View Information Collection Request (ICR) Package

Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.

View ICR - OIRA Conclusion

OMB Control No: 0970-0461	ICR Reference No: 202005-0970-010
Status: Historical Active	Previous ICR Reference No: 201901-0970-009
Agency/Subagency: HHS/ACF	Agency Tracking No: OHSEPR
Title: Immediate Disaster Case Management Intake Assessment
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR: No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/14/2020
	Date Received in OIRA: 05/27/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2023	36 Months From Approved	07/31/2020
Responses	11,163	0	630,000
Time Burden (Hours)	11,163	0	630,000
Cost Burden (Dollars)	0	0	0

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to Adjustment in Estimate
Annual Number of Responses	11,163	630,000	-618,837
Annual Time Burden (Hours)	11,163	630,000	-618,837
Annual Cost Burden (Dollars)	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: The estimated number of respondents has been updated based on the previous three years of experience. The result is a reduced number of estimated respondents, and therefore overall burden has decreased. There is one modification to the proposed use of resulting aggregate data, to include a use of the data to develop a Quality Assurance/Performance Improvement process.

Annual Cost to Federal Government: $981,227

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. No

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

Agency Contact: Molly Buck 202 205-4724 mary.buck@acf.hhs.gov

Something went wrong when downloading this file. If you have any questions, please send an email to risc@gsa.gov.