA Audit Corrective Action Report (Form M–17H) .......................................
Estimated Annual Burden Hours Total .....................................................
Average
burden hours
per response
Annual total
burden hours
90
114
1.0
1.0
1.00
1.00
90.00
114.00
18
131
1.0
1.0
0.75
1.00
13.50
131.00
224
224
1.0
1.0
0.75
1.00
168.00
224.00
78
78
312
78
78
156
780
78
1.0
1.0
1.0
1.0
1.0
1.0
1.0
1.0
4.00
2.00
1.00
1.00
1.00
1.00
0.50
1.00
312.00
156.00
312.00
78.00
78.00
156.00
390.00
78.00
........................
........................
........................
14,184.65
ESTIMATED BURDEN HOURS FOR CONTRACTOR INTERIM FINAL RULE AUDITORS
Annual
number of
responses per
respondent
Annual
number of
respondents
Information collection title
Average
burden hours
per response
Annual total
burden hours
Preaudit Questionnaire and Audit Documentation Requested Checklist
(Form M–17A) ..............................................................................................
Instructions for Site Visit and Facility Tour (Form M–17B) .............................
Interview Guide: Random Sample of Staff Interview (Form M–17C) ..............
Interview Guide: Program Director (Form M–17D) .........................................
Interview Guide: PSA Compliance Manager (Form M–17E) ..........................
Interview Guide: Specialized Staff (Form M–17F) ..........................................
Interview Guide: Unaccompanied Child (Form M–17G) .................................
PSA Audit Corrective Action Report (Form M–17H) .......................................
8
8
8
8
8
8
8
8
48.0
48.0
48.0
48.0
48.0
48.0
48.0
48.0
3.00
1.00
1.00
1.00
1.00
1.00
0.50
2.00
1,152.00
384.00
384.00
384.00
384.00
384.00
192.00
768.00
Estimated Annual Burden Hours Total .....................................................
........................
........................
........................
4,032.00
ESTIMATED BURDEN HOURS FOR CONTRACTOR MONITORS—UNLICENSED FACILITIES
Annual
number of
respondents
lotter on DSK11XQN23PROD with NOTICES1
Information collection title
Unlicensed Facility Monitoring Notes (Form M–6A–UF) .................................
Unlicensed Facility LTFC Monitoring Notes (Form M–6C–UF) .......................
ICF Monitoring Notes (Form M–6E–UF) .........................................................
Unlicensed Facility Site Visit Guide (Form M–7A–UF) ...................................
ICF Monitoring Site Visit Guide (Form M–7G) ................................................
Unlicensed Facility UC Case File Checklist (Form M–8A–UF) .......................
Unlicensed Facility LTFC UC Case File Checklist (Form M–8B–UF) .............
Unlicensed Facility Staff Secure Addendum to Case File Checklist (Form
M–8D–UF) ....................................................................................................
Unlicensed Facility On-Site Monitoring Checklist (Form M–9A–UF) ..............
Unlicensed Facility Foster Home Onsite Monitoring Checklist (Form M–9B–
UF) ...............................................................................................................
Unlicensed Facility Personnel File Checklist (Form M–10A–UF) ...................
ICF Personnel File Checklist (Form M–10E) ...................................................
Unlicensed Facility Program Staff Questionnaires (Forms M–11A–UF to M–
11K–UF) .......................................................................................................
Unlicensed Facility Interpreter Questionnaire (Form M–11P–UF) ..................
Unlicensed Facility UC Questionnaires (Forms M–12A–UF to M–12B–UF &
M–12E–UF) ..................................................................................................
Unlicensed Facility Legal Service Provider Questionnaire (Form M–13C–
UF) ...............................................................................................................
VerDate Sep<11>2014
16:50 May 30, 2023
Jkt 259001
PO 00000
Frm 00043
Fmt 4703
Sfmt 4703
Annual
number of
responses per
respondent
Average
burden hours
per response
Annual total
burden hours
18
18
18
18
18
18
18
12.0
0.2
0.7
12.0
0.7
62.0
1.0
12.00
12.00
12.00
29.00
29.00
6.00
6.00
2,592.00
43.20
151.20
6,264.00
365.40
6,696.00
108.00
18
18
2.0
12.0
6.00
4.00
216.00
864.00
18
18
18
0.4
50.0
3
4.00
1.00
1.00
28.80
900.00
54.00
18
18
100.0
12.0
1.00
0.50
1,800.00
108.00
18
62.0
0.50
558.00
18
12.0
0.75
162.00
E:\FR\FM\31MYN1.SGM
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34865
Federal Register / Vol. 88, No. 104 / Wednesday, May 31, 2023 / Notices
ESTIMATED BURDEN HOURS FOR CONTRACTOR MONITORS—UNLICENSED FACILITIES—Continued
Annual
number of
responses per
respondent
Annual
number of
respondents
Information collection title
Average
burden hours
per response
Annual total
burden hours
Unlicensed Facility Case Coordinator Questionnaire (Form M–13E–UF) ......
18
12.0
1.00
216.00
Estimated Annual Burden Hours Total .....................................................
........................
........................
........................
21,126.60
ESTIMATED BURDEN HOURS FOR CONTRACTOR MONITORS—PREVIOUSLY APPROVED FOR LICENSED FACILITIES
Average
burden hours
per response
Annual total
burden hours
Corrective Action Report (Form M–1) .............................................................
Site Visit Guide (Forms M–7A) ........................................................................
LTFC Site Guide (Forms M–7C) .....................................................................
Home Study and Post-Release Services Site Visit Guide (Form M–7E) .......
Personnel File Checklist (Form M–10A) ..........................................................
Supplement to Personnel File Checklist (Form M–10B) .................................
Home Study and Post-Release Services Personnel File Checklist (Form M–
10C) ..............................................................................................................
Long Term Foster Care Foster Parent Checklist (Form M–10D) ...................
Program Staff Questionnaires (Forms M–11A to M–11K) ..............................
Secure Detention Officer Questionnaire (Form M–11L) ..................................
Long Term Foster Care Home Finder Questionnaire (Form M–11M) ............
Long Term Foster Care Independent Living Life Skills Staff Questionnaire
(Form M–11N) ..............................................................................................
Long Term Foster Care Foster Parent Questionnaire (Form M–11O) ...........
UC Questionnaires (Forms M–12A to M–12B & M–12E) ...............................
Long Term Foster Care Client Questionnaire (Form M–12C) ........................
Secure Client Questionnaire (Form M–12D) ...................................................
Home Study and Post-Release Services Director Questionnaire (Form M–
13A) ..............................................................................................................
Home Study and Post-Release Services Caseworker Questionnaire (Form
M–13B) .........................................................................................................
Legal Service Provider Questionnaire (Form M–13C) ....................................
Long Term Foster Care Legal Service Provider Questionnaire (Form M–
13D) ..............................................................................................................
Case Coordinator Questionnaire (Form M–13E) .............................................
Monitoring Visit (Form M–14) ..........................................................................
Monitoring Schedule (Form M–15) ..................................................................
4
4
4
4
4
4
25.0
7.0
1.0
2.0
31.0
54.0
22.00
29.00
21.00
21.00
1.00
1.00
2,200.00
812.00
84.00
168.00
124.00
216.00
4
4
4
4
4
6.0
2.0
54.0
0.1
1.0
1.00
0.50
1.00
1.00
1.00
24.00
4.00
216.00
0.40
4.00
4
4
4
4
4
1.0
2.0
33.0
5.0
0.4
1.00
0.75
0.50
0.50
0.50
4.00
6.00
66.00
10.00
0.80
4
2.0
0.50
4.00
4
4
6.0
7.0
1.00
1.00
24.00
28.00
4
4
4
4
1.0
8.0
8.0
0.3
0.75
1.00
0.50
0.30
3.00
32.00
16.00
0.36
Estimated Annual Burden Hours Total .....................................................
........................
........................
........................
4,046.56
Authority: 6 U.S.C. 279; 8 U.S.C.
1232; Flores v. Reno Settlement
Agreement, No. CV85–4544–RJK (C.D.
Cal. 1996); 45 CFR part 411.
ACTION:
HRSA is publishing this
notice of petitions received under the
National Vaccine Injury Compensation
Program (the Program), as required by
the Public Health Service (PHS) Act, as
amended. While the Secretary of HHS is
named as the respondent in all
proceedings brought by the filing of
petitions for compensation under the
Program, the United States Court of
Federal Claims is charged by statute
with responsibility for considering and
acting upon the petitions.
[FR Doc. 2023–11487 Filed 5–30–23; 8:45 am]
BILLING CODE 4184–45–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Health Resources and Services
Administration
Health Resources and Services
Administration (HRSA), Department of
Health and Human Services (HHS).
VerDate Sep<11>2014
16:50 May 30, 2023
Jkt 259001
For
information about requirements for
filing petitions, and the Program in
general, contact Lisa L. Reyes, Clerk of
Court, United States Court of Federal
Claims, 717 Madison Place NW,
Washington, DC 20005, (202) 357–6400.
FOR FURTHER INFORMATION CONTACT:
National Vaccine Injury Compensation
Program; List of Petitions Received
AGENCY:
Notice.
SUMMARY:
Mary B. Jones,
ACF/OPRE Certifying Officer.
lotter on DSK11XQN23PROD with NOTICES1
Annual
number of
responses per
respondent
Annual
number of
respondents
Information collection title
PO 00000
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For information on HRSA’s role in the
Program, contact the Director, National
Vaccine Injury Compensation Program,
5600 Fishers Lane, Room 08N146B,
Rockville, Maryland 20857; (301) 443–
6593, or visit our website at: https://
www.hrsa.gov/vaccinecompensation/
index.html.
The
Program provides a system of no-fault
compensation for certain individuals
who have been injured by specified
childhood vaccines. Subtitle 2 of Title
XXI of the PHS Act, 42 U.S.C. 300aa–
10 et seq., provides that those seeking
compensation are to file a petition with
the United States Court of Federal
Claims and to serve a copy of the
petition to the Secretary of HHS, who is
named as the respondent in each
proceeding. The Secretary has delegated
this responsibility under the Program to
SUPPLEMENTARY INFORMATION:
E:\FR\FM\31MYN1.SGM
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Agencies
[Federal Register Volume 88, Number 104 (Wednesday, May 31, 2023)]
[Notices]
[Pages 34858-34865]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-11487]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
Submission for Office of Management and Budget (OMB) Review;
Monitoring and Compliance for ORR Care Provider Facilities (OMB #:
0970-0564)
AGENCY: Office of Refugee Resettlement, Administration for Children and
Families, U.S. Department of Health and Human Services.
ACTION: Request for public comments.
-----------------------------------------------------------------------
[[Page 34859]]
SUMMARY: The Office of Refugee Resettlement (ORR), Administration for
Children and Families (ACF), U.S. Department of Health and Human
Services (HHS), is inviting public comments on the proposed collection.
The request consists of several forms that allow the ORR Unaccompanied
Children (UC) Program to enhance monitoring efforts at care provider
facilities that are not licensed by the State, as well as continue
standard monitoring activities that ensure its care provider facilities
are in compliance with Federal and State laws and regulations,
licensing and accreditation standards, ORR policies and procedures, and
child welfare standards. This notice is specific to forms that were
recently approved through emergency approval for 180 days and
additional proposed forms.
DATES: Comments due within 30 days of publication. OMB must make a
decision about the collection of information between 30 and 60 days
after publication of this document in the Federal Register. Therefore,
a comment is best assured of having its full effect if OMB receives it
within 30 days of publication.
ADDRESSES: Written comments and recommendations for the proposed
information collection should be sent within 30 days of publication of
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. You can
also obtain copies of the proposed collection of information by
emailing [email protected]. Identify all emailed requests by
the title of the information collection.
SUPPLEMENTARY INFORMATION:
Description
Current Proposed Revisions
Quarterly Unlicensed Facility Site Visits
Unlicensed Facility Unaccompanied Child Case File
Checklist (Form M-8A-UF)
[cir] Admission Documents
[ssquf] Inventory of Property and Cash: Corrected timeframe to
align with policy. The inventory log should be completed ``within 2
hours of admission'' not 24 hours.
[ssquf] Clothing and Supplies: Added language to clarify what is
covered under this item.
[cir] Orientation Documents--Added new item checking for compliance
with ORR's access to reproductive health care policy (also known as the
Garza policy).
[cir] Legal Information
[ssquf] Acknowledgement of Receiving Legal Resource Guide: Changed
``within 24 hours'' to ``within 24 hours of admission'' to clarify the
policy requirement.
[ssquf] EOIR Docs: Corrected name Executive Office for Immigration
Review (``Review'' was missing)
[cir] Medical Documents
[ssquf] Authorization for Medical, Dental, and Mental Health Care:
Changed ``within 24 hours'' to ``within 24 hours of admission'' to
clarify the policy requirement.
[ssquf] Documentation of Initial Medical Exam: Added ``within 48
hours of admission'' to clarify policy requirement. Updated form
expiration dates referenced. Added reminder that completion of the exam
form is mandatory.
[ssquf] Dental Exam Form: Updated form expiration dates referenced.
Added reminder that completion of the form is mandatory.
[ssquf] Supplemental TB Screening Form: Updated form expiration
dates referenced. Added reminder that completion of the form is
mandatory.
[ssquf] Prescriptions: Changed ``log'' to ``record/log'' for
clarity.
[ssquf] Split Medical and Mental Health Records into two separate
line items and added language to clarify the policy requirements.
[cir] Assessments
[ssquf] Unaccompanied Child Case Review: In first bullet point,
clarified that it's the initial case review that is continuously
updated until 30 calendar days after admission. In second bullet point,
changed ``Every 30 calendars days . . .'' to ``Subsequently every 30
calendar days . . .'' for clarity.
[ssquf] Sponsor Assessment: Updated form expiration dates
referenced. Changed ``Within 5 days'' to ``Must be initiated within 5
days'' for clarity.
[ssquf] Individual Service Plan: Changed ``Within 5 days'' to
``Initial must be done within 5 days'' for clarity.
[cir] Case Management--Recreation/Leisure: Changed ``log'' to
``plan/log'' for clarity. Removed ``Effective 3/20/20--avoid community
outing due to COVID-19'' since this is no longer applicable.
[cir] Clinical Services--Added ``Disclosure Notice'' to reflect new
policy requirement.
[cir] Discharge
[ssquf] Removed ``CDC Covid-19 Fact Sheet and Symptoms Sheet
(Effective: 3/13/20)''--the revised sponsor letter has replaced that
fact sheet.
[ssquf] Added ``Post-18 Plan (if applicable)'' to align with policy
and procedures.
[ssquf] Family Reunification Packet: Updated form expiration dates
referenced.
[cir] Post-Discharge--Health Follow-Up Call: Updated effective
dates for related guidance and added language clarify requirements.
Unlicensed Facility Staff Secure Addendum to Case File
Checklist (Form M-8D-UF)--Made minor edits for more precise language
and changed formatting to bullet point lists for several items.
Unlicensed Facility Personnel File Checklist (Form M-10A-
UF)
[cir] Removed Training Directive per ORR Management section because
it is no longer a requirement. This requirement was related to a
specific webinar series on the topic of trauma-informed care. It was
removed because it is duplicative of the requirements in the
cooperative agreement that require training on strength-based behavior
management and trauma-informed care approaches.
[cir] Annual Trainings--Removed ``Hover for additional comments''
and corresponding comment that read ``How does the employee confirm
comprehension of a training? i.e., quiz/test score or signature
confirming comprehension'' because respondents reported the comments
were unhelpful.
[cir] Trainings Every Two Years per Cooperative Agreement--
[ssquf] Medication Management: Added ``must also receive medication
administration training''
[ssquf] Removed ``Hover for additional comments'' and corresponding
comment that read ``How does the employee confirm comprehension of a
training? i.e., quiz/test score or signature confirming comprehension''
because respondents reported the comments were unhelpful.
[ssquf] Rephrased ``Strength-based behavior management . . .'' to
``Strength-based behavior management and trauma-informed care
approaches'' to reflect current cooperative agreement requirements.
Reinstated the following forms as the number of respondents has
increased to more than nine respondents.
Unlicensed Facility LTFC Monitoring Notes (Form M-6C-UF)
Unlicensed Facility LTFC UC Case File Checklist (Form M-
8B-UF)
Unlicensed Facility Staff Secure Addendum to Case File
Checklist (Form M-8D-UF)
Unlicensed Facility Foster Home Onsite Monitoring
Checklist (M-9B-UF)
Quarterly Influx Care Facility Site Visits
Added the below-listed alternate version of a form that was
previously
[[Page 34860]]
approved by OMB but was removed from the information collection due to
the number of respondents. Differences between the previously approve
version and the alternate version are noted below.
Influx Care Facility (ICF) Monitoring Notes (Form M-6E)
[cir] Instructs monitors to review the facility's contract and
statement of work (as opposed to the grant application and cooperative
agreement) to reflect the funding method used for ICFs.
[cir] Removes the following sections that are specific to grants.
[ssquf] Fiscal year budget
[ssquf] Key positions approved by the Project Officer
[cir] Instructs monitors to review Serious Incident Reports (SIRs)
from the past three months (as opposed to six months for shelters).
This revision does not represent a reduction in SIR review, rather it
reflects the ongoing SIR review process that occurs for ICFs. Monitors
are performing site visits within the first three months of an ICR
opening, which means that there would only be three months' worth of
SIRs available during the initial site visit. Thereafter, three months
will cover review of all SIRs since the last site visit. For example,
if an ICF opened at the start of January, the initial site visit would
occur by the end of March and SIRs generated from January through March
would be reviewed. The next site visit would then occur at the end of
June and during that visit SIRs generated April through June would be
review. There would be no need to review six months' worth of SIRs at
that time because the SIRs generated January through March would have
already been reviewed. This pattern of quarterly reviews would continue
while the ICF is operational.
[cir] Reworded questions under the staffing plan section to be more
specific to contracts.
[cir] Added instruction for monitors to ensure that the facility is
following their supervision plan (as reported in the ICF Site Visit
Guide) for any staff whose relevant background checks are still
pending. All staff must pass a public records criminal background check
before hire. Staff with direct access to children must also pass an FBI
fingerprint check and child abuse and neglect check (CA/N). However,
staff may be hired provisionally before FBI or CA/N check results are
received if at all times prior to receipt of results the staff member
is within the sight and under the supervision of a staff member whose
background checks are complete.
[cir] Removed questions on State licensing.
[cir] Removed section on mosquito control inspections. These
inspections were originally established to address concerns with the
Zika virus and are no longer performed.
Added the below-listed alternate versions of forms already approved
under this information collection. Differences between the already
approved versions and the alternate versions are as noted below.
ICF Monitoring Site Visit Guide (Form M-7G)--Revisions
were made to develop a more in-depth guide to reflect the size and
complexity of influx sites. ORR plans to pilot this revised guide at
ICFs and later decide on whether some or all of these revisions should
be made to site visit guides for other levels of care. ORR will seek
OMB approval for any future revision to other versions of the site
visit guide.
[cir] Reorganized and grouped questions under different sections,
as well as rewording questions and instructions for clarity.
[cir] Added text boxes and tables to make clear where the ICF
should enter information.
[cir] Added areas for the ICF to provide a brief overview of their
site operations and list of subcontractors and their respective scopes
of work.
[cir] Expanded the list of facility points of contact requested.
[cir] Added areas for the ICF to share any innovative and/or best
practices implemented at the site and for the ICF to describe know
deficiencies and/or areas for improvement.
[cir] Added a table in the stakeholders section to prompt the ICF
to provide more detail information about the frequency and type of
collaboration as well as areas in need of improvement.
[cir] Expanded section on personnel to include questions about
personnel evaluation practices, whistleblower policies, and significant
staffing changes, vacancies, deficiencies, and/or barriers to personnel
capacity.
[cir] In addition to providing copies of internal procedures, ICFs
are asked to document information about the personnel responsible for
internal reviews, protocols for responding to noncompliance, and how
the ICF protects child privacy and confidentiality.
[cir] Expands the question asking for the program's video
monitoring policies and procedures to include all perimeter and
internal security mechanisms.
[cir] In addition to providing copies of emergency and evacuation
plans, programs are asked to describe related procedures and provide
information on emergency drills and after-action reviews.
[cir] Added area for programs to describe their safety inspection
practices and related drills, as well as an area to note concerns/
deficiencies related to safety and security.
[cir] Added questions on the program's procedures for staffing
cases, case status updates, and how case managers coordinate with other
discipline (e.g., clinical).
[cir] Split the question asking for the programs discharge
procedures into several questions that prompt the program to
specifically provide information about their procedures for transfers,
age redetermination cases, and managing age outs.
[cir] Added question that requests the program's procedures on
facilitating visits among children in care.
[cir] Added question asking the program to note any complex or
especially vulnerable cases that required specialized service
coordination.
[cir] Added question asking the program to note any concerns/
deficiencies related to case management.
[cir] Added new section on child supervision that asks for
program's procedures on supervision plans and direct care staffing
ratios, determining room/bed assignments, accurately monitoring the
location of the child, and behavior management.
[cir] Expanded the section that asks for a description of ancillary
services to include recreational/leisure, religious, languages access,
and phone call, visitation, and mail services (in addition to education
and transportation).
[cir] In addition to requesting copies of nutritional services
procedures, adds a section for programs to describe these services.
This includes food storage and safety protocols, how child dietary
needs are meet, how cultural and religious preferences are meet, and
any concerns/deficiencies.
[cir] Expands the medical services section to add questions asking
the program to describe their medical intakes procedures, onsite
medical services, medication administration protocols, medical records
system, the process for referring a child for offsite medical services,
and vaccination procurement and administration protocols.
[cir] Expands the mental health services section to add questions
asking the program to describe their mental health intake procedures
and onsite mental health services.
[cir] In addition to requesting copies of prevention of sexual
abuse procedures and related materials, asks the program to describe
several specific aspects of their procedures.
[[Page 34861]]
[cir] Breaks the general question asking the program to describe
their SIR procedures into several more specific questions on who the
responsible parties are for submitting reports, follow-up/addendums,
and notification/coordination with external entities.
[cir] Adds a new question asking the program how long it took to
complete the form.
[cir] Updates the type of background check documentation requested
to align with background check requirements specific to influx care
facilities.
ICF Personnel File Checklist (Form M-10E)
[cir] Pre-Service Trainings--Removed ``State licensed required
trainings'' because ICF are not State-licensed.
[cir] Removed Training Directive per ORR Management section because
it is no longer a requirement. This requirement was related to a
specific webinar series on the topic of trauma-informed care. It was
removed because it is duplicative of a new item added to the annual
trainings section that monitors for training on strength-based behavior
management and trauma-informed care approaches.
[cir] Annual Trainings--Added ``Strengths-based behavior management
approaches and trauma-informed care approaches, such as using conflict
resolution, problem solving skills, using rewards and consequences, de-
escalation techniques and helping children and youth learn
accountability and self-control.''
[cir] Removed Trainings Every Two Years per Cooperative Agreement
section because ICFs are funded through contracts and not grants.
Prevention of Sexual Abuse (PSA) Audits
ORR is seeking approval to add eight new instruments that will
allow ORR to audit its care provider programs for compliance with the
IFR on Standards to Prevent, Detect, and Respond to Sexual Abuse and
Sexual Harassment Involving Unaccompanied Children (45 CFR Subpart L).
These instruments are currently in use without OMB approval; this
request will allow ORR to comply with the Paperwork Reduction Act
requirements. The proposed new instruments are:
Preaudit Questionnaire and Audit Documentation Requested
Checklist (Form M-17A)
Instructions for Site Visit and Facility Tour (Form M-17B)
Interview Guide: Random Sample of Staff Interview (Form M-
17C)
Interview Guide: Program Director (Form M-17D)
Interview Guide: Prevention of Sexual Abuse (PSA)
Compliance Manager (Form M-17E)
Interview Guide: Specialized Staff (Form M-17F)
Interview Guide: Unaccompanied Child (Form M-17G)
PSA Audit Corrective Action Report (Form M-17H)
Revisions to Existing Forms
The below noted revisions were made to existing forms in this
collection to better align with ORR policies and procedures and
strengthen monitoring protocols.
FFS Compliance and Safety Site Visit Report (Form M-3A)
[cir] Converted the original Excel version into a web-based format.
[cir] Removed the following items that are best practices but not
explicitly required in ORR policy/procedures:
[ssquf] Client's rights are posted in language unaccompanied child
understands
[ssquf] Daily schedule is posted in language unaccompanied child
understands
[cir] Added the following fields
[ssquf] ORR Region
[ssquf] Please note the number of children in the group being
interviewed
[ssquf] Please note the estimate age range of the group of children
you interviewed
[cir] Renamed field ``FFS Name'' to ``ORR Representative Name''
[cir] Consolidated separate questions regarding compliance with
staffing ratios into two questions (``Is the program compliant with all
ORR staffing ratios?'' and ``Are there staffing concerns?'') and added
field ``If Yes, please confirm you elevated this to the Project Officer
for resolution or to address UC capacity.''
PSA Unaccompanied Child Incident Review (Form M-5A)--
Corrected typo in the When did the incident occur? field dropdown
options, changing ``pm'' to ``am.''
PSA Adult Incident Review (Form M-5B)--Corrected typo in
the When did the incident occur? field dropdown options, changing
``pm'' to ``am.''
Site Visit Guide (Form M-7A)
[cir] Under Child Protection--Added requirement for program to
provide link to mandatory reporting laws/rules and specify who is
classified as a mandatory reported in the State in which the program is
located.
[cir] Under Background Checks--Clarified that information on foster
parents is also required.
[cir] Removed reference to mosquito control inspections. These
inspections were originally established to address concerns with the
Zika virus and are no longer performed.
[cir] Added Personnel and Volunteer List as a supplemental tool to
use with this instrument. This list directly corresponds to the
information requested in the Background Checks section of the guide.
Foster Care Site Visit Guide (Form M-7C)
[cir] Retitled form ``Foster Care Site Visit Guide.'' The former
title was ``Long Term Foster Care Site Visit Guide.''
[cir] Under Program Management--Added requirement to describe
internal policies and procedures related to referral and placement.
[cir] Under Child Protection--Rephrased question 3 from ``Describe
the State's licensing child maltreatment reporting requirements.
(Provide state link to licensing requirements for reporting
requirements.)'' to ``Describe the State's child maltreatment reporting
requirements. (Provide a link to the state's mandatory reporting laws/
rules. Also, include who classifies as a mandatory reporter in your
state.)''
[cir] Under Facility, Foster Homes, and Food Services
[ssquf] Retitled ``Facility, Foster Homes, and Food Services
section to ``Foster Homes.''
[ssquf] Moved the two questions unrelated to foster homes into
their own section titled ``Facility and Food Services'' and added
additional instructions to clarify what programs are expected to
include in their description of the facility space.
[cir] Under Case Management--Clarified what programs must provide
related to their procedures on post-18 planning.
[cir] Under Background Checks--Reordered and rephrased some of the
questions.
[cir] Under Health Services--Added examples of communicable
diseases.
[cir] Under Problems Encountered--Removed requirement to provide
list of commonly used partnerships and services.
[cir] In the list of requested materials
[ssquf] Added educational curriculum and weekly class schedule
[ssquf] Reformatted the item requesting various policies and
procedures into a bullet point list
[cir] Added a note clarifying that ORR will request foster parent
documentation for foster homes that are visited during the site visit.
Personnel File Checklist (Form M-10A)
[cir] Removed Training Directive per ORR Management section because
it is no longer a requirement. This requirement was related to a
specific webinar series on the topic of trauma-informed care. It was
removed because it is duplicative of the requirements in the
cooperative agreement that require
[[Page 34862]]
training on strength-based behavior management and trauma-informed care
approaches.
[cir] Annual Trainings--Removed ``Hover for additional comments''
and corresponding comment that read ``How does the employee confirm
comprehension of a training? i.e. quiz/test score or signature
confirming comprehension'' because respondents reported the comments
were unhelpful.
[cir] Trainings Every Two Years per Cooperative Agreement--
[ssquf] Medication Management: Added ``must also receive medication
administration training''
[ssquf] Removed ``Hover for additional comments'' and corresponding
comment that read ``How does the employee confirm comprehension of a
training? i.e. quiz/test score or signature confirming comprehension''
because respondents reported the comments were unhelpful.
[ssquf] Rephrased ``Strength-based behavior management . . .'' to
``Strength-based behavior management and trauma-informed care
approaches'' to reflect current cooperative agreement requirements.
Foster Parent Checklist (Form M-10D)
[cir] Under General Documentation--Added requirement for monitors
to check for completed foster home study assessments/inspections.
[cir] General Documentation
[ssquf] Foster Home License: Added ``(Effective: 2022; please
reference the program-specific Cooperative Agreement)'' to clarify
requirements in the current cooperative agreement.
[ssquf] Added new item ``Completed Foster Home Study Assessments/
Inspections (Effective: 2022; please reference the program-specific
Cooperative Agreement)'' to align with requirements in the current
cooperative agreement.
[ssquf] Added new item ``Foster Parent Agreement (signed;
Effective: 2022; please reference the program-specific Cooperative
Agreement)'' to align with requirements in the current cooperative
agreement.
[cir] Pre-Service Trainings--ORR Standards to Prevent, Detect, and
Respond to SA and SH involving unaccompanied children: Removed ``New
employees must complete training before hire.'' to align with current
guidance that allows hire (but no interaction with children) before
training.
Foster Parent Questionnaire (Form M-11O)
[cir] Added instructions on the first page.
[cir] Reordered some questions.
[cir] Clarified that when asking the foster parent what information
they received on the child, that ORR is asking about information on the
child's individual services needs and provided examples (education,
health, dietary, religious, etc.).
[cir] Added example of independent living to question asking what
types of activities the child participates in.
Unaccompanied Child Questionnaire--Ages 6-12 Years Old
(Form M-12As)--Updated Spanish translation to match currently-approved
English version.
Unaccompanied Child Questionnaire--Ages 13 and Older (Form
M-12Bs)--Updated Spanish translation to match currently-approved
English version.
ORR is requesting that the following instruments be removed from
this information collection:
Remote Monitoring Site Visit Guide (Form M-7B)--Remove
from information collection. This instrument was created for use during
the height of the COVID-19 pandemic. Monitors have resumed in-person
site visits and the instrument is no longer needed.
Long Term Foster Care Remote Site Visit Guide (Form M-
7D)--Remove from information collection. This instrument was created
for use during the height of the COVID-19 pandemic. Monitors have
resumed in-person site visits and the instrument is no longer needed.
Voluntary Agency Site Visit Guide (Form M-7F)--Remove from
information collection. This instrument is completed by less than 10
respondents and therefore not subject to PRA.
Revisions Approved Under Emergency Approval
Added Interpreter Questionnaire (Form M-11P), which is currently
approved under OMB #0970-0558, to this information collection.
Quarterly Unlicensed Facility Site Visits
Added the following forms that were previously approved by OMB but
were removed from the information collection due to the number of
respondents. Differences between the previously approved versions and
the current versions that will be used by contractor monitors are as
noted below.
Monitoring Notes (Form M-6A-UF)
[cir] Directions added to top of form.
UC Case File Checklist (Form M-8A-UF)
[cir] Added a Read Me tab with directions.
[cir] Added a summary tab that auto-sums data from other tabs.
[cir] Revised the formatting of the UC Services tab.
On Site Monitoring Checklist (M-9A-UF)
[cir] Removed section on mosquito control. These inspections were
originally established to address concerns with the Zika virus and are
no longer performed.
[cir] Under Documents that Should be Posted--Removed reference to
two discontinued items.
[cir] Under Other--Removed reference to mosquito repellant.
[cir] Under Logs/Schedules--Removed reference to the discontinued
UC Temperature Tracker.
Added the below-listed alternate versions of forms already approved
under this information collection. Differences between the already
approved versions and the alternate versions are as noted below.
Unlicensed programs will continue to receive comprehensive biennial
monitoring visits pursuant to UC Policy Guide section 5.5.1 during
which the full original versions of these forms will be used. Quarterly
monitoring visits will mainly focus on health and safety. To align with
that purpose and help streamline forms that will be administered more
often than their full version counterparts, adjustments made to the
alternate versions removed some items related to program management.
Other adjustments were made for clarity or to align with current ORR
policy and procedures. Quarterly monitoring visits will continue to
monitor the same areas related to child welfare practices and provision
of services as biennial monitoring visits.
Site Visit Guide (Form M-7A-UF)
[cir] Under Child Protection--Added requirement for program to
provide link to mandatory reporting laws/rules and specify who is
classified as a mandatory reported in the State in which the program is
located.
[cir] Under Background Checks--Clarified that information on foster
parents is also required.
[cir] Removed reference to mosquito control inspections. These
inspections were originally established to address concerns with the
Zika virus and are no longer performed.
Personnel File Checklist (Form M-10A-UF)
[cir] Under General Documentation--Removed job description;
employment application; personal and professional references;
educational records; professional licensure; and I-9 documents.
Program Director Questionnaire (Form M-11A-UF)
[cir] Removed question on what changes the program director
envisions for the program in the next year.
[[Page 34863]]
[cir] Modified the question on how the program incorporates input
from others to assess the program to only ask about how input from
minors and staff is used. Previously, the question asked how input from
minors, staff, program partners, legal services providers, and sponsor
is used.
Clinician Questionnaire (Form M-11C-UF)
[cir] Removed question on what system the clinician uses to
document clinical sessions.
[cir] Removed question asking clinician to describe their
relationship with their supervisor.
Case Manager Questionnaire (Form M-11E-UF)
[cir] Removed question asking case manager to describe their
relationship with their supervisor.
Education Staff Questionnaire (Form M-11G-UF)
[cir] No modifications made.
Medical Coordinator Questionnaire (Form M-11I-UF)
[cir] Removed question asking medical coordinator to describe their
relationship with their supervisor.
Youth Care Worker Questionnaire (Form M-11J-UF)
[cir] Removed question on access to UC Portal.
[cir] Removed question on how often staff meetings are held.
[cir] Removed question asking youth care worker to describe their
relationship with their supervisor.
Prevention of Sexual Abuse Compliance Manager Staff
Questionnaire (Form M-11K-UF)
[cir] No modifications made.
Interpreter Questionnaire (Form M-11P-UF)
[cir] No modifications made.
UC Questionnaire--Ages 6-12 Years Old (Forms M-12A-UF and
M-12As-UF)
[cir] Under Communication with Family--Added question on how often
and how long the child speaks with their family.
[cir] Removed placeholder sections on meetings with case management
and clinical staff, which are not asked of children ages 6-12.
UC Questionnaire--Ages 13 and Older (Forms M-12B-UF and M-
12Bs-UF)
[cir] Under Admission/Orientation--Removed question asking what the
child remembers about documents signed/received during the first couple
days.
[cir] Under Communication with Family--Added question on how often
and how long the child speaks with their family. Removed question on
sending/receiving mail and email.
UC Questionnaire--Ages 5 and Under (Form M-12E-UF and M-
12Es-UF)
[cir] No modifications made.
Legal Service Provider Questionnaire (Form M-13C-UF)
[cir] Reworded questions on ability to perform Know Your Rights and
legal screenings.
[cir] Removed question on with which program staff members legal
service providers regularly interact.
[cir] Removed questions method used to inform legal service
providers of incidents affecting the child's legal case.
Case Coordinator Questionnaire (Form M-13E-UF)
[cir] No modifications made.
For information about all currently approved forms under this OMB
number, see: https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202108-0970-016.
Respondents: ORR grantee and contractor staff; foster parents; and
UC.
Annual Burden Estimates:
Note: These burden estimates include burden related to the
revisions described above and currently approved forms for which we are
not proposing any changes.
Estimated Burden Hours for Respondents
----------------------------------------------------------------------------------------------------------------
Annual number Average burden
Information collection title Annual number of responses hours per Annual total
of respondents per respondent response burden hours
----------------------------------------------------------------------------------------------------------------
Corrective Action Report (Form M-1)............. 262 0.4 5.00 524.00
FFS Compliance and Safety Site Visit Report 262 12.0 1.00 3,144.00
(Form M-3A)....................................
Out-of-Network Site Visit Report (Form M-3B).... 24 5.0 1.00 120.00
Checklist for a Child-Friendly Environment (Form 262 12.0 0.25 786.00
M-4)...........................................
Incident Reviews (Forms M-5A to M-5B)........... 262 0.3 1.50 117.90
Site Visit Guide (Forms M-7A)................... 114 1.0 13.00 1,482.00
LTFC Site Visit Guide (Forms M-7C).............. 18 1.0 6.00 108.00
Home Study and Post-Release Services Site Visit 30 1.0 6.00 180.00
Guide (Form M-7E)..............................
ICF Monitoring Site Visit Guide (Form M-7G)..... 3 1 15.00 45.00
Unlicensed Facility Site Visit Guide (Form M-7A- 56 4.0 1.00 224.00
UF)............................................
Unlicensed Facility UC Case File Checklist (Form 56 20.0 1.00 1,120.00
M-8A-UF).......................................
Unlicensed Facility LTFC UC Case File Checklist 1 20 1.00 20.00
(Form M-8B-UF).................................
Unlicensed Facility Staff Secure Addendum Case 2 20 1.00 40.00
File Checklist (Form M-8B-UF)..................
Program Staff Questionnaires (Forms M-11A to M- 917 1.0 1.00 917.00
11K)...........................................
Secure Detention Officer Questionnaire (Form M- 1 1.0 1.00 1.00
11L)...........................................
Long Term Foster Care Home Finder Questionnaire 18 1.0 1.00 18.00
(Form M-11M)...................................
Long Term Foster Care Independent Living Life 18 1.0 1.00 18.00
Skills Staff Questionnaire (Form M-11N)........
Long Term Foster Care Foster Parent 35 1.0 0.75 26.25
Questionnaire (Form M-11O).....................
Interpreter Questionnaire (Form M-11P).......... 115 2.0 0.50 115.00
Unlicensed Facility Program Staff Questionnaires 56 32.0 1.00 1,792.00
(Forms M-11A-UF to M-11K-UF)...................
Unlicensed Facility Interpreter Questionnaire 56 4.0 0.50 112.00
(Form M-11P-UF)................................
UC Questionnaires (Forms M-12A to M-12B & M-12E) 563 1.0 0.50 281.50
Long Term Foster Care Client Questionnaire (Form 88 1.0 0.50 44.00
M-12C).........................................
Secure Client Questionnaire (Form M-12D)........ 5 1.0 0.50 2.50
Unlicensed Facility UC Questionnaires (Forms M- 1,120 1.0 0.50 560.00
12A-UF to M-12B-UF & M-12E-UF).................
Home Study and Post-Release Services Director 30 1.0 1.00 30.00
Questionnaire (Form M-13A).....................
[[Page 34864]]
Home Study and Post-Release Services Caseworker 90 1.0 1.00 90.00
Questionnaire (Form M-13B).....................
Legal Service Provider Questionnaire (Form M- 114 1.0 1.00 114.00
13C)...........................................
Long Term Foster Care Legal Service Provider 18 1.0 0.75 13.50
Questionnaire (Form M-13D).....................
Case Coordinator Questionnaire (Form M-13E)..... 131 1.0 1.00 131.00
Unlicensed Facility Legal Service Provider 224 1.0 0.75 168.00
Questionnaire (Form M-13C-UF)..................
Unlicensed Facility Case Coordinator 224 1.0 1.00 224.00
Questionnaire (Form M-13E-UF)..................
Preaudit Questionnaire and Audit Documentation 78 1.0 4.00 312.00
Requested Checklist (Form M-17A)...............
Instructions for Site Visit and Facility Tour 78 1.0 2.00 156.00
(Form M-17B)...................................
Interview Guide: Random Sample of Staff 312 1.0 1.00 312.00
Interview (Form M-17C).........................
Interview Guide: Program Director (Form M-17D).. 78 1.0 1.00 78.00
Interview Guide: PSA Compliance Manager (Form M- 78 1.0 1.00 78.00
17E)...........................................
Interview Guide: Specialized Staff (Form M-17F). 156 1.0 1.00 156.00
Interview Guide: Unaccompanied Child (Form M- 780 1.0 0.50 390.00
17G)...........................................
PSA Audit Corrective Action Report (Form M-17H). 78 1.0 1.00 78.00
---------------------------------------------------------------
Estimated Annual Burden Hours Total......... .............. .............. .............. 14,184.65
----------------------------------------------------------------------------------------------------------------
Estimated Burden Hours for Contractor Interim Final Rule Auditors
----------------------------------------------------------------------------------------------------------------
Annual number Average burden
Information collection title Annual number of responses hours per Annual total
of respondents per respondent response burden hours
----------------------------------------------------------------------------------------------------------------
Preaudit Questionnaire and Audit Documentation 8 48.0 3.00 1,152.00
Requested Checklist (Form M-17A)...............
Instructions for Site Visit and Facility Tour 8 48.0 1.00 384.00
(Form M-17B)...................................
Interview Guide: Random Sample of Staff 8 48.0 1.00 384.00
Interview (Form M-17C).........................
Interview Guide: Program Director (Form M-17D).. 8 48.0 1.00 384.00
Interview Guide: PSA Compliance Manager (Form M- 8 48.0 1.00 384.00
17E)...........................................
Interview Guide: Specialized Staff (Form M-17F). 8 48.0 1.00 384.00
Interview Guide: Unaccompanied Child (Form M- 8 48.0 0.50 192.00
17G)...........................................
PSA Audit Corrective Action Report (Form M-17H). 8 48.0 2.00 768.00
---------------------------------------------------------------
Estimated Annual Burden Hours Total......... .............. .............. .............. 4,032.00
----------------------------------------------------------------------------------------------------------------
Estimated Burden Hours for Contractor Monitors--Unlicensed Facilities
----------------------------------------------------------------------------------------------------------------
Annual number Average burden
Information collection title Annual number of responses hours per Annual total
of respondents per respondent response burden hours
----------------------------------------------------------------------------------------------------------------
Unlicensed Facility Monitoring Notes (Form M-6A- 18 12.0 12.00 2,592.00
UF)............................................
Unlicensed Facility LTFC Monitoring Notes (Form 18 0.2 12.00 43.20
M-6C-UF).......................................
ICF Monitoring Notes (Form M-6E-UF)............. 18 0.7 12.00 151.20
Unlicensed Facility Site Visit Guide (Form M-7A- 18 12.0 29.00 6,264.00
UF)............................................
ICF Monitoring Site Visit Guide (Form M-7G)..... 18 0.7 29.00 365.40
Unlicensed Facility UC Case File Checklist (Form 18 62.0 6.00 6,696.00
M-8A-UF).......................................
Unlicensed Facility LTFC UC Case File Checklist 18 1.0 6.00 108.00
(Form M-8B-UF).................................
Unlicensed Facility Staff Secure Addendum to 18 2.0 6.00 216.00
Case File Checklist (Form M-8D-UF).............
Unlicensed Facility On-Site Monitoring Checklist 18 12.0 4.00 864.00
(Form M-9A-UF).................................
Unlicensed Facility Foster Home Onsite 18 0.4 4.00 28.80
Monitoring Checklist (Form M-9B-UF)............
Unlicensed Facility Personnel File Checklist 18 50.0 1.00 900.00
(Form M-10A-UF)................................
ICF Personnel File Checklist (Form M-10E)....... 18 3 1.00 54.00
Unlicensed Facility Program Staff Questionnaires 18 100.0 1.00 1,800.00
(Forms M-11A-UF to M-11K-UF)...................
Unlicensed Facility Interpreter Questionnaire 18 12.0 0.50 108.00
(Form M-11P-UF)................................
Unlicensed Facility UC Questionnaires (Forms M- 18 62.0 0.50 558.00
12A-UF to M-12B-UF & M-12E-UF).................
Unlicensed Facility Legal Service Provider 18 12.0 0.75 162.00
Questionnaire (Form M-13C-UF)..................
[[Page 34865]]
Unlicensed Facility Case Coordinator 18 12.0 1.00 216.00
Questionnaire (Form M-13E-UF)..................
---------------------------------------------------------------
Estimated Annual Burden Hours Total......... .............. .............. .............. 21,126.60
----------------------------------------------------------------------------------------------------------------
Estimated Burden Hours for Contractor Monitors--Previously Approved for Licensed Facilities
----------------------------------------------------------------------------------------------------------------
Annual number Average burden
Information collection title Annual number of responses hours per Annual total
of respondents per respondent response burden hours
----------------------------------------------------------------------------------------------------------------
Corrective Action Report (Form M-1)............. 4 25.0 22.00 2,200.00
Site Visit Guide (Forms M-7A)................... 4 7.0 29.00 812.00
LTFC Site Guide (Forms M-7C).................... 4 1.0 21.00 84.00
Home Study and Post-Release Services Site Visit 4 2.0 21.00 168.00
Guide (Form M-7E)..............................
Personnel File Checklist (Form M-10A)........... 4 31.0 1.00 124.00
Supplement to Personnel File Checklist (Form M- 4 54.0 1.00 216.00
10B)...........................................
Home Study and Post-Release Services Personnel 4 6.0 1.00 24.00
File Checklist (Form M-10C)....................
Long Term Foster Care Foster Parent Checklist 4 2.0 0.50 4.00
(Form M-10D)...................................
Program Staff Questionnaires (Forms M-11A to M- 4 54.0 1.00 216.00
11K)...........................................
Secure Detention Officer Questionnaire (Form M- 4 0.1 1.00 0.40
11L)...........................................
Long Term Foster Care Home Finder Questionnaire 4 1.0 1.00 4.00
(Form M-11M)...................................
Long Term Foster Care Independent Living Life 4 1.0 1.00 4.00
Skills Staff Questionnaire (Form M-11N)........
Long Term Foster Care Foster Parent 4 2.0 0.75 6.00
Questionnaire (Form M-11O).....................
UC Questionnaires (Forms M-12A to M-12B & M-12E) 4 33.0 0.50 66.00
Long Term Foster Care Client Questionnaire (Form 4 5.0 0.50 10.00
M-12C).........................................
Secure Client Questionnaire (Form M-12D)........ 4 0.4 0.50 0.80
Home Study and Post-Release Services Director 4 2.0 0.50 4.00
Questionnaire (Form M-13A).....................
Home Study and Post-Release Services Caseworker 4 6.0 1.00 24.00
Questionnaire (Form M-13B).....................
Legal Service Provider Questionnaire (Form M- 4 7.0 1.00 28.00
13C)...........................................
Long Term Foster Care Legal Service Provider 4 1.0 0.75 3.00
Questionnaire (Form M-13D).....................
Case Coordinator Questionnaire (Form M-13E)..... 4 8.0 1.00 32.00
Monitoring Visit (Form M-14).................... 4 8.0 0.50 16.00
Monitoring Schedule (Form M-15)................. 4 0.3 0.30 0.36
---------------------------------------------------------------
Estimated Annual Burden Hours Total......... .............. .............. .............. 4,046.56
----------------------------------------------------------------------------------------------------------------
Authority: 6 U.S.C. 279; 8 U.S.C. 1232; Flores v. Reno Settlement
Agreement, No. CV85-4544-RJK (C.D. Cal. 1996); 45 CFR part 411.
Mary B. Jones,
ACF/OPRE Certifying Officer.
[FR Doc. 2023-11487 Filed 5-30-23; 8:45 am]
BILLING CODE 4184-45-P