Information Collection Request

National Family Caregiver Support Program (NFCSP) Outcome Evaluation

ICR 201705-0985-002 · OMB 0985-0052 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 1 Comparison group care recipients - 12 month followup Form and Instruction Unchanged Available
Form 1 Comparison group of care recipients - Baseline Form and Instruction Unchanged Available
Form 1 Comparison group non-NFCSP family caregivers - 12 month followup Form and Instruction Unchanged Available
Form 1 Comparison group non-NFCSP family caregivers - 6 month followup Form and Instruction Unchanged Available
Form 1 Comparison Group non-NFCSP family caregivers - Baseline Form and Instruction Unchanged Available
Form 1 National Family Caregiver Support Program (NFCSP) Outcome Evaluation Form and Instruction Unchanged Available
Form 1 Care Recipients of NFCSP Clients Form and Instruction Unchanged Available
Form 1 National Family Caregiver Support Program Outcome Evaluation - 12 month followup Form and Instruction Unchanged Available
Form 1 National Family Caregiver Support Program (NFCSP) Outcome Evaluation 6 month follow up Form and Instruction Unchanged Available
Form 1 National Family Caregiver Support Program Outcome Evaluation (Baseline) Form and Instruction Unchanged Available
Nonsubstantive Modifications to NFCSP Data Tool_18may2017.docx Justification for No Material/Nonsubstantive Change Uploaded 2017-05-19 Available
HHS Information Technology Security Program PIA Guide_v1-caregiver outcome evaluation-CLEAN 3-2-16.docx Supplementary Document Uploaded 2016-03-08 Available
ACL_CaregiverOutcomeEvaluation_OMB_PRA_SectionB_August_31_2015.docx Supporting Statement B Uploaded 2015-10-06 Available
CaregiverOutcomeEvaluation_PRA_SectionA_Passback_CLEAN 3-2-16 v2.docx Supporting Statement A Uploaded 2016-03-08 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
218730 Comparison group care recipients - 12 month followup Form and Instruction Unchanged
218729 Comparison group of care recipients - Baseline Form and Instruction Unchanged
218728 Comparison group non-NFCSP family caregivers - 12 month followup Form and Instruction Unchanged
218727 Comparison group non-NFCSP family caregivers - 6 month followup Form and Instruction Unchanged
218516 Comparison Group non-NFCSP family caregivers - Baseline Form and Instruction Unchanged
218515 National Family Caregiver Support Program (NFCSP) Outcome Evaluation Form and Instruction Unchanged
218514 Care Recipients of NFCSP Clients Form and Instruction Unchanged
218512 National Family Caregiver Support Program Outcome Evaluation - 12 month followup Form and Instruction Unchanged
218509 National Family Caregiver Support Program (NFCSP) Outcome Evaluation 6 month follow up Form and Instruction Unchanged
218477 National Family Caregiver Support Program Outcome Evaluation (Baseline) Form and Instruction Unchanged

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
03/31/2019 03/31/2019 03/31/2019
12,500 0 12,500
5,514 0 5,514
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 12,500 12,500 0 0 0 0
Annual Time Burden (Hours) 5,514 5,514 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No