Domestic Victims of Human Trafficking Program Data

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 9 Victim Outreach Form	Form	Unchanged	Available
Form 9 Victim Outreach Form	Form	Unchanged	Repair queued
Form 8 Training Form	Form	Unchanged	Available
Form 8 Training Form	Form	Unchanged	Repair queued
Form 7 Partnership Development Exit Form	Form	Unchanged	Available
Form 7 Partnership Development Exit Form	Form	Unchanged	Repair queued
Form 6 Partnership Development Enrollment Form	Form	Unchanged	Available
Form 6 Partnership Development Enrollment Form	Form	Unchanged	Repair queued
Form 5 DVHT Spending Form	Form	Unchanged	Available
Form 5 DVHT Spending Form	Form	Unchanged	Repair queued
Form 4 Barriers to Service Delivery and Monitoring Form	Form	Unchanged	Available
Form 4 Barriers to Service Delivery and Monitoring Form	Form	Unchanged	Repair queued
Form 3 Client Case Closure Form	Form	Unchanged	Available
Form 3 Client Case Closure Form	Form	Unchanged	Repair queued
Form 2 Client Service Use and Delivery Form	Form	Unchanged	Available
Form 2 Client Service Use and Delivery Form	Form	Unchanged	Repair queued
Form 1 Client Characteristics and Enrollment Form	Form	Modified	Available
Form 1 Client Characteristics and Enrollment Form	Form	Modified	Repair queued
NonSub Change Request_DVHT (0970-0542)_8.12.21.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-08-13	Repair queued
OTIP-0564 - DVHT New - Overview of Response to Public.docx	Supplementary Document	Uploaded 2020-01-23	Repair queued
FY21 DVHT Grantee Reporting Reference Guide_Clean.docx	Supplementary Document	Uploaded 2021-08-13	Repair queued
Attachment A - OTIP-0564 - DVHT New - Legislative Authority.docx	Supplementary Document	Uploaded 2020-01-23	Repair queued
OTIP-0564 - DVHT New - Supporting Statement_1.22.20.docx	Supporting Statement A	Uploaded 2020-01-23	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
239409	Victim Outreach Form	Form	Unchanged	Victim Outreach Form
239409	Victim Outreach Form	Form	Unchanged
239408	Training Form	Form	Unchanged	Training Form
239408	Training Form	Form	Unchanged
239407	Partnership Development Exit Form	Form	Unchanged	Partnership Development Exit Form
239407	Partnership Development Exit Form	Form	Unchanged
239406	Partnership Development Enrollment Form	Form	Unchanged	Partnership Development Enrollment Form
239406	Partnership Development Enrollment Form	Form	Unchanged
239405	DVHT Spending Form	Form	Unchanged	DVHT Spending Form
239405	DVHT Spending Form	Form	Unchanged
239404	Barriers to Service Delivery and Monitoring Form	Form	Unchanged	Barriers to Service Delivery and Monitoring Form
239404	Barriers to Service Delivery and Monitoring Form	Form	Unchanged
239402	Client Case Closure Form	Form	Unchanged	Client Case Closure Form
239402	Client Case Closure Form	Form	Unchanged
239401	Client Service Use and Delivery Form	Form	Unchanged	Client Service Use and Delivery Form
239401	Client Service Use and Delivery Form	Form	Unchanged
239400	Client Characteristics and Enrollment Form	Form	Modified	Client Characteristics and Enrollment Form
239400	Client Characteristics and Enrollment Form	Form	Modified

ICR Details

OMB Control No: 0970-0542	ICR Reference No: 202108-0970-011
Status: Historical Active	Previous ICR Reference No: 202001-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No: OTIP
Title: Domestic Victims of Human Trafficking Program Data
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 with change	Conclusion Date: 09/21/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/16/2021
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	03/31/2023	03/31/2023
Responses	3,772	0	3,772
Time Burden (Hours)	1,423	0	1,423
Cost Burden (Dollars)	0	0	0

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Abstract: This information collection is related to and funded by Domestic Victims of Human Trafficking Program, is authorized by Trafficking Victims Protection Act of 2000 (22 U.S.C. 7105(b)(1)(B)), as amended, and is being conducted by the Administration for Children and Families' Office on Trafficking in Persons (OTIP). The Domestic Victims of Human Trafficking (DVHT) Program funds grantees to provide comprehensive case management to U.S. citizens and lawful permanent residents who have experienced human trafficking. The DVHT Program will include: (1) the Domestic Victims of Human Trafficking Services and Outreach Program, (2) Demonstration Grants to Strengthen the Response to Victims of Human Trafficking in Native Communities Program, and (3) the Strengthen the Health Care Response for Victims of Human Trafficking Program. DVHT Program grantees are expected to effectively serve all victims of all forms of trafficking in a person-centered, culturally appropriate, and trauma-informed manner, including individuals belonging to groups that have been historically underserved, marginalized, or subject to discrimination or systemic disadvantage, in order to increase identification of and support for individuals from these groups. As such, we are seeking to make nonsubstantive changes to our existing Domestic Victims of Human Trafficking Program Data (OMB #0970-0564) collection, particularly data elements related to Sexual Orientation and Gender Identity (SOGI) Survey Measures to better support equity for individuals belonging to groups referenced in Executive Order 13985.

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Authorizing Statute(s): US Code: 22 USC 7105 Name of Law: Trafficking Victims Protection Act
  

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:
	84 FR 2873	02/08/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 4667	01/27/2020
Did the Agency receive public comments on this ICR? Yes

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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
Barriers to Service Delivery and Monitoring Form	4	Barriers to Service Delivery and Monitoring Form
Client Case Closure Form	3	Client Case Closure Form
Client Characteristics and Enrollment Form	1	Client Characteristics and Enrollment Form
Client Service Use and Delivery Form	2	Client Service Use and Delivery Form
DVHT Spending Form	5	DVHT Spending Form
Partnership Development Enrollment Form	6	Partnership Development Enrollment Form
Partnership Development Exit Form	7	Partnership Development Exit Form
Training Form	8	Training Form
Victim Outreach Form	9	Victim Outreach Form

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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	3,772	3,772	0	0	0	0
Annual Time Burden (Hours)	1,423	1,423	0	0	0	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:

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Annual Cost to Federal Government: $7,436

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.     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? No

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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: 08/16/2021

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