Domestic Violence Housing First Demonstration Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
0990_Section B Supporting Statement DVHF 11.15.16 clean.docx	Supporting Statement B	Uploaded 2017-08-14	Available
0990_Supporting Statement A- DVHF _OMB 8.9.17 CLEAN.docx	Supporting Statement A	Uploaded 2017-08-14	Available
30-day Federal Register, Volume 82 Issue 45 (Thursday, March 9, 2017).htm	Supplementary Document	Uploaded 2017-03-10	Repair queued
60-day Federal Register, Volume 81 Issue 235 (Wednesday, December 7, 2016).htm	Supplementary Document	Uploaded 2017-03-10	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226035	Form for community agency points of contact to verify agency information (monthly)	Other-listed	New
226034	Online survey of advocates' work	Other-form	New
226033	Online survey about advocates' work history and demographics	Other-survey	New
226032	Follow-up Interviews	Other-form	New
226031	Time 1 (Baseline) Interview	Other-INTERVIEW	New

ICR Details

OMB Control No: 0990-0458	ICR Reference No: 201701-0990-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Domestic Violence Housing First Demonstration 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 with change	Conclusion Date: 08/16/2017
	Date Received in OIRA: 03/13/2017
Terms of Clearance: Approved consistent with the understanding that ASPE will continue to engage and coordinate with other Federal stakeholders involved in overlapping areas of domestic violence research and services---in particular HHS/CDC's National Center for Injury Prevention and Control.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2020	36 Months From Approved
Responses	1,096	0	0
Time Burden (Hours)	1,063	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services, in partnership with the Office for Victims of Crimes within the U.S. Department of Justice, is seeking approval by OMB for a new information collection request entitled, ``Domestic Violence Housing First (DVHF) Demonstration Evaluation.'' The Washington State Coalition Against Domestic Violence (WSCADV) is overseeing and coordinating an evaluation of the DVHF Demonstration project through a contract with ASPE. This quasi-experimental research study involves longitudinally examining the program effects of DVHF on domestic violence survivors' safety and housing stability. The findings will be of interest to the general public, to policy-makers, and to organizations working with domestic violence survivors.

---

Authorizing Statute(s): US Code: 42 USC 10603(c)(4) Name of Law: Crime Victim Assistance
   US Code: 28 USC 530C Name of Law: Authority to use available funds
   US Code: 42 USC 10603(c)(1)(A) Name of Law: Crime Victim Assistance
  

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:
	81 FR 88247	12/07/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 13125	03/09/2017
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 5

table that charts list of burden

IC Title	Form No.	Form Name
Follow-up Interviews
Form for community agency points of contact to verify agency information (monthly)
Time 1 (Baseline) Interview
Online survey about advocates' work history and demographics
Online survey of advocates' work

---

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	1,096	0	0	1,096	0	0
Annual Time Burden (Hours)	1,063	0	0	1,063	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: New Collection

---

Annual Cost to Federal Government: $562,036

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: 03/13/2017

---