Family Self-Sufficiency Program Evaluation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form XX-XXXX 36 Month Follow-up Survey	Form	Removed	Available
Form Baseline Informati XX-XXXX	Form	Removed	Available
Form XX-XXXX Baseline Information Form-Head of Household	Form	Removed	Available
Form XX-XXXX Informed Consent	Form	Removed	Source copy available
PCLIA FSS (rcg 10.20.17).pdf	Supplementary Document	Uploaded 2017-11-27	Available
PTA_FSS Evaluation_Impact Analysis (v.3).pdf	Supplementary Document	Uploaded 2017-11-27	Available
11-15-17 final - X_FSS National Evaluation - OMB Supporting Statement B.docx	Supporting Statement B	Uploaded 2017-11-27	Available
X_FSS National Evaluation - OMB Supporting Statement A - final 03-02-2018.docx	Supporting Statement A	Uploaded 2018-03-06	Available
60-Day Notice.pdf	Supplementary Document	Uploaded 2017-07-26	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
229144	FSS PHA Staff Interviews Pre-Interview	Other-FSS PHA Staff Interviews Pre-Interview	New
229142	PHA Staff Interviews (telephone)	Other-PHA Staff Interviews (telephone)	New
229141	PHA Staff Interviews (on-site)	Other-PHA Staff Interviews On Site Case Managers	New
229140	Study Participant Interviews	Other-Study Participant Interviews	New
205698	FSS Evaluation	Form	Removed	36 Month Follow-up Survey
205698	FSS Evaluation	Form	Removed	XX-XXXX
205698	FSS Evaluation	Form	Removed	Baseline Information Form-Head of Household
205698	FSS Evaluation	Form	Removed	Informed Consent
205698	FSS Evaluation	Other-Draft mini-survey questionnaire	Removed

ICR Details

OMB Control No: 2528-0296	ICR Reference No: 201707-2528-005
Status: Historical Active	Previous ICR Reference No: 201607-2528-002
Agency/Subagency: HUD/PD&R	Agency Tracking No:
Title: Family Self-Sufficiency Program Evaluation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/06/2018
Retrieve Notice of Action (NOA)	Date Received in OIRA: 12/11/2017
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2021	36 Months From Approved	10/31/2019
Responses	144	0	2,551
Time Burden (Hours)	199	0	1,913
Cost Burden (Dollars)	2,612	0	0

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Abstract: The primary goal of the project is to increase our knowledge about the efficacy of FSS, which is aimed at helping Housing Choice Voucher holders (HCV) secure and maintain employment and gain independence from public support programs. The linkage of housing assistance to economic opportunities has long been an important component of US housing policy. For many years, policymakers and analysts have argued that low-income, working-age people who receive a rent subsidy from the government should strive for some degree of economic self-sufficiency, and that housing subsidy systems should play a more active role in supporting these efforts, such as through the Family Self-Sufficiency (FSS) program. However, housing assistance, and the FSS program itself, have had an unclear, uncertain impact upon economic opportunities for subsidized tenants.

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Authorizing Statute(s): US Code: 12 USC 1701z-1 Name of Law: Research and Demonstrations
  

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 32571	07/14/2017
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 58012	12/08/2017
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
FSS Evaluation	Baseline Information Form Adult, XX-XXXX, XX-XXXX, XX-XXXX	Informed Consent ,   Baseline Information Form-Head of Household ,   XX-XXXX ,   36 Month Follow-up Survey
FSS PHA Staff Interviews Pre-Interview
PHA Staff Interviews (on-site)
PHA Staff Interviews (telephone)
Study Participant Interviews

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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	144	2,551	0	-2,407	0	0
Annual Time Burden (Hours)	199	1,913	0	-1,714	0	0
Annual Cost Burden (Dollars)	2,612	0	0	2,612	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: This submission is a revision request for approval. This is the final round of data collection for the study which reflects an update to burden hours.

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Annual Cost to Federal Government: $49,452

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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: 12/11/2017

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