Supported Employment Demonstration (SED) Project

Forms and Documents

Document	Type	Status	Availability
Non-Substantive Change request 0806.doc	Justification for No Material/Nonsubstantive Change	Uploaded 2018-05-10	Available

IC Document Collections

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

ICR Details

OMB Control No: 0960-0806	ICR Reference No: 201805-0960-004
Status: Historical Active	Previous ICR Reference No: 201703-0960-007
Agency/Subagency: SSA	Agency Tracking No:
Title: Supported Employment Demonstration (SED) Project
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/28/2018
	Date Received in OIRA: 05/10/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2020	07/31/2020	07/31/2020
Responses	43,580	0	45,480
Time Burden (Hours)	20,605	0	21,230
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. This is a non-substantive Change Request to remove some questions from the CIDI Screener and to administer the CIDI Screener test to fewer respondents.

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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

IC Title	Form No.	Form Name
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
Quarterly Interview (Quarters 1, 2, 3, 5, 6, 7, 9, 10, and 11)
Competency and CIDI Screener
Baseline Interview

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ICR Summary 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	43,580	45,480	0	0	-1,900	0
Annual Time Burden (Hours)	20,605	21,230	0	0	-625	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: There is a decrease in burden hours, the burden stems from removing questions from the CIDI Screener test, and administrating it to fewer respondents.

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

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

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: 05/10/2018

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