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 Generic ICR - OIRA Conclusion
OMB Control No:
0930-0393
ICR Reference No:
202301-0930-003
Status:
Active
Previous ICR Reference No:
Agency/Subagency:
HHS/SAMHSA
Agency Tracking No:
Title:
Fast Track Generic Clearance for the Collection of Qualitative Feedback on the Substance Abuse and Mental Health Services Administration (SAMHSA) Service Delivery
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:
03/01/2023
Retrieve Notice of Action (NOA)
Date Received in OIRA:
01/23/2023
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
03/31/2026
36 Months From Approved
Responses
105,000
0
0
Time Burden (Hours)
60,250
0
0
Cost Burden (Dollars)
0
0
0
Abstract:
This Fast Track Generic collection of information is necessary to enable SAMHSA to garner customer and stakeholder feedback in an efficient, timely manner, in accordance with our commitment to improving service delivery. The information collected from our customers and stakeholders will help ensure that users have an effective, efficient, and satisfying experience with SAMHSA programs.
Authorizing Statute(s):
EO: EO 12862 Name/Subject of EO: Setting Customer Service Standards
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:
87 FR 68182
11/14/2022
30-day Notice:
Federal Register Citation:
Citation Date:
88 FR 3752
01/20/2023
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
30
IC Title
Form No.
Form Name
988 Suicide & Crisis Lifeline Customer Feedback
CT IDI Screener, CT Survey AQ, CT IDI Check-in, CT IDI Discussion Guide, CT Survey Screener
CT IDI Screener
,
CT Survey AQ
,
CT IDI Check-In
,
CT IDI Discussion Guide
,
CT Survey Screener
988 Suicide & Crisis Lifeline Customer Feedback
988 Suicide Crisis Lifeline Satisfaction Survey
988 Suicide Crisis Lifeline Satisfaction Survey
988 Suicide and Criss Lifeline Paid Ads Creative Testing
Creative Testing Survey, IDI Screener
Creative Testing Survey
,
IDI Screener
Crisis Response Training and Technical Assistance Center (TTAC) - Interviews
Crisis TTAC Grantee Interview Protocol, Crisis TTAC Org Agency Leader Interview Protocol
Crisis TTAC Grantee Interview Protocol
,
Crisis TTAC Org Agency Leader Interview Protocol
Crisis Response Training and Technical Assistance Center (TTAC) - Satisfaction Surveys
Crisis TTAC Post-Event Survey, Crisis TTAC Products + Resources Survey
Crisis TTAC Post-Event Survey
,
Crisis TTAC Products + Resources Survey
Crisis Response Training and Technical Assistance Center (TTAC) - Satisfaction Surveys
Satisfaction Survey, Satisfaction Post Event Survey
Satisfaction Survey
,
Satisfaction Post Event Survey
Crisis Response Training and Technical Assistance Center (TTAC) - TA Recipient Focus Group Protocol
Crises TTAC TA Recipient Focus Group Protocol
Crises TTAC TA Recipient Focus Group Protocol
Disaster Technical Assistance Center (DTAC) Disaster Behavioral Health Customer Feedback Survey (CFS)
SAMHSA DTAC CFS _ Instrument
SAMHSA DTAC CFS _ Instrument
Disaster Technical Assistance Center (DTAC) Disaster Behavioral Health Customer Feedback Survey (CFS)
Customer Feedback Survey
Customer Feedback Survey
Division of Services Improvement Summer Summit Survey
DSI Cross Grantee Meeting Pre-Survey, DSI Cross Grantee Meeting Post-Survey
DSI Cross Grantee Meeting Pre-Survey
,
DSI Cross Grantee Meeting Post-Survey
Division of Targeted Prevention (DTP) New Grantee Orientation Satisfaction Survey
CSAP DTP Grantee Satisfaction Survey
CSAP DTP Grantee Satisfaction Survey
Health Education Communications Campaign Testing (Phase 3)
Online Discussion Board Guide, Online Discussion Board Screener
Online Discussion Board Guide
,
Online Discussion Board Screener
Message Testing: Efficacy of Concepts for Prevention Professionals Working with Transition-Age Youth Not Attending College
Transition Age Youth Mini Campaign Instrument
Transition Age Youth Mini Campaign Instrument
Message Testing: Efficacy of Concepts for Primary Care Professionals' Screening for Substance Use Among Youth and Young Adults
OMB Base Year MC Screening Survey Instrument
OMB Base Year MC Screening Survey Instrument
National Training and Technical Assistance Center for Early Serious Mental Illness
Individualized TA Request Form, Individualized TA Satisfaction Form, TTA Individual Session Feedback Form, Overall Series Feedback Form
Individualized Technical Assistance (TA) Request Form
,
Individualized Technical Assistance (TA) Satisfaction Form
,
TTA Individual Session Feedback Form
,
Overall Series Feedback Form
Office of Assistant Secretary (OAS) Post-Meeting Evaluation
Customer Feedback Survey
Customer Feedback Survey
Office of Assistant Secretary (OAS) Post-Webinar Evaluation
Webinar Survey
Webinar Survey
Partnerships for Success FY 2024 In-Person Grantee Meeting for States and Communities
PFS Meeting Feedback Prompts, PFS Meeting Feedback Prompts-Discussion
PFS Meeting Feedback Prompts
,
PFS Meeting Feedback Prompts-Discussion
Program Evaluation, Effectiveness and Review Services (PEERS) Listening Sessions
PEERS Listening Session Questions
PEERS Listening Session Questions
Qualitative Message Testing of Revised SAMHSA Tips for Teens Fact Sheets
Survey Questions and Narrative
Survey Questions and Narrative
SAMHSA Continuing Medical Education Activities Data Collection
Registration Form, Post Course Evaluation Form, Follow-Up Evaluation
Registration Form
,
Post Course Evaluation Form
,
Follow-Up Evaluation
SAMHSA Data Webpages Customer Satisfaction Survey
Data Webpages Customer Satisfaction Survey
Data Webpages Customer Satisfaction Survey
SAMHSA Program to Advance Recovery Knowledge Training and Technical Assistance Request Form
SPARK TTA Request Form, SPARK TTA Request Form (Microsoft Image Preview)
SPARK TTA Request Form
,
SPARK TTA Request Form (Microsoft Image Preview)
SAMHSA Program to Advance Recovery Knowledge Training and Technical Assistance Request Form (Updated)
SPARK TA Request Form
SPARK TA Request Form
SAMHSA Publication and Digital Products Website Registration Revision
SAMHSA Main Site Survey, SAMHSA Store Survey
SAMHSA Main Site Survey
,
SAMHSA Store Survey
SAMHSA Walk for Recovery
SAMHSA Walk for Recovery form
SAMHSA Walk for Recovery form
SAMHSA's General Registration Form
Event Registration Form
Event Registration Form
SAMHSA's Publications and Digital Products Website Registration Survey
SAMHSA Main Site Survey, SAMHSA Store Survey
SAMHSA Main Site Survey
,
SAMHSA Store Survey
State Program Improvement Technical Assistance Event Satisfaction
LC Overall Series Feedback Form, TA Onsite_Offsite_initial and follow up feedback, LC Individual Session Feedback Form, LC Customer Feedback Form
TA Onsite_Offsite_initial and follow up feedback
,
LC Individual Session Feedback Form
,
LC Overall Series Feedback Form
,
LC Customer Feedback Form
Survey of Satisfaction of SAMHSA's Program to Advance Recovery Knowledge (SPARK) Training and Technical Assistance (TTA) Events
Satisfaction Survey of SAMHSA's SPARK TTA Events
Satisfaction Survey of SAMHSA's SPARK TTA Events
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
105,000
0
0
105,000
0
0
Annual Time Burden (Hours)
60,250
0
0
60,250
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:
$3,083,218
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?
No
Agency Contact:
Carlos Graham 204 276-0361 carlos.graham@samhsa.hhs.gov
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:
01/23/2023