Placement and Transfer of Unaccompanied [Alien] Children into ORR Care Provider Facilities

Forms and Documents

Document Name	Status
Form P-12B Bed Assignment and Capacity Overview Module (Form P-12B) Form and Instruction	Unchanged
Form P-12A Bed Configuration Module (Form P-12A) Form and Instruction	Unchanged
Form P-10B Placement Confirmation (Form P-10B) – Contractor Case Coordinator Form and Instruction	Unchanged
Form P-18 Notice of Administrative Review (Form P-18) Form	Unchanged
Form P-17 Influx Transfer Manual and Prescreen Criteria Review (Form P-17) Form and Instruction	Unchanged
Form P-16 Influx Transfer Manifest (Form P-16) Form and Instruction	Unchanged
Form P-15 Family Group Entity (Form P-15) Form and Instruction	Unchanged
Form P-10B Placement Confirmation (Form P-10B) – Grantee Case Manager Form and Instruction	Unchanged
Form P-10A Transfer Request (Form P-10A) – Contractor Case Coordinator Form and Instruction	Unchanged
Form P-14 ORR Transfer Notification - ORR Notification to ICE Chief Counsel of Transfer of UC and Request to Change Address/Venue (Form P-14) Form and Instruction	Unchanged
Form P-13 Unaccompanied Child Profile (Form P-13) Form and Instruction	Unchanged
Form P-12C Program Entity (Form P-12C) Form and Instruction	Unchanged
Form P-11 Transfer Summary and Tracking (Form P-11) Form and Instruction	Unchanged
Form P-10A Transfer Request (Form P-10A) – Grantee Case Manager Form and Instruction	Unchanged
Form P-9B Medical Checklist for Transfers to Influx Care Facilities (Form P-9B) Form and Instruction	Unchanged
Form P-9A Medical Checklist for Non-Influx Transfers (Form P-9A) Form and Instruction	Unchanged
Form P-8 Care Provider Checklist for Transfers to Influx Care Facilities (Form P-8) Form and Instruction	Unchanged
Form P-7 Unaccompanied [Alien] Child Referral (aka Intakes Restrictive Placement Checklist) (Form P-7) Form and Instruction	Unchanged
Form P-5 Long Term Foster Care Placement Memo (Form P-5) Form and Instruction	Unchanged
Form Form P-4 Notice of Placement in a Restrictive Setting (Form P-4) Form and Instruction	Unchanged
Form P-2 Authorization for Medical, Dental, and Mental Health Care (Form P-2) Form and Instruction	Modified
Form P-1 Placement Authorization (Form P-1) Form and Instruction	Unchanged
NonSub Change Request Template-Authorization for Medical, Dental, and Mental Health Care Package.docx Justification for No Material/Nonsubstantive Change	2026-01-12
NonSub Change Request_Intakes Placement checklist_12.5.25.docx Justification for No Material/Nonsubstantive Change	2025-12-10
Emergency SSA Attachment A_0970-0554_Placement and Transfer_2025 09 25.docx Supplementary Document	2025-09-25
Nonsub Memo_0970-0554_Placement and Transfer_009.docx Justification for No Material/Nonsubstantive Change	2024-07-30
Nonsub Memo_0970-0554_Placement and Transfer_008_2024 03 26.docx Justification for No Material/Nonsubstantive Change	2024-03-27
Nonsub Memo_0970-0554_Placement and Transfer_007 _2023 08 30.docx Justification for No Material/Nonsubstantive Change	2023-08-30
Appendix A - P-10 Transfer Request Revisions.xlsx Supplementary Document	2023-08-09
Nonsub Memo_0970-0554_Placement and Transfer_004 _2023 08 08.docx Justification for No Material/Nonsubstantive Change	2023-08-09
Extension SSA Attachment A_0970-0554_Placement and Transfer_003_2023 04 24.docx Supplementary Document	2023-04-25
Emergency SSA_0970-0554_Placement and Transfer_011_2025 09 25 CLEAN.docx Supporting Statement A	2025-09-25

IC Document Collections

IC ID	Document Title	Status
261944	Bed Assignment and Capacity Overview Module (Form P-12B) Form and Instruction	Unchanged
261943	Bed Configuration Module (Form P-12A) Form and Instruction	Unchanged
261526	Placement Confirmation (Form P-10B) – Contractor Case Coordinator Form and Instruction	Unchanged
256558	Notice of Administrative Review (Form P-18) Form	Unchanged
249643	Influx Transfer Manual and Prescreen Criteria Review (Form P-17) Form and Instruction	Unchanged
249642	Influx Transfer Manifest (Form P-16) Form and Instruction	Unchanged
249641	Family Group Entity (Form P-15) Form and Instruction	Unchanged
249640	Placement Confirmation (Form P-10B) – Grantee Case Manager Form and Instruction	Unchanged
249639	Transfer Request (Form P-10A) – Contractor Case Coordinator Form and Instruction	Unchanged
242799	ORR Transfer Notification - ORR Notification to ICE Chief Counsel of Transfer of UC and Request to Change Address/Venue (Form P-14) Form and Instruction	Unchanged
242798	Unaccompanied Child Profile (Form P-13) Form and Instruction	Unchanged
242797	Program Entity (Form P-12C) Form and Instruction	Unchanged
242796	Transfer Summary and Tracking (Form P-11) Form and Instruction	Unchanged
242795	Transfer Request (Form P-10A) – Grantee Case Manager Form and Instruction	Unchanged
242794	Medical Checklist for Transfers to Influx Care Facilities (Form P-9B) Form and Instruction	Unchanged
242793	Medical Checklist for Non-Influx Transfers (Form P-9A) Form and Instruction	Unchanged
242792	Care Provider Checklist for Transfers to Influx Care Facilities (Form P-8) Form and Instruction	Unchanged
242791	Unaccompanied [Alien] Child Referral (aka Intakes Restrictive Placement Checklist) (Form P-7) Form and Instruction	Unchanged
242790	Long Term Foster Care Placement Memo (Form P-5) Form and Instruction	Unchanged
242789	Notice of Placement in a Restrictive Setting (Form P-4) Form and Instruction	Unchanged
242788	Authorization for Medical, Dental, and Mental Health Care (Form P-2) Form and Instruction	Modified
242787	Placement Authorization (Form P-1) Form and Instruction	Unchanged

ICR Details

OMB Control No: 0970-0554	ICR Reference No: 202601-0970-004
Status: Received in OIRA	Previous ICR Reference No: 202512-0970-002
Agency/Subagency: HHS/ACF	Agency Tracking No: ORR
Title: Placement and Transfer of Unaccompanied [Alien] Children into ORR Care Provider Facilities
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 09/26/2025
Date Submitted to OIRA: 01/13/2026

	Requested	Previously Approved
Expiration Date	02/28/2026	02/28/2026
Responses	12,003,289	12,003,289
Time Burden (Hours)	5,950,965	5,950,965
Cost Burden (Dollars)	0	0

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Abstract: The Office of Refugee Resettlement (ORR) Unaccompanied Alien Children (UAC) Bureau provides care and custody for unaccompanied alien children until they can be safely released to a sponsor, repatriated to their home country, or obtain legal status. ORR funds residential care provider facilities that provide temporary housing and other services to children in ORR custody. Generally, care provider facilities are State licensed (with the exception of those located in states unwilling to license them and temporary influx care facilities) and must meet ORR requirements to ensure a high-level quality of care. Services provided at care provider facilities include, but are not limited to, education, recreation, vocational training, acculturation, nutrition, medical, mental health, legal, and case management. ORR uses several forms directly related to the care of unaccompanied alien children. The forms in this information collection allow ORR to place unaccompanied alien children referred to ORR by federal agencies into care provider facilities and to transfer children within the ORR care provider network. On September 26, 2025, the Office of Management and Budget approved revised versions of forms P-4 and P-7 through emergency approval, as authorized under 5 CFR 1320.13. ORR is proposing revisions to one form in this collection, the Authorization for Medical, Dental, and Mental Health Care (Form P-2). The purpose of the Authorization for Medical, Dental and Mental Health Care (Form P-2) is to inform the treating healthcare provider that the care provider program has the authority, on behalf of ORR, to provide consent for certain healthcare services for unaccompanied alien children and to collect the child’s health records for these services. In addition, the form explains the reimbursement procedure for the submission of healthcare claims. The approved version of the Authorization for Medical, Dental and Mental Health Care (Form P-2) is not consistent with ORR’s current consent policies, guidance on required healthcare services, and reimbursement processes. The lack of alignment has caused confusion in the healthcare community and a delay in reimbursement of services.  

Emergency Justfication: ACF is requesting emergency review and approval by OMB to update two forms approved under the Placement and Transfer of Unaccompanied Children into ORR Care Provider Facilities information collection (OMB #0970-0554), as authorized under 5 CFR 1320.13.  ACF is requesting approval as soon as possible due to secure beds becoming available on September 15, 2025 and requests 180 days of approval, during which time a full revision request will be submitted under normal procedures under the Paperwork Reduction Act. The information collection is essential to the mission of the agency, the use of normal clearance procedures is reasonably likely to prevent or disrupt the collection of information, and public harm is reasonably likely to result if normal clearance procedures are followed. For additional information see Attachment A.

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Authorizing Statute(s): PL: Pub.L. 113 - 4 1101(c) Name of Law: Violence Against Women Reauthorization Act of 2013
   US Code: 6 USC 279 Name of Law: Homeland Security Act (HSA)
   US Code: 8 USC 1232 Name of Law: Trafficking Victims Protection Reauthorization Act of 2008 (TVPRA)
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 22

IC Title	Form No.	Form Name
Authorization for Medical, Dental, and Mental Health Care (Form P-2)	P-2	Authorization for Medical, Dental, and Mental Health Care - UC Path Version
Bed Assignment and Capacity Overview Module (Form P-12B)	P-12B	Bed Assignment Capacity Overview Module
Bed Configuration Module (Form P-12A)	P-12A	Bed Configuration Module
Care Provider Checklist for Transfers to Influx Care Facilities (Form P-8)	P-8	Care Provider Checklist for Transfers to Influx Care Facilities
Family Group Entity (Form P-15)	P-15	Family Group Entity
Influx Transfer Manifest (Form P-16)	P-16	Influx Transfer Manifest
Influx Transfer Manual and Prescreen Criteria Review (Form P-17)	P-17	Influx Transfer Manual and Prescreen Criteria Review
Long Term Foster Care Placement Memo (Form P-5)	P-5	Long Term Foster Care Placement Memo
Medical Checklist for Non-Influx Transfers (Form P-9A)	P-9A	Medical Checklist for Transfers
Medical Checklist for Transfers to Influx Care Facilities (Form P-9B)	P-9B	Medical Checklist for Influx Transfers
Notice of Administrative Review (Form P-18)	P-18, P-18s, P-18d, P-18p	Notice of Administrative Review ,   Notice of Administrative Review - Spanish ,   Notice of Administrative Review - Dari ,   Notice of Administrative Review - Pashto
Notice of Placement in a Restrictive Setting (Form P-4)	Form P-4	Notice of Placement in a Restrictive Setting
ORR Transfer Notification - ORR Notification to ICE Chief Counsel of Transfer of UC and Request to Change Address/Venue (Form P-14)	P-14	ORR Transfer Notification - UC Path Version
Placement Authorization (Form P-1)	P-1	Placement Authorization - UC Path Version
Placement Confirmation (Form P-10B) – Contractor Case Coordinator	P-10B	Placement Confirmation
Placement Confirmation (Form P-10B) – Grantee Case Manager	P-10B	Placement Confirmation
Program Entity (Form P-12C)	P-12C, P-12	Program Entity ,   UC Portal Capacity Report (Form P-12) - UC Portal
Transfer Request (Form P-10A) – Contractor Case Coordinator	P-10A	Transfer Request
Transfer Request (Form P-10A) – Grantee Case Manager	P-10A	Transfer Request
Transfer Summary and Tracking (Form P-11)	P-11	Transfer Summary and Tracking - UC Path Version
Unaccompanied Child Profile (Form P-13)	P-13, P-13	UC Profile - UC Portal ,   Add New UC (Form P-13) - UC Path
Unaccompanied [Alien] Child Referral (aka Intakes Restrictive Placement Checklist) (Form P-7)	P-7, P-7	UC Referral ,   Unaccompanied [Alien] Child Referral (aka Intakes Restrictive Placement Checklist)

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ICR Summary of Burden

	Total Request	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	12,003,289	12,003,289	0	0	0	0
Annual Time Burden (Hours)	5,950,965	5,950,965	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $8,916,556

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? No

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 01/13/2026

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