Agency Information Collection Activities: Submission to OMB for Review and Approval; Public Comment Request; Information Collection Request Title: Title V Maternal and Child Health Services Block Grant to States Program: Guidance and Forms for the Title V Application/Annual Report, OMB No. 0915-0172-Revision

Issuing agencies

Abstract

In compliance with the Paperwork Reduction Act of 1995, HRSA 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.

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<title>Federal Register, Volume 91 Issue 202 (Wednesday, October 21, 2026)</title>
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[Federal Register Volume 91, Number 202 (Wednesday, October 21, 2026)]
[Notices]
[Pages 66563-66565]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2026-21519]


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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; Information Collection 
Request Title: Title V Maternal and Child Health Services Block Grant 
to States Program: Guidance and Forms for the Title V Application/
Annual Report, OMB No. 0915-0172--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 
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 November 
20, 2026.

ADDRESSES: Written comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this particular 
information collection by selecting ``Currently under Review--Open for 
Public Comments'' or by using the search function.

FOR FURTHER INFORMATION CONTACT: To request a copy of the clearance 
requests submitted to OMB for review, email Samantha Miller, the HRSA 
Information Collection Clearance Officer, at <a href="/cdn-cgi/l/email-protection#cfbfaebfaabdb8a0bda48fa7bdbcaee1a8a0b9"><span class="__cf_email__" data-cfemail="b1c1d0c1d4c3c6dec3daf1d9c3c2d09fd6dec7">[email&#160;protected]</span></a> or call 
(301) 443-9094.

SUPPLEMENTARY INFORMATION: 
    Information Collection Request Title: Title V Maternal and Child 
Health Services Block Grant to States Program: Guidance and Forms for 
the Title V Application/Annual Report OMB No. 0915-0172--Revision.
    Abstract: The Title V Maternal and Child Health (MCH) Services 
Block Grant to States Program is authorized by Sections 501-509 of 
Title V of the Social Security Act (42 U.S.C. 701-709). HRSA is 
updating the Title V Maternal and Child Health Services Block Grant to 
States Program: Guidance and Forms for the Title V Application/Annual 
Report (Guidance). This Guidance is used annually by the 50 states and 
nine jurisdictions (the District of Columbia, the Republic of the 
Marshall Islands, the Federated States of Micronesia, the Republic of 
Palau, the Commonwealth of Puerto Rico, the U.S. Virgin Islands, Guam, 
American Samoa, and the Commonwealth of the Northern Mariana Islands; 
hereafter referred to as ``state'') in applying for Block Grants under 
Title V of the Social Security Act and in preparing the required Annual 
Report. The updates being proposed by HRSA for this edition of the 
Guidance continue to support the federal-state partnership that is 
supported by the Title V MCH Services Block Grant and the state's role 
in developing a 5-Year Action Plan that addresses its individual 
priority needs. Updates to this edition of the Guidance are editorial 
and technical revisions based on feedback from the states in using the 
Guidance and Forms since January 2024, and by comments received from 
State Title V program leadership, national MCH leaders, other MCH 
stakeholders, and the public.
    A 60-day notice published in the Federal Register on May 19, 2026, 
vol. 91, No. 96; pp. 29140-41 (91 FR 29140). The 60-day Federal 
Register Notice (FRN) stated that minor editorial corrections and 
clarifications were made to Form 7, Form 10, Form 12 instructions and 
the Glossary, and that updates were made to the short and long titles 
of the National Performance Measures to improve title accuracy and 
fulfill Government Accountability Office recommendations and align 
National Performance Measures with other HRSA program measures. 
However, the reference to Form 12 instructions in the 60-day FRN was a 
technical error; instead, the FRN should have referred to Form 11, to 
which additional minor clarifications were made.
    HRSA received comments from five respondents (state Title V 
programs and other MCH stakeholders) on the proposed updates to the 
eleventh edition of the Guidance. The submitted responses included 
multiple comments. Of the five respondents, four respondents provided 
comments related to implementation of the guidance or the Title V 
Information System (TVIS) that would be addressed most effectively in 
the form of technical assistance, rather than adjusting the guidance 
instructions. Two respondents recommended expanding the definitions of 
budget-related glossary terms to

[[Page 66564]]

include additional examples for each category. HRSA considered all 
public comments as part of its deliberative process in finalizing 
updates to the eleventh edition of the Title V Maternal and Child 
Health Services Block Grant to States Program: Guidance and Forms for 
the Title V Application/Annual Report.
    A discussion of the public comments received during the 60-day 
comment period and HRSA's response to the comments is set below:
    (1) Organization and Structure of the Application/Annual Report 
Guidance.
    Comments: Some respondents expressed support for the Application/
Annual Report Guidance reporting structure that was implemented as part 
of the tenth edition and maintained through this edition. Respondents 
provided additional comments related to combining various sections of 
the Application/Annual Report, such as: (1) Systems and Services for 
Children with Special Health Care Needs with Relationship with 
Medicaid; (2) Title V Purpose and Design, Organizational Structure, 
Impact of Organizational Structure, and Impact of Agency Capacity; (3) 
System of Care for Mothers, Infants, and Families with Systems and 
Services for Children with Special Health Care Needs; (4) How Title V 
Funds Support MCH Efforts and the Expenditures and Budget Narratives; 
(5) MCH Population Health and Wellbeing and State Description; (6) 
Impact of Organizational Structure, Impact of Agency Capacity, and 
Title V Workforce Capacity and Workforce Development; and (7) Title V 
Partnerships, Collaboration, and Coordination and Family and Community 
Partnerships.
    HRSA Response: HRSA will not adopt the recommendation to 
consolidate the identified sections, as each section requests distinct 
types of information or fulfills a legislative requirement. 
Consolidating sections increases the risk that important information 
may be left out or overlooked. HRSA also sought to minimize revisions 
in the eleventh edition of the guidance to provide State Title V 
programs sufficient time to implement and adjust to the Application/
Annual Report reporting structure that was introduced in the tenth 
edition. HRSA wants State Title V programs to have sufficient 
opportunities to fully implement and assess the revised structure 
before making a significant number of revisions to the TVIS reporting 
structure.
    (2) TVIS Functionality.
    Comments: Some respondents provided comments regarding the 
character limits in the Executive Summary section and requested that 
HRSA increase the character limits to allow states to provide 
additional detail, including more comprehensive descriptions of program 
successes (i.e., success stories). Respondents also requested an 
increase in character limits for the Relationship with Medicaid 
section, to allow states to more fully describe relevant program 
activities and efforts.
    HRSA Response: HRSA will not adopt the recommendation related to 
character limits in the Executive Summary section but will adopt the 
recommendation related to the increase in character count for the 
Relationship with Medicaid Section. The Executive Summary is intended 
to be a standalone document that enables the reader to acquire a clear 
understanding of the state's Title V program without having to read the 
entire MCH Block Grant Application/Annual Report. The Executive Summary 
also serves as the narrative portion of the TVIS State Snapshot, 
serving as a quick point of reference for MCH stakeholders and other 
interested parties. Character limits for the Executive Summary are 
established in TVIS to support these purposes. The Relationship with 
Medicaid section character limits are established within TVIS and 
related to the functionality of the data entry system, rather than to 
requirements contained in the Guidance. HRSA will increase the 
character limit for the Relationship with Medicaid section, which will 
be implemented as part of system updates to TVIS. Additionally, HRSA 
will communicate any relevant changes to states through skills-building 
training or technical assistance provided prior to the release of the 
data entry system.
    (3) Guidance Implementation and Technical Assistance.
    Comments: Some respondents requested additional support related to 
Interim Needs Assessment reporting and data entry for Form 5 and Form 
10.
    HRSA Response: HRSA recognizes the importance of providing 
technical assistance to support states in their submission of the 
Application/Annual Report. For Forms 5 and 10, HRSA provides dedicated 
Learning Labs that include presentations from states on their 
approaches to completing and reporting on these forms. HRSA will also 
provide technical assistance on the interim Needs Assessment Reporting.
    (4) Statutory Requirement Clarification.
    Comments: Two respondents recommended incorporating the Public 
Input section into the Family and Community Engagement (i.e., Family 
and Community Partnerships) section, stating that community input is 
centered on engagement in program planning, implementation, and 
evaluation, rather than on the formal application process itself. The 
respondents also questioned whether a separate Public Input section is 
statutorily required.
    HRSA Response: While public input may include family and community 
engagement activities, the two sections serve distinct purposes. 
Section 505(a) of Title V of the Social Security Act requires states to 
make the Application/Annual Report available for public comment during 
its development and after its transmittal. Maintaining a separate 
Public Input section provides a clear and consistent mechanism for 
states to annually document compliance with this statutory requirement. 
The Family and Community Partnerships section addresses ongoing 
engagement activities with families, individuals, and family-led 
organizations and is only required to be updated every 5 years. As a 
result, HRSA will not adopt this recommendation and will provide 
technical assistance to the states through group webinars and one-on-
one calls, as appropriate.
    (5) Expanded Definitions of Budget-Related Glossary Terms.
    Comments: Two respondents requested an expansion of budget-related 
glossary terms.
    HRSA Response: HRSA agrees that additional examples would improve 
the clarity of the budget-related glossary terms. HRSA will revise the 
definitions of local, program income, and other funds to include 
additional examples.
    (6) State General Revenue Funds Delineation.
    Comments: Two respondents recommended revising the guidance to 
require states to report on the specific delineation of the percent of 
undesignated state general revenue funds used for non-federal Title V 
funding.
    HRSA Response: HRSA will not adopt this recommendation. Requiring 
states to provide this additional information would increase the 
reporting burden associated with the Application/Annual Report. 
However, states may elect to include this information in the financial 
narrative at their discretion.
    Need and Proposed Use of the Information: Each year, all states are 
required to submit an Application/Annual Report for federal funds for 
their Title V MCH Services Block Grant to States Program to HRSA 
(Sections 505(a) and 506(a)(1) of Title V of the Social Security Act). 
In addition, the

[[Page 66565]]

state MCH Services Block Grant programs are required to conduct a 
state-wide, comprehensive needs assessment every 5 years. The 
information and instructions for the preparation and submission of this 
Application/Annual Report are contained in the Guidance.
    Likely Respondents: Likely respondents are state MCH agencies and 
other MCH stakeholders.
    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 ICR are summarized in the table below. States will use the updated 
edition of the Guidance to prepare and submit the fiscal year (FY) 
2028, FY 2029, and FY 2030 Applications/FY 2026, FY 2027, and FY 2028 
Annual Reports, which will not contain the 5-Year Needs Assessment 
Summary. States will submit the next 5-Year Needs Assessment Summary in 
2030, as part of the FY 2031 Application/FY 2029 Annual Report.

                                     Total Estimated Annualized Burden Hours
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                                                     Number of                    Average burden
            Form name                Number of     responses per       Total       per response    Total burden
                                    respondents     respondent       responses      (in hours)         hours
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Application and Annual Report                 59               1              59             116           6,844
 without Five-Year Needs
 Assessment Summary.............
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    Total.......................              59  ..............              59  ..............           6,844
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Maria G. Button,
Director, Executive Secretariat.
[FR Doc. 2026-21519 Filed 10-20-26; 8:45 am]
BILLING CODE 4165-15-P


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