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View ICR - OIRA Conclusion

OMB Control No: 0990-0458	ICR Reference No: 201902-0990-004
Status: Historical Active	Previous ICR Reference No: 201701-0990-004
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Domestic Violence Housing First Demonstration Evaluation
Type of Information Collection: Revision of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 08/30/2019
	Date Received in OIRA: 05/23/2019
Terms of Clearance: Approved consistent with the understanding that ASPE will continue to engage and coordinate with other Federal stakeholders involved in overlapping areas of domestic violence research and services---in particular HHS/CDC's National Center for Injury Prevention and Control.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2022	36 Months From Approved	08/31/2020
Responses	1,192	0	1,096
Time Burden (Hours)	1,183	0	1,063
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Agency Discretion
Annual Number of Responses	1,192	1,096	96
Annual Time Burden (Hours)	1,183	1,063	120
Annual Cost Burden (Dollars)	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: The Office of the Assistant Secretary for Planning and Evaluation (ASPE) within the U.S. Department of Health and Human Services, in partnership with the Office for Victims of Crimes within the U.S. Department of Justice, is seeking approval by OMB for a revision to add a 24-month follow-up data collection to an existing information collection request entitled, “Domestic Violence Housing First (DVHF) Demonstration Evaluation” (OMB Control Number: HHS-OS-0990-0458). The proposed revision to the collection would add a fourth follow-up data collection to be administered 24 months after study enrollment (Time 1) to examine longer-term impacts of the Domestic Violence Housing First Demonstration program. The follow-up survey is identical to the one used at the 6, 12, and 18 month follow-up. The respondents are domestic violence survivors who are enrolled in the Domestic Violence Housing First Demonstration Evaluation (OMB Control Number HHS-OS-0990-0458). Study enrollment is taking place over 15 months, so the annualized burden for the 24-month follow-up survey is based on 12/15 (256) of the expected sample (320).

Annual Cost to Federal Government: $562,036

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? Uncollected

Agency Contact: Kaitlyn Jones 202 205-4696 kaitlyn.jones@hhs.gov

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