Domestic Victims of Human Trafficking Program Data

Forms and Documents

Document Name	Status
Form 9 Victim Outreach Form Form	New
Form 8 Training Form Form	New
Form 7 Partnership Development Exit Form Form	New
Form 6 Partnership Development Enrollment Form Form	New
Form 5 DVHT Spending Form Form	New
Form 4 Barriers to Service Delivery and Monitoring Form Form	New
Form 3 Client Case Closure Form Form	New
Form 2 Client Service Use and Delivery Form Form	New
Form 1 Client Characteristics and Enrollment Form Form	New
OTIP-0564 - DVHT New - Overview of Response to Public.docx Supplementary Document	2020-01-23
DVHT Grantee Reporting Reference Guide_1.21.20.docx Supplementary Document	2020-01-23
Attachment A - OTIP-0564 - DVHT New - Legislative Authority.docx Supplementary Document	2020-01-23
OTIP-0564 - DVHT New - Supporting Statement_1.22.20.docx Supporting Statement A	2020-01-23

IC Document Collections

IC ID	Document Title	Status
239409	Victim Outreach Form Form	New
239408	Training Form Form	New
239407	Partnership Development Exit Form Form	New
239406	Partnership Development Enrollment Form Form	New
239405	DVHT Spending Form Form	New
239404	Barriers to Service Delivery and Monitoring Form Form	New
239402	Client Case Closure Form Form	New
239401	Client Service Use and Delivery Form Form	New
239400	Client Characteristics and Enrollment Form Form	New

ICR Details

OMB Control No: 0970-0542	ICR Reference No: 202001-0970-006
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/ACF	Agency Tracking No: OTIP
Title: Domestic Victims of Human Trafficking Program Data
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 without change	Conclusion Date: 03/17/2020
	Date Received in OIRA: 01/27/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2023	36 Months From Approved
Responses	3,772	0	0
Time Burden (Hours)	1,423	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: This information collection is related to and funded by Domestic Victims of Human Trafficking Program, is authorized by Trafficking Victims Protection Act of 2000 (22 U.S.C. 7105(b)(1)(B)), as amended, and is being conducted by the Administration for Children and Families' Office on Trafficking in Persons (OTIP). This is a new collection. The Domestic Victims of Human Trafficking (DVHT) Program funds grantees to provide comprehensive case management to U.S. citizens and lawful permanent residents who have experienced human trafficking. The DVHT Program will include: (1) the Domestic Victims of Human Trafficking Services and Outreach Program, (2) Demonstration Grants to Strengthen the Response to Victims of Human Trafficking in Native Communities Program, and (3) the Strengthen the Health Care Response for Victims of Human Trafficking Program. OTIP seeks to implement the proposed information collection to measure grantee progress and performance, improve program evaluation, inform policy, assess program outcomes, and build a response to human trafficking that is responsive to the needs of victims. ACF proposes to collect information on a quarterly and annual basis. The information collection captures information on participant demographics (e.g., age, sex, and country of origin), types of trafficking experienced (e.g., sex, labor, or both), types of enrollment, types of services requested and provided along with their cost, barriers to service delivery, subrecipients enrolled into the grantee’s network, victim outreach activities, and the types of training provided to subrecipient organizations or other partners.

---

Authorizing Statute(s): US Code: 22 USC 7105 Name of Law: Trafficking Victims Protection 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:
	84 FR 2873	02/08/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 4667	01/27/2020
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 9

IC Title	Form No.	Form Name
Client Characteristics and Enrollment Form	1	Client Characteristics and Enrollment Form
Client Service Use and Delivery Form	2	Client Service Use and Delivery Form
Client Case Closure Form	3	Client Case Closure Form
Barriers to Service Delivery and Monitoring Form	4	Barriers to Service Delivery and Monitoring Form
DVHT Spending Form	5	DVHT Spending Form
Partnership Development Enrollment Form	6	Partnership Development Enrollment Form
Partnership Development Exit Form	7	Partnership Development Exit Form
Training Form	8	Training Form
Victim Outreach Form	9	Victim Outreach Form

---

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	3,772	0	0	3,772	0	0
Annual Time Burden (Hours)	1,423	0	0	1,423	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 information collection.

---

Annual Cost to Federal Government: $7,436

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? Uncollected

---

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: 01/27/2020

---