Evaluation of Programs to Provide Services to Persons Who Are Homeless with Mental and /or Substance Use Disorders

Forms and Documents

Document Name	Status
Form Discussion Guide_C Project Director Interview Form and Instruction	New
Form PSH Self-Assessmen PSH Self-Assessment Form and Instruction	New
Form EBP Self-Assessmen EBP Self-Assessment Part 2 Form and Instruction	New
Form EBP Self-Assessmen EBP Self-Assessment Part 1 Form and Instruction	New
Form Discussion Guide_C Cost Interview Form and Instruction	New
Form Discussion Guide_C Client Focus Group Form and Instruction	New
Form Discussion Guide_C Evaluator Interview Form and Instruction	New
Form Discussion Guide_C Stakeholder Interview Form and Instruction	New
Form Discussion Guide_C Case Manager, Treatment, Housing Staff/provider Interview Form and Instruction	New
Form Discussion Guide_C Opening Session/Project Director Form and Instruction	New
Form PD Interview Project Director - Telephone Follow-up Form and Instruction	New
HomelessProgramsEval OMB SS-B_1.13.14.docx Supporting Statement B	2014-01-13
Attachment 09_PSH Web Consent.docx Supplementary Document	2013-08-19
Attachment 08_EBP Web Consent.docx Supplementary Document	2013-08-19
Attachment 08_EBP Web Consent.docx Supplementary Document	2013-08-19
Attachment 06 and 07_Staff and Client SiteVisit Consent.docx Supplementary Document	2013-08-19
Attachment 06 and 07_Staff and Client SiteVisit Consent.docx Supplementary Document	2013-08-19
Attachment 06 and 07_Staff and Client SiteVisit Consent.docx Supplementary Document	2013-08-19
Attachment 06 and 07_Staff and Client SiteVisit Consent.docx Supplementary Document	2013-08-19
Attachment 06 and 07_Staff and Client SiteVisit Consent.docx Supplementary Document	2013-08-19
Attachment 06 and 07_Staff and Client SiteVisit Consent.docx Supplementary Document	2013-08-19
Attachment 10_Analysis Table Shells.docx Supplementary Document	2013-08-19
Attachment 05_PD Interview_Consent and Script.docx Supplementary Document	2013-08-19
HomelessProgramsEval OMB SS-A_1.14.14.docx Supporting Statement A	2014-01-14

IC Document Collections

IC ID	Document Title	Status
210019	Project Director Interview Form and Instruction	New
208314	PSH Self-Assessment Form and Instruction	New
208313	EBP Self-Assessment Part 2 Form and Instruction	New
208312	EBP Self-Assessment Part 1 Form and Instruction	New
208311	Cost Interview Form and Instruction	New
208310	Client Focus Group Form and Instruction	New
208309	Evaluator Interview Form and Instruction	New
208308	Stakeholder Interview Form and Instruction	New
208307	Case Manager, Treatment, Housing Staff/provider Interview Form and Instruction	New
208306	Opening Session/Project Director Form and Instruction	New
208305	Project Director - Telephone Follow-up Form and Instruction	New

ICR Details

OMB Control No: 0930-0339	ICR Reference No: 201308-0930-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 20343
Title: Evaluation of Programs to Provide Services to Persons Who Are Homeless with Mental and /or Substance Use Disorders
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 01/14/2014
	Date Received in OIRA: 08/20/2013
Terms of Clearance: Consistent with the changes to this collection, this collection is not an impact study. It is not a study of causes. The study is an observational, longitudinal study which draws from extant and new data collections, including prior program evaluations, to describe comparative program performance for particular client cohorts.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2017	36 Months From Approved
Responses	1,942	0	0
Time Burden (Hours)	2,835	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Homeless Programs cross-program evaluation broadly aims to identify commonalities across the Homeless Programs service delivery by examining which service models are delivered, with what outcomes, for which populations, and with what resulting comparative effectiveness and cost effectiveness. To compare programs, the evaluation will identify service models based on service approach (e.g., direct vs. referral), services (type of service and adherence to practice), housing types and models, type of partnerships and factors leading to program sustainability. The resulting models will facilitate interpretation of client and program-level outcomes, comparative effectiveness and cost-effectiveness evaluation.

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Authorizing Statute(s): US Code: 42 USC 506 Name of Law: Grants for the Benefit of Homeless Individuals
  

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
60-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 36204	06/17/2013
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 50429	08/19/2013
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 11

IC Title	Form No.	Form Name
Project Director - Telephone Follow-up	PD Interview	PD Interview
Opening Session/Project Director	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
Case Manager, Treatment, Housing Staff/provider Interview	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
Stakeholder Interview	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
Evaluator Interview	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
Client Focus Group	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
Cost Interview	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
EBP Self-Assessment Part 1	EBP Self-Assessment Part 1 and Part 2	EBP Self-Assessment Part 1 and Part 2
EBP Self-Assessment Part 2	EBP Self-Assessment Part 1 and Part 2	EBP Self-Assessment Part 1 and Part 2
PSH Self-Assessment	PSH Self-Assessment	PSH Self-Assessment
Project Director Interview	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire

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ICR Summary of Burden

	Total Approved	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	1,942	0	0	1,942	0	0
Annual Time Burden (Hours)	2,835	0	0	2,835	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $522,494

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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? Uncollected

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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: 08/20/2013

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