Supported Employment Demonstration (SED) Project

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SED Supporting Statement - Part B (clean version) 07-28-2017.docx	Supporting Statement B	Uploaded 2017-07-31	Available
SED Supporting Statement - Part A (clean version) 07-28-2017.docx	Supporting Statement A	Uploaded 2017-07-31	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226133	Person-Centered Interview	Other-Person Centered Interview	New
226132	Participant Focus Groups	Other-Participant Focus Group Questions	New
226131	Key Informant Interview	Other-Key Informant Interview	New
226130	Fidelity Assessment Family Member Interview	Other-Fidelity Assessement Family Member Interview	New
226129	Fidelity Assessment Participant Interview	Other-Fidelity Assessment Interview	New
226128	Annual Interview (Quarters 4, 8, and 11)	Other-Annual Interview Questions	New
226127	Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 9, 10, and 11)	Other-Quarterly Interview Questions	New
226126	Baseline Interview	Other-Baseline Interview Questions	New
226125	Competency and CIDI Screener	Other-CIDI Screener	New

ICR Details

OMB Control No: 0960-0806	ICR Reference No: 201703-0960-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: SSA	Agency Tracking No:
Title: Supported Employment Demonstration (SED) Project
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: 07/31/2017
	Date Received in OIRA: 05/12/2017
Terms of Clearance: This collection is approved based on the revised materials provided by SSA.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	36 Months From Approved
Responses	45,480	0	0
Time Burden (Hours)	21,230	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The SED will offer these same services to individuals with mental illness for whom SSA denied Social Security disability benefits. SSA seeks to determine whether offering this evidence-based package of integrated vocational and mental health services to denied disability applicants fosters employment that leads to self-sufficiency; improved mental health and quality of life; and reduced demand for disability benefits. This study will test the two treatment conditions against each other and against the control group on multiple outcomes of policy interest to SSA. The key outcomes of interest include: (1) employment; (2) earnings; (3) income; (4) mental status; (5) quality of life; (6) health services utilization; and (7) SSA disability benefit receipt and amount. SSA is also interested in the study take up rate (participation); knowing who enrolls (and who does not); and fidelity to evidence-based treatments; among other aspects of implementation. Data collection for the evaluation of the SED will consist of the following activities: baseline in-person participant interviews; quarterly participant telephone interviews; receipt of SSA administrative record data; and collection of site-level program data. Evaluation team members will also conduct site visits involving: (1) pre-visit environmental scans to understand the local context in which we embed SED services; (2) independent fidelity assessments in conjunction with those carried out by state Mental Health or Vocational Rehabilitation staff; (3) key informant interviews with the IPS specialist, the nurse care coordinator, the case manager, and facility director; (4) focus groups with participants in the Full Service and Basic-Service Treatment groups; and (5) ethnographic data collection consisting of observations in the natural environment, and person centered interviews with participants and non-participants. The respondents are study participants and non-participants; family members; IPS specialists; nurse care coordinators; case managers; and facility directors.

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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:
	82 FR 10623	02/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 18335	04/18/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 9

table that charts list of burden

IC Title	Form No.	Form Name
Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 9, 10, and 11)
Competency and CIDI Screener
Baseline Interview
Fidelity Assessment Participant Interview
Fidelity Assessment Family Member Interview
Key Informant Interview
Person-Centered Interview
Annual Interview (Quarters 4, 8, and 11)
Participant Focus Groups

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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	45,480	0	0	45,480	0	0
Annual Time Burden (Hours)	21,230	0	0	21,230	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: This is a new demonstration project that increases the public reporting burden. See chart above for burden figures.

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Annual Cost to Federal Government: $63,918,323

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 05/12/2017

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