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:
0930-0357
ICR Reference No:
201811-0930-002
Status:
Historical Active
Previous ICR Reference No:
201601-0930-002
Agency/Subagency:
HHS/SAMHSA
Agency Tracking No:
Title:
Monitoring Data Collection Tools for the Minority AIDS Initiative (MAI)
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:
03/29/2019
Retrieve Notice of Action (NOA)
Date Received in OIRA:
11/27/2018
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2022
36 Months From Approved
05/31/2019
Responses
30,620
0
806
Time Burden (Hours)
7,880
0
2,848
Cost Burden (Dollars)
0
0
0
Abstract:
The Minority AIDS Initiative (MAI) monitoring tools includes both youth and adult questionnaires as well as the quarterly progress report. The target population for the MAI grantees will be at-risk minority adolescents and young adults. All MAI grantees are expected to report their monitoring data using SAMHSA’s Strategic Prevention Framework (SPF) to target minority populations, as well as other high risk groups residing in communities of color with high prevalence of Substance Abuse and HIV/AIDS.
Authorizing Statute(s):
US Code:
5 USC 516
Name of Law: Priority Substance Abuse Prevention Needs of Regional 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:
83 FR 39766
08/10/2018
30-day Notice:
Federal Register Citation:
Citation Date:
83 FR 59391
11/23/2018
Did the Agency receive public comments on this ICR?
Yes
Number of Information Collection (IC) in this ICR:
3
IC Title
Form No.
Form Name
Adult Questionnaire
Adult Questinnaire
Adult Questinnaire
HIV Testing Retrospective Reporting Tool
HIV Testing Retrospective Reporting Tool
HIV Testing Retrospective Reporting Tool
Indirect Services Outcomes
Indirect Services Outcomes
Indirect Services Outcomes
Quarterly Progress Report
Quarterly Progress Report
Quarterly Progress Report
Youth Questionnaire
Youth Questinnaire
Youth Questinnaire
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
30,620
806
0
29,814
0
0
Annual Time Burden (Hours)
7,880
2,848
0
5,032
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:
Yes
Burden Reduction Due to:
Miscellaneous Actions
Short Statement:
Currently, there are 2,848 burden hours in the OMB inventory. The Program is requesting 7,880 burden hours. This increase of 5,032 hours is a program change due to adding the Adult Questionnaire and the Youth Questionnaire to this data collection.
Annual Cost to Federal Government:
$361,202
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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.
No
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
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:
11/27/2018
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