SCSEP Older Workers Study Impact Evaluation

Forms and Documents

Document Name	Status
Supporting Statement Part B SCSEP Impact Study Revised 12 4 24_Edited.docx Supporting Statement B	2025-02-07
Supporting Statement Part A SCSEP Impact Study Revised 12 13 25.docx Supporting Statement A	2025-02-07
signed_PRA Signature Form_Older Workers Study Impact Evaluation Package_20240806.pdf Supplementary Document	2024-12-23

IC Document Collections

IC ID	Document Title	Status
273228	INFORMED CONSENT FORM AND BASELINE INFORMATION FORM FOR STUDY PARTICIPANTS Other-INFORMED CONSENT FORM AND BASELINE INFORMATION FORM FOR ST	Modified

ICR Details

OMB Control No:	ICR Reference No: 202502-1290-005
Status: Received in OIRA	Previous ICR Reference No: 202412-1290-001
Agency/Subagency: DOL/OS	Agency Tracking No:
Title: SCSEP Older Workers Study Impact Evaluation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 02/13/2025

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	1,600	0
Time Burden (Hours)	400	0
Cost Burden (Dollars)	0	0

---

Abstract: The Senior Community Service Employment Program (SCSEP), administered by the U.S. Department of Labor, aims to help low-income seniors ages 55 and older obtain private-sector, unsubsidized employment through job training and placement activities. To learn more about SCSEP and to inform continuous improvement of the program, the Older Workers Study, OMB Control Number 1290-0040, was created. This is a new collection request associated with the same study.

---

Authorizing Statute(s): None

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:
	89 FR 79963	10/01/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	90 FR 7190	01/21/2025
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
INFORMED CONSENT FORM AND BASELINE INFORMATION FORM FOR STUDY PARTICIPANTS

---

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	1,600	0	0	1,600	0	0
Annual Time Burden (Hours)	400	0	0	400	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: No

Burden Reduction Due to:

Short Statement: This is a new collection and therefore no on the OMB Inventory.

---

Annual Cost to Federal Government: $553,064

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.     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

---

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: 02/13/2025

---