View Information Collection Request (ICR) Package
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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:
0930-0304
ICR Reference No:
201603-0930-007
Status:
Historical Active
Previous ICR Reference No:
201408-0930-002
Agency/Subagency:
HHS/SAMHSA
Agency Tracking No:
Title:
Survey of Current and Alumni SAMHSA Fellows of the Minority Fellowship Program (MFP)
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:
08/01/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
03/18/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
08/31/2019
36 Months From Approved
10/31/2017
Responses
1,868
0
788
Time Burden (Hours)
1,260
0
484
Cost Burden (Dollars)
0
0
0
Abstract:
The current SAMHSA MFP Fellows currently receiving support during their master’s-level program, doctoral-level training or psychiatric residency will be asked about their experiences in the MFP (from recruitment into the program through their participation in the various activities provided by the Grantees). The MFP Alumni who participated in the MFP during the time the program was administered by SAMHSA will be asked about their previous experiences as Fellows in the MFP and also about their subsequent involvement and leadership in their professions.
Authorizing Statute(s):
US Code:
42 USC 505
Name of Law: Data Collection
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:
81 FR 1196
01/11/2016
30-day Notice:
Federal Register Citation:
Citation Date:
81 FR 14456
03/17/2016
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
2
IC Title
Form No.
Form Name
Alumni Fellows Survey
Alumni Fellows Survey
Alumni Fellows Survey
Current Fellows Survey
Current Fellows Survey
Current Fellows Survey
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
1,868
788
0
1,080
0
0
Annual Time Burden (Hours)
1,260
484
0
776
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:
Currently there are 484 burden hours in the OMB inventory. SAMHSA is now requesting 1,260 hours. The increase of 776 hours is due to a program change for the time needed for the current and alumni Fellows to complete the additional survey questions, which are estimated to add 5 minutes to each survey’s completion time, and the result of including the NITT-MFP-Y and NITT-MFP-AC Fellows (up to 300 current Fellows and up to 780 alumni Fellows) into the respondent pool.
Annual Cost to Federal Government:
$41,967
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:
03/18/2016
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