Employment First State Leadership Mentoring Program Community of Practice Evaluation

Forms and Documents

Document Name	Status
EF Clearance Memo 001.jpg Supplementary Document	2014-07-02
COP Survey Pre implementation E-mail_2014-07-02.docx Supplementary Document	2014-07-02
EF_Eval_PRA_Package_Part_A_ 2014-07-02.docx Supporting Statement A	2014-07-02
Supplemental-Romano Memorandum_01.15.09.docx Supplementary Document	2013-11-01
EFSLMP Evaluation PRA Package Part B 06272014.docx Supporting Statement B	2014-07-02

IC Document Collections

IC ID	Document Title	Status
209076	Employment First Survey Other-Survey	New

ICR Details

OMB Control No: 1230-0007	ICR Reference No: 201310-1230-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOL/ODEP	Agency Tracking No:
Title: Employment First State Leadership Mentoring Program Community of Practice Evaluation
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: 10/20/2014
	Date Received in OIRA: 07/09/2014
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2017	36 Months From Approved
Responses	180	0	0
Time Burden (Hours)	47	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This new data collection refers to a census of 30 State government teams involved in the Employment First State Leadership Mentoring Program (EFLSMP) Community of Practice (CoP), the activities of which are being funded by the U.S. Department of Labor (DOL), Office of Disability Employment Policy (ODEP). The CoP provides monthly technical assistance sessions, Webinars, and discussion forums designed to facilitate collaboration and sharing of information, approaches, and practices. Since the fall of 2012, ODEP has been conducting monthly technical assistance Webinars and other information dissemination via its electronic portal as part of the CoP activities. The goal of the technical assistance provided through the EFLSMP CoP is to increase the capacity of participating states to implement policies, practices, and approaches that place integrated employment as the priority outcome for individuals with disabilities.

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Authorizing Statute(s): None

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:
	79 FR 24453	04/30/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 38960	07/09/2014
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Employment First Survey

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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	180	0	0	180	0	0
Annual Time Burden (Hours)	47	0	0	47	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 Employment First State Leadership Mentoring Program Community of Practice survey is a new information collection.

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Annual Cost to Federal Government: $156,407

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: 07/09/2014

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