Evaluation of the Family Unification Program

Forms and Documents

Document Name	Status
NonSub Change Request - 0970-0514 (04-03-2020).docx Justification for No Material/Nonsubstantive Change	2020-04-03
Attachment 8 - FUP logic Model 062018.docx Supplementary Document	2018-07-06
Attachment 7 - FUP Evaluation Information Sheet _062718_rev.docx Supplementary Document	2018-07-06
Attachment 6 -Outreach Phone Call Script for Parents_062718_clean.docx Supplementary Document	2018-07-06
Attachment 5 - Outreach Email_Template_Clean.docx Supplementary Document	2020-04-03
Attachment 4-Informed Consent for Staff 6-27-18.docx Supplementary Document	2018-07-06
Attachment 3-Informed Consent for Parents 06-27-2018.docx Supplementary Document	2018-07-06
Attachment 2 - 60 day notice.pdf Supplementary Document	2018-07-06
Attachment 1-Informed Consent Form_06-27-18.docx Supplementary Document	2018-07-06
FUP Part B Support Statement_062718_clean.docx Supporting Statement B	2018-07-06
FUP Part A Support Statement_082718 Clean.docx Supporting Statement A	2018-09-11

IC Document Collections

IC ID	Document Title	Status
232070	Appendix U: Administrative Data List Other-Admin Data List	Unchanged
232069	Appendix T: Dashboard Other-Dashboard	Unchanged
232060	Appendix S: Ongoing Services Questionnaire Other-Questionnaire	Unchanged
232059	Appendix R: Housing Assistance Questionnaire Other-Questionnaire	Unchanged
232058	Appendix Q: Randomization Tool Other-Randomization Tool	Unchanged
232057	Appendix P: Referral Form Other-Referral Form	Modified
232056	Appendix O: Housing Status Form Other-Housing Status Form	Modified
232055	Appendix N: Guide for Implementation Study for Service Provider Management Other-Implementation Study Guide	Unchanged
232054	Appendix M: Guide for Implementation Study for PCWA FUP Management (Third) Other-Implementation Study Guide	Unchanged
232053	Appendix L: Guide for Implementation Study Focus Groups with Frontline Workers Other-Focus Group Guide	Unchanged
232052	Appendix K: Guide for Implementation Study for Parents (Second, Third) Other-Implementation Study Guide	Unchanged
232051	Appendix J: Guide for Implementation Study Focus Groups with PHA Frontline Workers Other-Focus Group Guide	Unchanged
232050	Appendix I: Guide for Implementation Study for PHA FUP Management Other-Implementation Study Guide	Unchanged
232049	Appendix H: Guide for Implementation Study with PCWA FUP Management (Second) Other-Implementation Study Guide	Unchanged
232048	Appendix G: Guide for Implementation Study for Referral Provider Administrators Other-Implementation Study Guide	Unchanged
232047	Appendix F: Guide for Implementation Study for CoC Management Other-Implementation Study Guide	Unchanged
232046	Appendix E: Guide for Implementation Study for PHA Management Other-Implementation Study Guide	Unchanged
232045	Appendix D: Guide for Implementation Study for PCWA Management Other-Implementation Study Guide	Unchanged
232044	Appendix C: Guide to Develop an Evaluation Plan for PHA FUP Management Other-Eval Plan Guide	Unchanged
232043	Appendix B: Guide to Develop an Evaluation Plan for PCWA FUP Management Other-Eval Plan Guide	Unchanged
232042	Appendix A: Guide for Recruitment with PHA and PCWA Administrators Other-Recruitment Guide	Unchanged

ICR Details

OMB Control No: 0970-0514	ICR Reference No: 202004-0970-003
Status: Historical Active	Previous ICR Reference No: 201807-0970-006
Agency/Subagency: HHS/ACF	Agency Tracking No: OPRE
Title: Evaluation of the Family Unification Program
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 04/06/2020
	Date Received in OIRA: 04/06/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2021	09/30/2021	09/30/2021
Responses	8,073	0	8,073
Time Burden (Hours)	849	0	849
Cost Burden (Dollars)	0	0	0

---

Abstract: The Evaluation of the Family Unification Program study was approved on September 18, 2018. Since approval, we recruited four sites to participate in the study, which is less than our goal of 6-10 sites. We now have the opportunity to recruit additional sites. With our four current sites, we have completed the recruitment interviews with staff, the first site visit (to set up the evaluation) and have collected housing status forms, referral forms and dashboards from each of the sites. Through these activities, we received feedback that the sites wanted the referral form to be simplified and shortened. This nonsubstantive change request is to make some updates to the Referral Form (Appendix P) and the Housing Status Form (Appendix O) based on feedback. Additionally, many of the sites are currently dealing with issues that have to do with the COVID-19 pandemic. As a result, an outreach letter has been updated to acknowledge that they may be dealing with additional challenges related to the COVID-19 pandemic.

---

Authorizing Statute(s): US Code: 42 USC 626 Name of Law: Title IV-E of the Social Security Act
  

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:
	83 FR 381	01/03/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 32128	07/11/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 21

IC Title	Form No.	Form Name
Appendix I: Guide for Implementation Study for PHA FUP Management
Appendix J: Guide for Implementation Study Focus Groups with PHA Frontline Workers
Appendix L: Guide for Implementation Study Focus Groups with Frontline Workers
Appendix Q: Randomization Tool
Appendix T: Dashboard
Appendix U: Administrative Data List
Appendix D: Guide for Implementation Study for PCWA Management
Appendix E: Guide for Implementation Study for PHA Management
Appendix G: Guide for Implementation Study for Referral Provider Administrators
Appendix F: Guide for Implementation Study for CoC Management
Appendix C: Guide to Develop an Evaluation Plan for PHA FUP Management
Appendix N: Guide for Implementation Study for Service Provider Management
Appendix P: Referral Form
Appendix R: Housing Assistance Questionnaire
Appendix A: Guide for Recruitment with PHA and PCWA Administrators
Appendix H: Guide for Implementation Study with PCWA FUP Management (Second)
Appendix B: Guide to Develop an Evaluation Plan for PCWA FUP Management
Appendix K: Guide for Implementation Study for Parents (Second, Third)
Appendix M: Guide for Implementation Study for PCWA FUP Management (Third)
Appendix O: Housing Status Form
Appendix S: Ongoing Services Questionnaire

---

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	8,073	8,073	0	0	0	0
Annual Time Burden (Hours)	849	849	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	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: This is a new information collection request.

---

Annual Cost to Federal Government: $450,346

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.     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? Yes

---

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: 04/06/2020

---