Triennial Evaluation of the Projects for Assistance in Transition from Homelessness (PATH)

Forms and Documents

Document Name	Status
Form Consumer Focus Gro Consumer Focus Group Discussion Form and Instruction	New
Form Provider Site Visi Provider Staff-Worker/Case Manager Form and Instruction	New
Form Provider Site Visi Provider Staff Supervisior/Admin. Form and Instruction	New
Form Site Visit Intervi State PATH Contact Form and Instruction	New
FW Comments Triennial Evaluation of the Projects for Assistance in Transition From Homelessness.txt Supplementary Document	2011-09-27
Path-SS-B.doc Supporting Statement B	2011-08-16
Attachment G--Letters of Introduction.doc Supplementary Document	2011-08-19
PATH OMB Statement 12-8-11 FINAL.docx Supporting Statement A	2011-12-08

IC Document Collections

IC ID	Document Title	Status
199306	Consumer Focus Group Discussion Form and Instruction	New
199305	Provider Staff-Worker/Case Manager Form and Instruction	New
199304	Provider Staff Supervisior/Admin. Form and Instruction	New
199303	State PATH Contact Form and Instruction	New

ICR Details

OMB Control No: 0930-0332	ICR Reference No: 201109-0930-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Triennial Evaluation of the Projects for Assistance in Transition from Homelessness (PATH)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 12/11/2011
	Date Received in OIRA: 09/19/2011
Terms of Clearance: During this review, SAMHSA removed its two online surveys from this collection, reducing burden and improving quality. SAMHSA simplified its interview and focus group protocols and eliminated the prospect of group interviews, further reducing burden. SAMHSA amended its research questions to focus on process and administration goals. SAMHSA also justified its incentives and clarified its sampling frame.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2014	36 Months From Approved
Responses	150	0	0
Time Burden (Hours)	205	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The data collection will focus on the perceptions of key PATH stakeholders at the State and local levels related to PATH operations, services, and effectiveness. This knowledge can help further improve PATH program operations.

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Authorizing Statute(s): US Code: 42 USC 528 Name of Law: Requirement of Reporst by States
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 33324	06/08/2011
30-day Notice:	Federal Register Citation:	Citation Date:
	76 FR 51046	08/17/2011
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

IC Title	Form No.	Form Name
State PATH Contact	Site Visit Interview Guide	Site Visit Interview Guide
Provider Staff Supervisior/Admin.	Provider Site Visit Interview Guide	Provider Site Visit Interview Guide
Provider Staff-Worker/Case Manager	Provider Site Visit Interview Guide	Provider Site Visit Interview Guide
Consumer Focus Group Discussion	Consumer Focus Group Discussion Guide	Consumber Focus Group Discussion Guide

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ICR Summary of Burden

	Total Approved	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	150	0	0	150	0	0
Annual Time Burden (Hours)	205	0	0	205	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 data collection.

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Annual Cost to Federal Government: $260,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? 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

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Common Form ICR:  No

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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: 09/19/2011

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