Homelessness Data for Health and Human Services Mainstream Programs

Forms and Documents

Document Name	Status
0990-Homelessness Data for HHS Mainstream Programs 8-10-07.doc Supporting Statement A	2007-08-15

IC Document Collections

IC ID	Document Title	Status
181792	State official responsible for administering the Medicaid Program Other-Medicaid Survey	New
181791	State official responsible for administering the TANF program Other-Interview Guide	New

ICR Details

OMB Control No: 0990-0320	ICR Reference No: 200708-0990-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Homelessness Data for Health and Human Services Mainstream Programs
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 without change	Conclusion Date: 01/14/2008
	Date Received in OIRA: 08/24/2007
Terms of Clearance: Approved consistent with the following terms of clearance: OMB approves the proposed survey for purposes of clarifying the data set that is currently available at the State level regarding housing status in the population of interest, OMB does not at this time approve the use of such data for purposes of performance assessment.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2011	36 Months From Approved
Responses	102	0	0
Time Burden (Hours)	102	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of the Assistant Secretary for Planning and Evaluation will study data collection practices from Temporary Assistant for Needy Families (TANF) and Medicaid state programs regarding homelessness and housing. Telephone interviews will be conducted with state officials from all 50 states and the District of Columbia who administer the TANF and Medicaid programs to collect information about the type and quality of data related to homelessness and housing status that are collected from and recorded about TANF and Medicaid applicants.

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Authorizing Statute(s): US Code: 42 USC 301 Name of Law: Public Health Service Act
  

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:
	72 FR 26818	05/11/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 42412	08/02/2007
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
State official responsible for administering the TANF program
State official responsible for administering the Medicaid Program

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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	102	0	0	102	0	0
Annual Time Burden (Hours)	102	0	0	102	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 new data collection.

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Annual Cost to Federal Government: $190,930

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

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

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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: 08/24/2007

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