Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
POD Baseline Survey New 16500 5500 0 Form and Instruction N/A
POD End of Year (EOYR) Form - Online New 405 68 0 Form and Instruction N/A
POD End of Year Reporting (EOYR) From - Paper New 945 236 0 Form and Instruction N/A
POD Informed Consent Form New 16500 2750 0 Form POD Informed Consent Form
Other-Letter to Recruited Respondents
Other-Informational Brochure
POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Online New 9360 780 0 Form N/A
POD Monthly Earnings and Impairment-Related Work Expenses (IRWE) Reporting Form - Paper New 21840 3640 0 Form and Instruction N/A
POD Onsite Audit of Sample of Case Files in MIS New 16 5 0 Other-Interview Topics and Assessment of Implementation Fidelity
POD Semi-Structured Interviews with Treatment Group Subjects New 144 144 0 Other-Interview Topics
POD Staff Interviews with Site Staff New 160 176 0 Other-Interview Topics and Explanation
POD Year 1 Follow-up Survey New 6000 2800 0 Other-Follow-up Surveys
Other-Follow-up Survey Letters
POD Year 2 Follow-up Surveys New 12000 4600 0 Other-Follow-up Surveys
Other-Follow-up Survey Letters
Total burden requested under this ICR: 83870 20699 0  
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