Memo on revisions to SSVF 2900-0757

	Department of Veterans Affairs		Memorandum
Date:		November 18, 2013
From:		VHA PRA Compliance Liaison (10B4)
Subject:		Non Substantive Change for OMB Control # 2900-0757
To:		VA Desk Officer, Office of Management & Budget (OMB)
Cc:		VA Clearance Officer, Crystal Rennie (OI&T- 005R1B)

1. See the following new, updated, and additional information for OMB Control # 2900-0757:

a. Updates: Proposed changes 10-10072a SSVF Participant Satisfaction Survey:

Added disclaimer “Thank you for your willingness to complete this survey about the services you have received. Your responses will be used by VA to better understand the effectiveness of the program and where services might be either kept the same, or changed, to help other Veterans and their families. All answers you provide on this survey are confidential as survey data does not include names.”

Removed line 1 Date.

Revised line 2 added “Organization that provided you with SSVF Services”

Removed line 4: “Number of individuals in household receiving supportive services from this provider”.

Question 1: Changed to four point scale (poor, average, good, excellent).

Removed question 3: “How satisfied are you with the services you have received from this supportive services provider?” Too much overlap with question 1 (quality of services)

Question 4: Removed ‘and had a choice of where to go at no cost to you’ portion of “If you needed help again and had a choice of where to go at no cost to you, would you return to this supportive services provider?”

Renumber question 6 to 4A for direction.

Table 8: Changed scoring from five to four point scale (poor, average, good, excellent).

Question 9: Removed last option: “In a family or friend’s apartment or house because you had nowhere else to go”

Question 10 -> Removed “If you answered Yes to any of the places listed in Question 9, on how many separate occasions did you sleep in one of those places?”

Question 11, 12 and 13: Underline: in the year before

Question 12: Reworded to “In the year before you requested help from this supportive services provider, was it sometimes hard to pay for housing due to a change in income?”

Question 14 -> renumbered to 10A,

Added a 10B question “If you answered No to Question 11, what is your employment status?”

Question 16: Reworded to “Since you started receiving services was there a time when your income decreased so much that it became hard to pay your housing costs?”

Question 18 -> Renumbered to 13A

Added a 13B question “If you answered No to Question 11, what is your employment status?”.

Added mailing instructions “Please place your completed survey in the envelope provided, seal the envelope and return it in accordance with the instructions you were given at the time you received the survey. Do not place your name on this survey or on the envelope.”

b. Supplementary Documents: 10-10072a SSVF Participant Satisfaction Survey .