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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:
0930-0298
ICR Reference No:
201512-0930-003
Status:
Historical Active
Previous ICR Reference No:
201208-0930-001
Agency/Subagency:
HHS/SAMHSA
Agency Tracking No:
Title:
Minority Substance Abuse/HIV Prevention Initiative
Type of Information Collection:
Revision of a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
03/15/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
12/22/2015
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2019
36 Months From Approved
03/31/2016
Responses
235,980
0
20,512
Time Burden (Hours)
35,139
0
15,049
Cost Burden (Dollars)
0
0
0
Abstract:
The Youth and Adult Minority Substance Abuse Questionnaires will be used to survey populations at risk for Substance Abuse, HIV/AIDS, and hepatitis. The participants are those in the Program who receive direct services for over 30 days at three time points: (1) baseline (program entry), (2) program exit, and (3) three to six months post-exit.
Authorizing Statute(s):
US Code:
42 USC 516
Name of Law: Priority Substance Abuse Prevention Needs of Reginional and National Significance
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:
80 FR 58742
09/30/2015
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 12345
12/22/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
4
IC Title
Form No.
Form Name
Adult
Adult Questionnaire
Adult Questionnaire
Group Dosage Form
Group Dosage Form
Group Dosage Form
Individual Dosage Form
Individual Dosage Form
Individual Dosage Form
Youth
Youth Questionnaire
Youth 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
235,980
20,512
0
215,468
0
0
Annual Time Burden (Hours)
35,139
15,049
0
20,090
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:
Changing Regulations
Burden decreases because of Program Change due to Agency Discretion:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
Currently there were 16,770 hours in the OMB inventory. SAMHSA is requesting 35,139 to continue this cross-site evaluation. The additional 18,369 hours are due to program changes, including an increase in the number of grantees funded by the MSI CBO and CBI programs and related increase in the expected numbers of participants to be served. Additionally, the estimates of the number of participants by service duration and of response rates to the surveys are based on data submitted by more recent cohorts and are more representative of the probable activities of the current cohorts of grantees. Finally, two brief dosage forms have been added to the data collection protocol.
Annual Cost to Federal Government:
$606,800
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
Agency Contact:
Summer King 2402761243
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:
12/22/2015
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