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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Discussion Guide_C Discussion Guide_Cost Questionnaire	Form and Instruction	Removed	Available
Form PSH_Self-Assessmen PSH_Self-Assessment	Form and Instruction	Modified	Available
Form Self-Assessment_Pa Self-Assessment_Part_1_and_2	Form and Instruction	Modified	Available
Form Self-Assessment_Pa Self-Assessment_Part_1_and_2	Form and Instruction	Modified	Available
Form SV Guide_Cost Ques SV Guide_Cost Questionnaire	Form and Instruction	Modified	Available
Form SV Guide_Cost Ques SV Guide_Cost Questionnaire	Form and Instruction	Modified	Available
Form SV Guide_Cost Ques SV Guide_Cost Questionnaire	Form and Instruction	Modified	Available
Form SV Guide_Cost Ques SV Guide_Cost Questionnaire	Form and Instruction	Modified	Available
Form SV Guide_Cost Ques SV Guide_Cost Questionnaire	Form and Instruction	Modified	Available
Form SV Guide_Cost Ques SV Guide_Cost Questionnaire	Form and Instruction	Modified	Available
Form PD Interview PD Interview	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 ID	Collection	Type	Status	Form
210019	Project Director Interview	Form and Instruction	Removed	Discussion Guide_Cost Questionnaire
208314	PSH Self-Assessment	Form and Instruction	Modified	PSH_Self-Assessment
208313	EBP Self-Assessment Part 2	Form and Instruction	Modified	Self-Assessment_Part_1_and_2
208312	EBP Self-Assessment Part 1	Form and Instruction	Modified	Self-Assessment_Part_1_and_2
208311	Cost Interview	Form and Instruction	Modified	SV Guide_Cost Questionnaire
208310	Client Focus Group	Form and Instruction	Modified	SV Guide_Cost Questionnaire
208309	Evaluator Interview	Form and Instruction	Modified	SV Guide_Cost Questionnaire
208308	Stakeholder Interview	Form and Instruction	Modified	SV Guide_Cost Questionnaire
208307	Case Manager, Treatment, Housing Staff/provider Interview	Form and Instruction	Modified	SV Guide_Cost Questionnaire
208306	Opening Session/Project Director	Form and Instruction	Modified	SV Guide_Cost Questionnaire
208305	Project Director - Phone Interview/web Survey	Form and Instruction	Modified	PD Interview

ICR Details

OMB Control No: 0930-0339	ICR Reference No: 201701-0930-003
Status: Historical Active	Previous ICR Reference No: 201308-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 20343
Title: Evaluation of Programs to Provide Services to Persons Who Are Homeless with Mental and /or Substance Use Disorders
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 05/17/2017
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/26/2017
Terms of Clearance: Consistent with prior terms of clearance, this collection is not an impact study. It is not a study of causes. The study is an observational, longitudinal study which draws from extant and new data collections, including prior program evaluations, to describe comparative program performance for particular client cohorts.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2020	36 Months From Approved	05/31/2017
Responses	1,971	0	1,942
Time Burden (Hours)	3,287	0	2,835
Cost Burden (Dollars)	0	0	0

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Abstract: The Homeless Programs cross-program evaluation broadly aims to identify commonalities across the Homeless Programs service delivery by examining which service models are delivered, with what outcomes, for which populations, and with what resulting comparative effectiveness and cost effectiveness. To compare programs, the evaluation will identify service models based on service approach (e.g., direct vs. referral), services (type of service and adherence to practice), housing types and models, type of partnerships and factors leading to program sustainability. The resulting models will facilitate interpretation of client and program-level outcomes, comparative effectiveness and cost-effectiveness evaluation.

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Authorizing Statute(s): US Code: 42 USC 506 Name of Law: Grants for the Benefit of Homeless Individuals
  

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:
	81 FR 84601	11/23/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 8197	01/24/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Case Manager, Treatment, Housing Staff/provider Interview	SV Guide_Cost Questionnaire	SV Guide_Cost Questionnaire
Client Focus Group	SV Guide_Cost Questionnaire	SV Guide_Cost Questionnaire
Cost Interview	SV Guide_Cost Questionnaire	SV Guide_Cost Questionnaire
EBP Self-Assessment Part 1	Self-Assessment_Part_1_and_2	Self-Assessment_Part_1_and_2
EBP Self-Assessment Part 2	Self-Assessment_Part_1_and_2	Self-Assessment_Part_1_and_2
Evaluator Interview	SV Guide_Cost Questionnaire	SV Guide_Cost Questionnaire
Opening Session/Project Director	SV Guide_Cost Questionnaire	SV Guide_Cost Questionnaire
PSH Self-Assessment	PSH_Self-Assessment	PSH_Self-Assessment
Project Director - Phone Interview/web Survey	PD Interview	PD Interview
Project Director Interview	Discussion Guide_Cost Questionnaire	Discussion Guide_Cost Questionnaire
Stakeholder Interview	SV Guide_Cost Questionnaire	SV Guide_Cost Questionnaire

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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	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

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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Currently, there are 2,835 burden hours in the OMB inventory. SAMHSA is now requesting 3,286 hours. The program change of an increase of 451 hours is mostly due to an increase in the number of site visits to be conducted annually. In the previous evaluation, 25 site visits were conducted, whereas for the CABHI evaluation, 30 site visits will be conducted. Additionally, for some of the site visit interviews (e.g., the Case Management, Treatment, and Housing Provider Interview), the 9 State sub-recipients will be treated as their own site given that they closely mirror the function of a CABHI Local Government or Community grantee, further increasing the estimated number of respondents for those interviews. These increases in burden are offset by the reduction in the number of respondents for the PD Phone Interview/Web Survey, EBP Self-Assessment, and the PSH Self-Assessment.

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Annual Cost to Federal Government: $1,450,552

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: 01/26/2017

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