Notice2026-20314
Submission for Office of Management and Budget Review; Mental Health Assessment Form and Onsite Health Intervention Form
Primary source
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Published
October 5, 2026
Issuing agencies
Health and Human Services DepartmentChildren and Families Administration
Abstract
The Administration for Children and Families (ACF) Office of Refugee Resettlement (ORR) is requesting a 3-year extension with changes of the Mental Health Assessment Form and Onsite Health Intervention Form (formerly Public Health Investigation Form: Non-TB Illness, and Public Health Investigation Form: Active TB, OMB #0970- 0509, expiration 9/30/2026). Proposed revisions include merging two forms (Public Health Investigation Forms, Active TB and Non-TB Illness) into the single Onsite Health Intervention (OHI) Form. The proposed restructuring and revisions will improve transparency, lessen burden, improve data quality, and ensure alignment with ORR requirements. In addition, to ensure continuity of care, the request has been revised to include the sharing of health information with the Department of Homeland Security (DHS) in specific circumstances.
Full Text
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<title>Federal Register, Volume 91 Issue 191 (Monday, October 5, 2026)</title>
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[Federal Register Volume 91, Number 191 (Monday, October 5, 2026)]
[Notices]
[Pages 63292-63294]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-20314]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Administration for Children and Families
[Office of Management and Budget #: 0970-0509]
Submission for Office of Management and Budget Review; Mental
Health Assessment Form and Onsite Health Intervention Form
AGENCY: Office of Refugee Resettlement, Administration for Children and
Families, U.S. Department of Health and Human Services.
ACTION: Request for public comments.
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SUMMARY: The Administration for Children and Families (ACF) Office of
Refugee Resettlement (ORR) is requesting a 3-year extension with
changes of the Mental Health Assessment Form and Onsite Health
Intervention Form (formerly Public Health Investigation Form: Non-TB
Illness, and Public Health Investigation Form: Active TB, OMB #0970-
0509, expiration 9/30/2026). Proposed revisions include merging two
forms (Public Health Investigation Forms, Active TB and Non-TB Illness)
into the single Onsite Health Intervention (OHI) Form. The proposed
restructuring and revisions will improve transparency, lessen burden,
improve data quality, and ensure alignment with ORR requirements. In
addition, to ensure continuity of care, the request has been revised to
include the sharing of health information with the Department of
Homeland Security (DHS) in specific circumstances.
DATES: Comments due November 4, 2026.
ADDRESSES: The public may view and comment on this information
collection request at: <a href="https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202609-0970-009">https://www.reginfo.gov/public/do/PRAViewICR?ref_nbr=202609-0970-009</a>. You can also obtain copies of the
proposed collection of information by emailing
<a href="/cdn-cgi/l/email-protection#bbd2d5ddd4d8d4d7d7ded8cfd2d4d5fbdad8dd95d3d3c895dcd4cd"><span class="__cf_email__" data-cfemail="cea7a0a8a1ada1a2a2abadbaa7a1a08eafada8e0a6a6bde0a9a1b8">[email protected]</span></a>. Identify all emailed requests by the title
of the information collection.
SUPPLEMENTARY INFORMATION: Description: Unaccompanied alien children in
ORR custody are placed in care provider programs until unification with
a qualified sponsor. Care providers ensure children receive a range of
services including routine and emergency medical, dental, and mental
health care. Care provider staff are expected to implement all
recommended treatment plans (e.g., referrals to specialists, medication
administration, accommodation for physical or mental impairments that
impact daily living activities) as directed by the evaluating
healthcare provider. Care provider staff are also expected to respond
to reported or observed non-emergency healthcare concerns (including
exposures to specific reportable communicable illnesses) through triage
with a licensed healthcare professional or administration of over-the-
counter medications as indicated by the child's primary healthcare
provider's standing orders. If a child with a health condition that
requires daily management or accommodation (e.g., medication, durable
medical equipment) is identified for repatriation by DHS, relevant
information from their established treatment plan must be shared with
DHS to ensure continuity of care. See ``Proposed Changes'' for more
information.
Data from scheduled mental health assessments and onsite health
interventions is captured through the following forms under OMB# 0970-
0509:
<bullet> Mental Health Assessment Form
<bullet> Onsite Health Intervention Form (Formerly, Public Health
Investigation Form: Active TB, and Public Health Investigation Form:
Non-TB Illness)
The Mental Health Assessment Form (MHAF) has a corresponding
instructional ``Dear Colleague'' letter that healthcare providers are
expected to read at the initial visit with the child. The forms are
used as worksheets by healthcare providers and care provider staff to
compile information that would otherwise have been collected during the
health assessment or onsite health intervention. Once completed, care
provider staff transcribe the information from the form into ORR's
secure, electronic system of record. Although the MHAF is not completed
during emergency or urgent care visits, hospitalizations, or admissions
to an out-of-network facility (e.g., residential treatment center),
care providers are required to complete the respective form in ORR's
electronic system of record by extracting relevant data from health
records.
Data is used by ORR to monitor and support the health of
unaccompanied alien children while in care, for case management of
identified illnesses/conditions, and to ensure care provider compliance
with ORR requirements. Finally, ORR has updated the stated uses of data
sharing to include providing relevant health information to DHS when a
child with healthcare needs is identified by DHS for repatriation.
[[Page 63293]]
Proposed Changes
ORR is proposing updates to streamline and strengthen health
documentation by combining the two Public Health Investigation Forms
into a single expanded Onsite Health Intervention Form that would cover
quarantine for communicable disease exposure, triage with a licensed
healthcare professional, and medication-related standing orders. The
MHAF would also be revised to:
<bullet> reduce duplicate documentation by removing the History
section requirement for follow-up mental health visits,
<bullet> improve compliance and care tracking by strengthening the
disabilities and accommodations field and adding a field for all
ordered or completed labs and imaging, and
<bullet> improve data quality through clearer instructions by visit
type, standardizing options for findings outside of normal limits for
the mental status exam, expanding the types of substances that may have
been used by the child, adding a healthcare provider acknowledgement
and signature section authorizing record sharing with ORR, replacing
fixed diagnosis choices with free-text fields, and broadening field
reformatting.
The related Dear Colleague Letter would also be updated to reflect
these MHAF changes.
In addition, language was updated to expand the purposes of data to
include sharing relevant health data captured on the MHAF with DHS when
a child in ORR custody has healthcare needs and is identified by DHS
for repatriation. Shared information includes:
<bullet> Child's identifying information (name, alien number, date of
birth)
<bullet> Active diagnoses or concerns that require management
<bullet> Allergies
<bullet> Current medications and dosages
<bullet> Isolation/Quarantine requirements
<bullet> Health-related accommodations (including durable medical
equipment needs)
<bullet> Health-related travel restrictions
The purpose of sharing this data is to ensure children receive
healthcare services and accommodation as recommended by their treating
healthcare providers.
Respondents: Mental health professionals (psychiatrists,
psychiatric nurse practitioners and physician assistants, licensed
psychologists, social workers, and any other community-based licensed
mental health provider) and care provider staff.
Annual Burden Estimates
The overall annual burden of response and recordkeeping time
decreased by 46.1 and 55.1 percent, respectively.
The decrease is attributed to a significantly lower census of
unaccompanied alien children in ORR care which reduced the number of
respondents and responses per respondent. In addition, the average
burden hours per response decreased for each form because unnecessary
fields were removed and skip patterns were introduced for fields that
are only needed for specific types of visits.
Estimated Response Time for Respondents
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Average
Total number Annual number burden Annual
Instrument Respondent of of responses hours per burden
respondents per respondent response hours
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Mental Health Assessment Form....... Mental health 250 9.8 0.13 318.5
professionals.
Onsite Health Intervention Form..... Care Provider Staff... 150 321.6 0.09 4,341.6
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Estimated Total Annual Burden ...................... ............ .............. .......... 4,660.1
Hours.
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Estimated Recordkeeping Time
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Annual number Average burden
Instrument Respondent Total number of responses hours per Annual burden
of respondents per respondent response hours
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Mental Health Assessment Form Care Provider 150 16.4 0.17 418.2
completed by a mental health Staff.
professional.
Mental Health Assessment Form ................ 150 4.4 0.21 138.6
not completed by a mental
health
professional(information
obtained via health records).
Onsite Health Intervention ................ 150 321.6 0.07 3,376.8
Form.
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Estimated Total Annual ................ .............. .............. .............. 3,933.6
Burden Hours.
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Authority: These information collections are related to and funded
by the ORR Unaccompanied Alien Children Bureau (UACB), are authorized
by the statutes and regulations listed below, and are being conducted
by ORR UACB.
<bullet> Homeland Security Act (HSA), 6 U.S.C. 279--Transferred
responsibilities for the care and placement of unaccompanied alien
children from the Commissioner of the former Immigration and
Naturalization Service to the Director of ORR.
<bullet> Unaccompanied Children Program Foundational Rule, 45 CFR
part 410--Establishes a uniform set of standards and procedures
concerning the placement, care, and services provided to unaccompanied
alien children in ORR care that is consistent with ORR's statutory
duties. Sec. 410.1306(g) and 410.1307 require care provider programs
to ensure children are provided with routine and emergency healthcare
services while in care.
<bullet> Lucas R. et al v. Becerra et al(Case No. 2:18-CV-05741 DMG
PLA) Psychotropic Medication Settlement Agreement--Establishes
standards for
[[Page 63294]]
monitoring the administration of psychotropic medication to children in
ORR custody and care.
Samantha L. Illangasekare,
ACF/OPRE Certifying Officer.
[FR Doc. 2026-20314 Filed 10-2-26; 8:45 am]
BILLING CODE 4184-45-P
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