Enhanced Services for the Hard-to-Employ (HtE) Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
HtE KS-MO 36M_App A_Videotape Consent Form FINAL.doc	Supplementary Document	Uploaded 2007-11-08	Available
H2E KS-MO 36M_Responses to OMB Questions_10-26-07 (2).doc	Supplementary Document	Uploaded 2007-11-08	Available
OMB HtE KS-MO_36M Supp Statement-Part B.doc	Supporting Statement B	Uploaded 2007-07-16	Available
HtE KCMO 36 month abstract.doc	Supplementary Document	Uploaded 2007-07-16	Available
Kansas and Missouri 36-Month Data Collection, 2nd Notice.doc	Supplementary Document	Uploaded 2007-07-12	Available
OMB HtE KS-MO_36M Supp Statement- Part A FINAL.doc	Supporting Statement A	Uploaded 2007-11-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
181683	Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection -- Child Survey	Other-Child Instrument	New
181682	Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection -- Parent Survey	Other-Survey Instrument	New

ICR Details

OMB Control No: 0970-0332	ICR Reference No: 200708-0970-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No:
Title: Enhanced Services for the Hard-to-Employ (HtE) Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection
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: 11/13/2007
	Date Received in OIRA: 08/15/2007
Terms of Clearance: This ICR is approved on the understanding that ACF will provide as incentives to 3-6 year old children a non-monetary incentive not to exceed $5. Also, ACF agrees to not provide assurances of confidentiality because ACF does not have stautory authority to do so.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2010	36 Months From Approved
Responses	976	0	0
Time Burden (Hours)	610	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: See attachment.

---

Authorizing Statute(s): PL: Pub.L. 42 - 613 413 Name of Law: Social Security Act
  

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 14578	03/27/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 33761	06/19/2007
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection -- Parent Survey
Enhanced Services for the Hard-to-Employ Demonstration and Evaluation: Kansas and Missouri 36-Month Data Collection -- Child Survey

---

ICR Summary of Burden

table that charts list 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	976	0	0	976	0	0
Annual Time Burden (Hours)	610	0	0	610	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 the 36 month follow up survey as part of a multi-site, random-assignment evaluation. Previous surveys were conducted at baseline and 12 months after random assignment.

---

Annual Cost to Federal Government: $350,000

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]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

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: 08/15/2007

---