Information Collection

RHY-HMIS: Transitional Living Program (including Maternity Group Home program and TLP Demonstration Programs; Intake)

IC 245723 under ICR 202102-0970-006 · OMB 0970-0573.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0970-0573 can be found here:

Documents and Forms

Document Name Document Type
Form 1 RHY-HMIS: Transitional Living Program (including Maternity Group Home program and TLP Demonstration Programs; Intake) Form
FY 2020 HMIS-Data-Standards-Manual.pdf Instruction
FY 2020 HMIS-Data-Standards-Manual.pdf Instruction
1 RHY-HMIS Data Elements RHY Program Specific Data Elements OMB V2.pdf Form
1 RHY-HMIS Data Elements RHY Program Specific Data Elements OMB V2.pdf Form

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	RHY-HMIS: Transitional Living Program (including Maternity Group Home program and TLP Demonstration Programs; Intake)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	1	RHY-HMIS Data Elements	RHY Program Specific Data Elements OMB V2.pdf		Yes	Yes	Fillable Fileable
Instruction			FY 2020 HMIS-Data-Standards-Manual.pdf		Yes	Yes	Paper Only

Line of Business: Community and Social Services

Subfunction: Social Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 18,000	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	5,940	5,940
Annual IC Time Burden (Hours)	2,280	2,280
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
No associated records found

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.