Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Appendix T STED_ETJD 30 Month Overview.docx	Supplementary Document	Uploaded 2014-05-06	Available
STED-ETJD Supporting Statement Part B - Updated August 2014 - Final.docx	Supporting Statement B	Uploaded 2014-09-02	Available
STED Young Adult to Adult Survey Comparison May 2013.docx	Supplementary Document	Uploaded 2013-05-13	Available
Appendix_B.1_Informed Consent Revised May 2013 Final.docx	Supplementary Document	Uploaded 2013-05-13	Available
Appendix_J_Interview Guides_26APR12.doc	Supplementary Document	Uploaded 2012-05-03	Available
Appendix_J_Interview Guides_26APR12.doc	Supplementary Document	Uploaded 2012-05-03	Available
Appendix_J_Interview Guides_26APR12.doc	Supplementary Document	Uploaded 2012-05-03	Available
STED-ETJD Supporting Statement Part A - Updated August 2014 - Clean.docx	Supporting Statement A	Uploaded 2014-09-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
211534	Appendix U Participant 30-month survey		New
207067	Participant 12-month survey (Young Adult sites)	Other-Survey	Modified
207066	Participant 6-month survey (Young Adult sites)	Other-Survey	Modified
202240	Program Staff Time-Use Worksheet	Other-Staff-Use Worksheet	Unchanged
202239	Referral Partner Interview Guides	Other-Referral Partners Interview Guides	Unchanged
202238	Employer Interview Guides	Other-Employer Interview Guides	Unchanged
202237	Program Staff Cost Data Collection Protocol	Other-Protocol	Unchanged
202236	Program Staff Interview Guides	Other-Program Staff Interview Guides	Unchanged
202235	Employer Implementation Questionnaire	Other-Employer Implementation Questionnaire	Unchanged
202234	Worksite Supervisor Implementation Questionnaire	Other-Worksite Supervisor Implementation Questionnaire	Unchanged
202233	Program Staff Implementation Questionnaire	Other-Program Staff Implementation Questionnaire	Unchanged
202232	Participant Focus Group Discussion Guide	Other-Focus Group Guide	Unchanged
202231	Participant Implementation Questionnaire	Other-Questionnaire	Unchanged
202230	Participant 12-month survey (Adult sites)	Other-12 Month Follow-Up	Modified
202229	Participant 6-month survey (Adult sites)	Other-6-month survey	Modified
202228	Participant ETJD tracking letters	Other-Tracking Letters	Unchanged
202227	Participant STED tracking letters	Other-Tracking Letters	Modified
202226	Participant Baseline Information Form	Other-BIF	Unchanged
202225	Participant Contact Information Form	Other-Contact Info Form	Unchanged

ICR Details

OMB Control No: 0970-0413	ICR Reference No: 201405-0970-001
Status: Historical Active	Previous ICR Reference No: 201305-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No: 19600
Title: Subsidized and Transitional Employment Demonstration (STED) and Enhanced Transitional Jobs Demonstration (ETJD)
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: 09/03/2014
	Date Received in OIRA: 06/03/2014
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2017	36 Months From Approved	08/31/2016
Responses	22,475	0	16,187
Time Burden (Hours)	7,006	0	4,393
Cost Burden (Dollars)	0	0	0

---

Abstract: This request is for a revision to the approved package, to include a 30-month follow-up survey and an update to the number of respondents to previously approved instruments. The updated number of respondents is based on actual recruitment experiences since the initial approval.

---

Authorizing Statute(s): PL: Pub.L. 74 - 271 413 Name of Law: Social Security Act; Research, Evaluations and National Studies
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 17547	03/28/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 31115	05/30/2014
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 19

table that charts list of burden

IC Title	Form No.	Form Name
Program Staff Cost Data Collection Protocol
Employer Interview Guides
Referral Partner Interview Guides
Program Staff Time-Use Worksheet
Participant 12-month survey (Young Adult sites)
Appendix U Participant 30-month survey
Participant Implementation Questionnaire
Participant Focus Group Discussion Guide
Program Staff Implementation Questionnaire
Worksite Supervisor Implementation Questionnaire
Employer Implementation Questionnaire
Program Staff Interview Guides
Participant 6-month survey (Young Adult sites)
Participant Contact Information Form
Participant Baseline Information Form
Participant STED tracking letters
Participant ETJD tracking letters
Participant 6-month survey (Adult sites)
Participant 12-month survey (Adult sites)

---

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	22,475	16,187	0	3,947	2,341	0
Annual Time Burden (Hours)	7,006	4,393	0	1,974	639	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: Burden changes are due to an additional information collection request (30 month follow-up survey) and to adjustments in estimated numbers of respondents since specific sites were recruited.

---

Annual Cost to Federal Government: $6,682,551

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

---

Common Form ICR:  No

---

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: 06/03/2014

---