Targeted Capacity Expansion Grants for Jail Diversion Programs

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0930-0277 can be found here:

Documents and Forms

Document Name Document Type
Form Attachment A Targeted Capacity Expansion Grants for Jail Diversion Programs Form and Instruction
Attachment A Baseline Interview Appendix A - JailDiversionTCE_Baseline_Revised2006.doc Form and Instruction
Attachment B 6-Month Interview Appendix B - JailDiversionTCE_6Month_Revised2006.doc Form and Instruction
Attachment C 12-Month Interview Appendix C - JailDiversionTCE_12-Month_Revised2006.doc Form
Attachment D Arrest Data Collection Form Appendix D - JailDiversionTCE_ArrestForm.doc Form and Instruction
Attachment E MH and SA Collection Form Appendix E - JailDiversionTCE_ServiceUseForm.doc Form and Instruction
Attachment G Baseline Person Tracking Info Form Appendix G - JailDiversionTCE_PersonTrackingForm.doc Form and Instruction
Appendix F - Example of an Informed Consent Form.doc Attachment F- Consent Form IC Document
Appendix H - Follow-up Interview Reminder Letter (template).doc Attachment H- Follow-up Letter IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	Targeted Capacity Expansion Grants for Jail Diversion Programs	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	Attachment A	Baseline Interview	Appendix A - JailDiversionTCE_Baseline_Revised2006.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment B	6-Month Interview	Appendix B - JailDiversionTCE_6Month_Revised2006.doc	Yes	Yes	Paper Only
Form	Attachment C	12-Month Interview	Appendix C - JailDiversionTCE_12-Month_Revised2006.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment D	Arrest Data Collection Form	Appendix D - JailDiversionTCE_ArrestForm.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment E	MH and SA Collection Form	Appendix E - JailDiversionTCE_ServiceUseForm.doc	Yes	Yes	Paper Only
Form and Instruction	Attachment G	Baseline Person Tracking Info Form	Appendix G - JailDiversionTCE_PersonTrackingForm.doc	Yes	Yes	Paper Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 686	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	21,869	-5,025	26,894
Annual IC Time Burden (Hours)	1,225	-148	1,373
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Attachment F- Consent Form	Appendix F - Example of an Informed Consent Form.doc
Attachment H- Follow-up Letter	Appendix H - Follow-up Interview Reminder Letter (template).doc

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.