Senior Corps Independent Living Evaluation Impact Study

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 1 Sc Independent Living Impact Evaluation: Program Directors	Form and Instruction	New	Available
Form 1 SC Independent Living Impact Evaluation: New Programs	Form and Instruction	New	Available
Form 1 Sc Independent Living Evaluation Impact Survey: Established Programs	Form and Instruction	New	Available
60 Day Notice Senior Corps IndLiving AB.doc	Supporting Statement B	Uploaded 2013-09-24	Available
Senior Companion SSA9.24.13.docx	Supporting Statement A	Uploaded 2013-09-24	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
207404	Sc Independent Living Impact Evaluation: Program Directors	Form and Instruction	New
207403	SC Independent Living Impact Evaluation: New Programs	Form and Instruction	New
207402	Sc Independent Living Evaluation Impact Survey: Established Programs	Form and Instruction	New

ICR Details

OMB Control No: 3045-0154	ICR Reference No: 201306-3045-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: CNCS	Agency Tracking No:
Title: Senior Corps Independent Living Evaluation Impact Study
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: 09/25/2013
	Date Received in OIRA: 06/19/2013
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2016	36 Months From Approved
Responses	2,961	0	0
Time Burden (Hours)	2,028	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Corporation for National and Community Service (CNCS) seeks approval to conduct a study to assess the impact of Senior Companion Program (SCP) on clients' self-efficacy, life satisfaction, and perceived social ties and social supports. This study will include a comparison group from the Health and Retirement Study (HRS) dataset developed and collected by the University of Michigan. The study will contribute to CNCS's ability to report on progress towards two of the goals of its Strategic Plan. The first goal is to increase the impact of national service on community needs in communities served by CNCS-supported programs. The second goal is to strengthen national service so that participants engaged in CNCS-supported programs consistently find satisfaction, meaning, and opportunity.

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Authorizing Statute(s): US Code: 42 USC 4950 Name of Law: Domestic Service Volunteer Act, as amended
  

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:
	77 FR 70739	11/27/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 36750	06/19/2013
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Sc Independent Living Evaluation Impact Survey: Established Programs	1	SC Independent Living Impact Evaluation CATI
SC Independent Living Impact Evaluation: New Programs	1	Sr Corps Independent Living Evaluation CATI Pre and Post
Sc Independent Living Impact Evaluation: Program Directors	1	Program Director Client List

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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	2,961	0	0	2,961	0	0
Annual Time Burden (Hours)	2,028	0	0	2,028	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: The burden has increased because this is a new information collection request.

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Annual Cost to Federal Government:

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: 06/19/2013

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