Information Collection Request

Evaluation of Programs to Provide Services to Persons Who Are Homeless with Mental and /or Substance Use Disorders

ICR 201701-0930-003 · OMB 0930-0339 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form Discussion Guide_C Project Director Interview Form and Instruction Removed Available
Form PSH_Self-Assessmen PSH Self-Assessment Form and Instruction Modified Available
Form Self-Assessment_Pa EBP Self-Assessment Part 2 Form and Instruction Modified Available
Form Self-Assessment_Pa EBP Self-Assessment Part 1 Form and Instruction Modified Available
Form SV Guide_Cost Ques Cost Interview Form and Instruction Modified Available
Form SV Guide_Cost Ques Client Focus Group Form and Instruction Modified Available
Form SV Guide_Cost Ques Evaluator Interview Form and Instruction Modified Available
Form SV Guide_Cost Ques Stakeholder Interview Form and Instruction Modified Available
Form SV Guide_Cost Ques Case Manager, Treatment, Housing Staff/provider Interview Form and Instruction Modified Available
Form SV Guide_Cost Ques Opening Session/Project Director Form and Instruction Modified Available
Form PD Interview Project Director - Phone Interview/web Survey Form and Instruction Modified Available
0930-0339_OMB_SS_PartB 1.24.17.docx Supporting Statement B Uploaded 2017-01-25 Available
0930-0339_OMB_SS_PartA 1.24.17.docx Supporting Statement A Uploaded 2017-01-25 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
210019 Project Director Interview Form and Instruction Removed
208314 PSH Self-Assessment Form and Instruction Modified
208313 EBP Self-Assessment Part 2 Form and Instruction Modified
208312 EBP Self-Assessment Part 1 Form and Instruction Modified
208311 Cost Interview Form and Instruction Modified
208310 Client Focus Group Form and Instruction Modified
208309 Evaluator Interview Form and Instruction Modified
208308 Stakeholder Interview Form and Instruction Modified
208307 Case Manager, Treatment, Housing Staff/provider Interview Form and Instruction Modified
208306 Opening Session/Project Director Form and Instruction Modified
208305 Project Director - Phone Interview/web Survey Form and Instruction Modified

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2020 36 Months From Approved 05/31/2017
1,971 0 1,942
3,287 0 2,835
0 0 0





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 1,971 1,942 0 29 0 0
Annual Time Burden (Hours) 3,287 2,835 0 -106 558 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No