Information Collection Request

FEMA-Administered Disaster Case Management (DCM)

ICR 202602-1660-001 · OMB 1660-0152 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form FEMA Form FF-104-F FEMA-Administered DCM Concent Form Form Modified Repair queued
Form FEMA Form FF-104-F FEMA-Administered DCM Intake Form Form Modified Repair queued
SORN, DHS-FEMA-016 Disaster Case Management (DCM) Files (87 FR 1171).pdf Supplementary Document Uploaded 2026-02-13 Repair queued
privacy-pia-fema056-adcmp-june2022.pdf Supplementary Document Uploaded 2026-02-13 Repair queued
1660-0152 Public Comment FEMA-2025-0047-0002.pdf Public Comments Uploaded 2025-10-01 Repair queued
PTA, FEMA - FEMA-Administered Disaster Case Management Consent Form, 20230427, PRIV Final.pdf Supplementary Document Uploaded 2026-02-06 Repair queued
PTA, FEMA - FEMA-Administered Disaster Case Management Intake Form, 20230501, PRIV Final.pdf Supplementary Document Uploaded 2026-02-06 Repair queued
1660-0152 - Published 30-Day Reinstatement FRN - 2026 02 11.pdf Supplementary Document Uploaded 2026-02-11 Repair queued
1660-0152 - Published 60-Day Reinstatement FRN - 2025 08 01.pdf Supplementary Document Uploaded 2026-02-06 Repair queued
USCODE-2019-title42-chap68-subchapIV-sec5189d.pdf Supplementary Document Uploaded 2021-11-09 Repair queued
1660-0152 - Supporting Statement A - 2026 02 11 clean.docx Supporting Statement A Uploaded 2026-02-11 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
250278 FEMA-Administered DCM Consent Form Form ModifiedFEMA-Administered DCM Concent Form
250278 FEMA-Administered DCM Consent Form Form Modified
250277 FEMA-Administered DCM Intake Form Form ModifiedFEMA-Administered DCM Intake Form
250277 FEMA-Administered DCM Intake Form Form Modified
ICR Details
1660-0152 202602-1660-001
Received in OIRA 202111-1660-002
DHS/FEMA
FEMA-Administered Disaster Case Management (DCM)
Reinstatement without change of a previously approved collection   No
Regular 02/13/2026
  Requested Previously Approved
36 Months From Approved
30,750 0
19,680 0
0 0

This collection tool will primarily be used as a guide to support FEMA-administered Disaster Case Management (DCM) case managers by outlining the allowable data elements they can collect from survivors on behalf of FEMA. While there will be a paper collection tool, the case managers will primarily be using the tool as a reference of data elements they can collect, and using their own case management database systems to guide the order in which the elements are collected. The elements within the tool are used to assess, screen, and refer disaster survivors to available resources that address their specific disaster-related unmet needs. Case managers then take the information from the intake form and manually upload the data into their secured case management database. Prior to any data collection, survivors will complete and sign a FEMA-administered DCM Consent Form, authorizing FEMA, or its agent, to collect data from the survivor in order to effectively provide case management services.

US Code: 42 USC 5189d Name of Law: Case Management Services
  
None

Not associated with rulemaking

  90 FR 36167 08/01/2025
91 FR 6234 02/11/2026
Yes

2
IC Title Form No. Form Name
FEMA-Administered DCM Consent Form FEMA Form FF-104-FY-21-147 FEMA-Administered DCM Concent Form
FEMA-Administered DCM Intake Form FEMA Form FF-104-FY-21-146 FEMA-Administered DCM Intake Form

  Total Request 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 30,750 0 0 0 -44,250 75,000
Annual Time Burden (Hours) 19,680 0 0 0 -28,320 48,000
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
There is an overall reduction of 28,320 burden hours due to a reduction in the estimate of expected respondents. There is an overall reduction of $814,195 in burden cost due to a reduction in burden hours, mitigated by a slight increase in wage rates.

$51,693,869
No
    Yes
    No
No
No
No
No
Krista Robinson 202 394-6377 [email protected]

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
02/13/2026