The Community Choice Demonstration

Forms and Documents

Document	Type	Status	Availability
Final - Attachment J.1_The Child Assessment and The Obesity & Type II Diabetes Risk Assessment _Flyer.pdf	Supplementary Document	Uploaded 2023-10-20	Repair queued
30-Day Notice The Community Choice Demonstration.pdf	Supplementary Document	Uploaded 2023-10-19	Missing upstream
Final - Attachment A.1_The Home Assessment_Flyer.pdf	Supplementary Document	Uploaded 2023-10-19	Repair queued
Evaluation of the Community Choice Demonstration 60-Day Notice.pdf	Supplementary Document	Uploaded 2023-10-19	Repair queued
Final - Supporting Statement B.docx	Supporting Statement B	Uploaded 2023-10-19	Repair queued
Final - Supporting Statement A.docx	Supporting Statement A	Uploaded 2023-10-25	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
262928	Tracking Calls	Other-Tracking Calls	New
262927	Tracking Emails/Texts	Other-Tracking Emails/Texts	New
262926	Semi-Structured Interviews	Other-Semi-Structured Interviews	New
262925	Consent for Semi-Structured Interviews	Other-Consent for Semi-Structured Interviews	New
262924	Blood Pressure Reading (adult)	Other-Blood Pressure Reading (adult)	New
262922	Accelerometers (child)	Other-Accelerometers (child)	New
262921	Accelerometers (adult)	Other-Accelerometers (adult)	New
262919	Home Observations/ Housing Assessment	Other-Home Observations/ Housing Assessment	New
262916	Blood Spot Samples (adult)	Other-Blood Spot Samples (adult)	New
262915	Anthropometric assessments (child, but accounting for parent's time)	Other-Anthropometric assessments (child, but accounting for pare	New
262912	Anthropometric assessments (child)	Other-Anthropometric assessments (child)	New
262910	Anthropometric assessments (adult)	Other-Anthropometric assessments (adult)	New
262909	Adult Survey	Other-Adult Survey	New
262906	Consent for Assessment	Other-Consent for Assessment	New
262905	Follow-up Call Phone Script	Other-Follow-up Call Phone Script	New
262904	Email Reminder	Other-Email Reminder	New
262902	Advance Letter	Other-Advance Letter	New
262901	Direct Child Assessment	Other-Direct Child Assessment	New
262900	Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment	Other-Survey about child (asked of parent/guardian) and parent/g	New
262899	Consent for Assessment	Other-Consent for Assessment	New
262898	Survey	Other-Survey	New
262897	Interviewer Observations	Other-Interviewer Observations	New
262892	Direct Measurements	Other-Direct Measurements	New
262891	Consent for Assessment	Other-Consent for Assessment	New
262890	Follow-up Call Phone Script	Other-Follow-up Call Phone Script	New
262889	Email Reminder	Other-Email Reminder	New
262887	Advance Letter	Other-Advance Letter	New
249837	PHASE 2- OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION	Other- Revised - Attachment P Phase 2 Other Adult Household Memb	Removed
249835	PHASE 2- HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION	Other- Revised - Attachment O Phase 2 Head of Household Waitlist	Removed
249834	PHASE 2- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION	Other-Revised - Attachment N Phase 2 HoH Existing Voucher Holder	Removed
249833	COST STUDY DATA COLLECTION OUTREACH	Other-Revised - Attachment M Cost Interview Advance Letter	Removed
249832	Landlord Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration	Other-Revised - Attachment L Landlord Interview Advance Letter	Removed
249829	Mobility Services Provider Interview Outreach Evaluation of the Housing Choice Voucher Mobility Demonstration	Other-Revised - Attachment K Mobility Services Provider Intervie	Removed
249828	Head of Household Family Interview Email Reminder Evaluation of the Housing Choice Voucher Mobility Demonstration	Other-Revised - Attachment J Family Interview Email Reminder	Removed
249827	Head of Household Family Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration	Other-Revised - Attachment I Family Interview Advance Letter	Removed
249826	HEAD OF HOUSEHOLD FAMILY INTERVIEW CONSENT FORM	Other-Revised - Attachment H Head of Household Family Interview	Removed
249825	Mobility Services Tracking Tool Evaluation of the Housing Choice Voucher Mobility Demonstration	Other-Revised - Attachment G Mobility Services Tracking Tool	Removed
249824	PARENT/GUARDIAN PERMISSION FORM	Other-Revised - Attachment E Parent Guardian Permission Form	Removed
249823	OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION	Other-Revised - Attachment D Other Adult Household Member Inform	Removed
249822	HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION	Other-Revised - Attachment C Head of Household Waitlist Family I	Removed
249821	PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION	Other- Revised - Attachment B Head of Household Existing Voucher	Removed
249820	COST DATA COLLECTION INTERVIEW GUIDE	Other-Revised - Instrument 8 Interview Guide for Cost Data Colle	Removed
249819	INTERVIEW GUIDE FOR OPPORTUNITY AREA LANDLORDS	Other- Revised - Instrument 7 Interview Guide for Participating	Removed
249818	INTERVIEW GUIDE FOR PARTICIPATING FAMILIES WHO HAVE LEASED UP	Other-Revised - Instrument 6 Interview Guide for Leased Up Famil	Removed
249817	INTERVIEW GUIDE FOR PARTICIPATING FAMILIES CURRENTLY SEARCHING FOR HOUSING	Other-Revised - Instrument 5 Interview Guide for Searching Famil	Removed
249816	MOBILITY SERVICES PROVIDERS INTERVIEW GUIDE	Other- Revised - Instrument 4 Mobility Services Provider Intervi	Removed
249815	PHA STAFF INTERVIEW GUIDE	Other- Revised - Instrument 3 PHA Staff Interview Guide	Removed
249814	BASELINE SURVEY	Other- Revised - Instrument 2 HCV Mobility Evaluation Baseline S	Removed
249811	HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM	Other- Revised - Instrument 1 Household Roster and Baseline Info	Removed

ICR Details

OMB Control No: 2528-0337	ICR Reference No: 202310-2528-003
Status: Received in OIRA	Previous ICR Reference No: 202209-2528-003
Agency/Subagency: HUD/PD&R	Agency Tracking No:
Title: The Community Choice Demonstration
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 10/25/2023

	Requested	Previously Approved
Expiration Date	36 Months From Approved	06/30/2025
Responses	42,826	101,941
Time Burden (Hours)	279,895	33,687
Cost Burden (Dollars)	0	0

---

Abstract: The Office of Policy Development and Research (PD&R), at the U.S. Department of Housing and Urban Development (HUD), is seeking approval to collect additional information of individuals participating in the Community Choice Demonstration (formerly known as the Housing Choice Voucher Mobility Demonstration) (“Demonstration” for short). The instruments required for the implementation and early phase of the evaluation of the Demonstration were originally approved by the OMB in May and June 2022. Approval was granted under OMB Control #2528-0337 and expires June 30, 2025.

---

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

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 40841	06/22/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 71594	10/17/2023
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 27

IC Title	Form No.	Form Name
Accelerometers (adult)
Accelerometers (child)
Adult Survey
Advance Letter
Advance Letter
Anthropometric assessments (adult)
Anthropometric assessments (child)
Anthropometric assessments (child, but accounting for parent's time)
BASELINE SURVEY
Blood Pressure Reading (adult)
Blood Spot Samples (adult)
COST DATA COLLECTION INTERVIEW GUIDE
COST STUDY DATA COLLECTION OUTREACH
Consent for Assessment
Consent for Assessment
Consent for Assessment
Consent for Semi-Structured Interviews
Direct Child Assessment
Direct Measurements
Email Reminder
Email Reminder
Follow-up Call Phone Script
Follow-up Call Phone Script
HEAD OF HOUSEHOLD FAMILY INTERVIEW CONSENT FORM
HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
HOUSEHOLD ROSTER AND BASELINE INFORMATION FORM
Head of Household Family Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration
Head of Household Family Interview Email Reminder Evaluation of the Housing Choice Voucher Mobility Demonstration
Home Observations/ Housing Assessment
INTERVIEW GUIDE FOR OPPORTUNITY AREA LANDLORDS
INTERVIEW GUIDE FOR PARTICIPATING FAMILIES CURRENTLY SEARCHING FOR HOUSING
INTERVIEW GUIDE FOR PARTICIPATING FAMILIES WHO HAVE LEASED UP
Interviewer Observations
Landlord Interview Advance Letter Evaluation of the Housing Choice Voucher Mobility Demonstration
MOBILITY SERVICES PROVIDERS INTERVIEW GUIDE
Mobility Services Provider Interview Outreach Evaluation of the Housing Choice Voucher Mobility Demonstration
Mobility Services Tracking Tool Evaluation of the Housing Choice Voucher Mobility Demonstration
OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION
PARENT/GUARDIAN PERMISSION FORM
PHA STAFF INTERVIEW GUIDE
PHASE 1- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
PHASE 2- HEAD OF HOUSEHOLD EXISTING VOUCHER FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
PHASE 2- HEAD OF HOUSEHOLD WAITLIST FAMILY INFORMED CONSENT FOR STUDY PARTICIPATION
PHASE 2- OTHER ADULT HOUSEHOLD MEMBER INFORMED CONSENT FOR STUDY PARTICIPATION
Semi-Structured Interviews
Survey
Survey about child (asked of parent/guardian) and parent/guardian's presence during direct Child Assessment
Tracking Calls
Tracking Emails/Texts

---

ICR Summary of Burden

	Total Request	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	42,826	101,941	0	-59,115	0	0
Annual Time Burden (Hours)	279,895	33,687	0	246,208	0	0
Annual Cost Burden (Dollars)	0	0	0	0	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: The Office of Policy Development and Research (PD&R), at the U.S. Department of Housing and Urban Development (HUD), is seeking approval to collect additional information of individuals participating in the Community Choice Demonstration (formerly known as the Housing Choice Voucher Mobility Demonstration) (“Demonstration” for short). The instruments required for the implementation and early phase of the evaluation of the Demonstration were originally approved by the OMB in May and June 2022. Approval was granted under OMB Control #2528-0337 and expires June 30, 2025.

---

Annual Cost to Federal Government: $2,113,333

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? No

---

Common Form ICR:  No

---

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: 10/25/2023

---