[Federal Register Volume 85, Number 12 (Friday, January 17, 2020)]
[Notices]
[Pages 3057-3058]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-00674]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Agency Information Collection Activities: Submission to OMB for 
Review and Approval; Public Comment Request; Maternal, Infant, and 
Early Childhood Home Visiting Program Home Visiting Budget Assistance 
Tool, OMB No. 0906-0025--Revision

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services.

ACTION: Notice.

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SUMMARY: In compliance with the Paperwork Reduction Act of 1995, HRSA 
has submitted an Information Collection Request (ICR) to the Office of 
Management and Budget (OMB) for review and approval. Comments submitted 
during the first public review of this ICR will be provided to OMB. OMB 
will accept further comments from the public during the review and 
approval period. OMB may act on HRSA's ICR only after the 30-day 
comment period for this Notice has closed.

DATES: Comments on this ICR should be received no later than February 
18, 2020.

ADDRESSES: Submit your comments, including the ICR Title, to the desk 
officer for HRSA, either by email to [email protected] or by 
fax to (202) 395-5806.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email Lisa Wright-Solomon, the 
HRSA Information Collection Clearance Officer at [email protected] or 
call (301) 443-1984.

SUPPLEMENTARY INFORMATION: When submitting comments or requesting 
information, please include the information request collection title 
for reference.
    Information Collection Request Title: Maternal, Infant, and Early 
Childhood Home Visiting Program Home Visiting Budget Assistance Tool, 
OMB No. 0906-0025--Revision.
    Abstract: HRSA is requesting continued approval of the Home 
Visiting Budget Assistance Tool (HV-BAT), as modified by HRSA in 
response to further testing and public comments, as further described 
below. The tool collects information on standardized cost metrics from 
programs that deliver home visiting services, as outlined in the HV-
BAT. During Fiscal Year (FY) 2020, prior to required use of the tool by 
awardees starting in FY 2021, HRSA intends to conduct a follow-up study 
to test the feasibility of the HV-BAT for universal implementation 
across Maternal, Infant, and Early Childhood Home Visiting (MIECHV) 
programs and the tool's capacity to support program planning, budget 
forecasting, fiscal sub-recipient monitoring and to estimate national 
program costs. In addition, HRSA will investigate the necessary 
resources and support for successful execution of the HV-BAT prior to 
initiating the reporting requirement. Upon successful completion of the 
FY 2020 feasibility study, beginning in FY 2021, HRSA will require 
reporting of HV-BAT data for one-third of awardees in each 3-year 
cycle, resulting in collection of data from all awardees over a 3-year 
time period, to inform program planning and budgeting.
    The MIECHV Program, authorized by section 511 of the Social 
Security Act, 42 U.S.C. 711, and administered by HRSA in partnership 
with the Administration for Children and Families, supports voluntary, 
evidence-based home visiting services during pregnancy and to parents 
with young children up to kindergarten entry. States, Tribal entities, 
and certain nonprofit organizations are eligible to receive funding 
from the MIECHV Program and have the flexibility to tailor the program 
to serve the specific needs of their communities. Funding recipients 
may subaward grant funds to local implementing agencies (LIAs) in order 
to provide services to eligible families in at-risk communities.
    HRSA is revising its originally described HV-BAT data collection 
purpose. Original clearance under this OMB control number was for pilot 
testing the reliability of a standardized cost-reporting tool among 
evidence-based home visiting programs. HRSA has revised the data 
collection tool to reflect findings and recommendations from the pilot 
study and in response to public comments to ensure clarity, usability 
and fidelity, including changes to instructions, definitions and 
estimated burden.
    A 60-day notice was published in the Federal Register on August 1, 
2019, vol. 84, No. 148, pp. 37655-56. There were eight public comments.
    HRSA announced a 60-day public comment period to solicit input on 
its HV-BAT data collection efforts. In response to this notice, HRSA 
received feedback on the following aspects:

 Utilization of Data Collection
 Documentation and Reporting Requirements
 Accuracy of the Estimated Burden
 Implementation

    HRSA carefully reviewed the comments received and used them to 
guide the development of the a follow-up HV-BAT feasibility study to be 
conducted in FY 2020 that will further inform the FY 2021 HV-BAT 
reporting requirements.

Responses to Comments on the Proposed MIECHV HV-BAT

    HRSA received eight responses to the request for public comment. 
Four commenters are current MIECHV awardees, two are home visiting 
model developers, one is a national association, and one is an 
individual respondent. Comments are summarized below.

Utilization of Data Collection

Summary of Comments
    Commenters expressed concern over the utility of the HV-BAT as a 
budget planning tool and its ability to account for variables that 
differ across models, program populations, providers and settings which 
could impact cost comparisons. In addition, respondents requested more 
information on the intended long-term use of the HV-BAT data.
Response
    HRSA intends the HV-BAT to inform future budget planning, 
monitoring, and review of the costs of implementing home visiting at 
the LIA level in a state and support other programmatic priorities such 
as cost-benefit analysis and reimbursement policies. The tool in its 
current state provides information to permit calculation of certain 
cost metrics, such as cost per family, which can be used to assist in 
program planning and budget forecasting. Further, the HV-BAT 
feasibility study will examine the use of the HV-BAT to conduct cost 
benefit calculations. The feasibility study will also examine how the 
HV-BAT accounts for other types of cost variation, such as cost of 
living and inflation. Information collected in the feasibility study 
will be used to establish standards for implementation.

[[Page 3058]]

Documentation and Reporting Requirements

Summary of Comments
    Commenters requested clarification around obligations to report 
cost data for home visiting services funded through sources other than 
the MIECHV program. In addition, a number of commenters cautioned that 
the home visiting model used, target population served, and geographic 
location are all factors that could have a significant impact on cost 
variation, making it difficult to compare data across models and 
locations/LIAs.
Response
    HRSA intends that use of the HV-BAT is limited to HRSA MIECHV-
funded programs. The HV-BAT includes variables that are used to capture 
variations in demographic information (e.g., percent of families living 
in rural areas, percent of families of living in poverty). Such 
variation was not found to be significant in the pilot study, although 
the HV-BAT feasibility study will further explore how different 
explanatory variables may affect cost variation in order to better 
understand how program features drive cost variation to support useful 
and meaningful comparisons.

Accuracy of Estimated Burden

Summary of Comments
    Several commenters indicated that HRSA's estimated burden was too 
low. In particular, while LIA burden was accounted for, the 
administrative burden of state awardees was not included. These 
commenters suggested that HV-BAT reporting requirements would add an 
administrative burden to state awardees in addition to the burden on 
LIAs and offered alternative calculations. Additional burden due to the 
potential competing demands of model fidelity and federal reporting 
requirements were also noted.
Response
    In response to these comments, HRSA has increased the estimated 
burden to 18 hours per agency (including both LIAs and state-level 
recipients). HRSA will also explore the ability to adjust the timing of 
the HV-BAT reporting requirement to accommodate for model-specific 
quality and fidelity review and reporting conditions.

Implementation

Summary of Comments
    Commenters requested HRSA offer more clear and specific guidance on 
the cost categories and program characteristic data (e.g., defining 
full-time equivalent, turnover, and program activities) to be collected 
as part of the HV-BAT to ensure consistency across LIAs and states.
Response
    HRSA plans to provide technical assistance materials, such as user 
guides, frequently asked questions, instrument instructions and 
definitions of data points for MIECHV awardees to assist recipients in 
providing data consistent with this notice.
    Need and Proposed Use of the Information: Immediately following OMB 
clearance, during FY 2020, HRSA plans to make the tool available for 
optional use by MIECHV state awardees prior to requiring its use in FY 
2021. Awardees who utilize the HV-BAT during FY 2020 will submit the 
data collected directly to HRSA. This will allow HRSA to further test 
the feasibility of collecting comprehensive cost data at the state 
level; estimate national level costs for use in conducting research and 
analysis of home visiting costs; understand cost variation; assess how 
comprehensive program cost data can inform other policy priorities, 
such as innovative financing strategies; review the data to ensure 
accuracy; and analyze the data for the purpose of federal research.
    Beginning in FY 2021, HRSA will require reporting of HV-BAT data 
for MIECHV awardees to inform program planning and budgeting as part of 
their annual formula funding application. HRSA anticipates that one-
third of the awardees will participate in this data collection each 
year as a component of their operational site visit and HRSA will 
identify the awardees with the HV-BAT reporting requirement in that 
year. This process will ease burden on awardees by requiring data 
collection for each awardee once every 3 years and allowing HRSA to 
capture a national data set every 3 years.
    Likely Respondents: MIECHV Program Awardees (n=56).
    Burden Statement: Burden in this context means the time expended by 
persons to generate, maintain, retain, disclose or provide the 
information requested. This includes the time needed to review 
instructions; to develop, acquire, install, and utilize technology and 
systems for the purpose of collecting, validating, and verifying 
information, processing and maintaining information, and disclosing and 
providing information; to train personnel and to be able to respond to 
a collection of information; to search data sources; to complete and 
review the collection of information; and to transmit or otherwise 
disclose the information. The total annual burden hours estimated for 
this Information Collection Request are summarized in the table below.

                                     Total Estimated Annualized Burden Hours
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                                                     Number of                    Average burden
           Instrument                Number of     responses per       Total         hours per     Total burden
                                    respondents     respondent       responses       response          hours
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Maternal, Infant, and Early                   19              13             247              18           4,446
 Childhood Home Visiting Program
 Budget Assistance Tool.........
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    Total.......................              19  ..............             247  ..............           4,446
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Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2020-00674 Filed 1-16-20; 8:45 am]
BILLING CODE 4165-15-P