Accelerated Benefits Demonstration Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Appendix D.doc	Supplementary Document	Uploaded 2008-12-30	Available
Appendix C.doc	Supplementary Document	Uploaded 2008-12-30	Available
Appendix B (treatment).doc.pdf	Supplementary Document	Uploaded 2009-01-30	Available
Appendix B (control).doc.pdf	Supplementary Document	Uploaded 2009-01-30	Available
Appendix A.doc	Supplementary Document	Uploaded 2008-12-30	Available
0960-0747 addendum 2008.doc	Supplementary Document	Uploaded 2008-12-30	Available
0960-0747 supporting statement B 2008.doc	Supporting Statement B	Uploaded 2008-12-30	Available
0960-0747 Supporting Statement A 2008.doc	Supporting Statement A	Uploaded 2008-12-30	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
187688	AB Demo Project 12-Month Follow-Up Survey	Other-Survey Script	New
180020	Early Use Survey	Other-Advance Letter - Early-Use Survey	Removed
180016	Baseline Survey Materials	Other-Survey Script	Removed

ICR Details

OMB Control No: 0960-0747	ICR Reference No: 200812-0960-018
Status: Historical Active	Previous ICR Reference No: 200803-0960-021
Agency/Subagency: SSA	Agency Tracking No:
Title: Accelerated Benefits Demonstration Project
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 02/23/2009
	Date Received in OIRA: 12/30/2008
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/29/2012	36 Months From Approved	08/31/2010
Responses	1,600	0	38,292
Time Burden (Hours)	1,200	0	6,812
Cost Burden (Dollars)	0	0	0

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Abstract: The Accelerated Benefits Demonstration Project is a multi-phase study designed to assess whether providing new SSDI beneficiaries with health benefits and employment supports will stabilize or improve their health and help them return to work early. In this long-term study, new SSDI disability recipients (i.e., those who have just begun receiving benefits and who have at least 18 months remaining before they qualify for Medicare) will be divided into three groups: 1) a control group that will just receive their regular SSDI benefits; 2) a treatment group that will receive immediate access to health care benefits; and 3) a treatment group that will receive health care benefits and additional care management, employment, and benefits services and support. The study, which is being conducted for SSA by research contractors and health care experts, will assess whether health benefits alone or health benefits with additional support services improve the health and employment outcomes of new SSDI beneficiaries. In this ICR, we are seeking OMB approval for a 12-month follow-up survey with study participants.

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Authorizing Statute(s): US Code: 42 USC 434 Name of Law: Social Security 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:
	73 FR 55584	09/25/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 75490	12/11/2008
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Baseline Survey Materials
Early Use Survey
AB Demo Project 12-Month Follow-Up Survey

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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	1,600	38,292	0	-36,692	0	0
Annual Time Burden (Hours)	1,200	6,812	0	-5,612	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: ROCIS registed a burden increase because we added a new IC, the 12-month follow-up survey. Overall, there is an actual decrease to this ICR's burden, because we had many more respondents previously (since we were screening large numbers of the public to select our sample group). Additionally, we eliminated the preliminary ICs since they are prelim surveys we are no longer conducting.

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Annual Cost to Federal Government: $1,961,000

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: 12/30/2008

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