Agency Information Collection Activities: Proposed Collection; Comment Request, 59190-59191 [E9-27524]
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59190
Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
Agency Information Collection
Activities: Proposed Collection;
Comment Request
In compliance with Section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995 concerning
opportunity for public comment on
proposed collections of information, the
Substance Abuse and Mental Health
Services Administration (SAMHSA)
will publish periodic summaries of
proposed projects. To request more
information on the proposed projects or
to obtain a copy of the information
collection plans, call the SAMHSA
Reports Clearance Officer on (240) 276–
1243.
Comments are invited on: (a) Whether
the proposed collections of information
are necessary for the proper
performance of the functions of the
agency, including whether the
information shall have practical utility;
(b) the accuracy of the agency’s estimate
of the burden of the proposed collection
of information; (c) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
Proposed Project: FASD Diagnosis and
Intervention Programs in the Fetal
Alcohol Spectrum Disorder (FASD)
Center of Excellence—New
operating a Fetal Alcohol Spectrum
Disorder (FASD) Center of Excellence
which addresses FASD mainly by
providing trainings and technical
assistance; and developing and
supporting systems of care that respond
to FASD using effective evidence based
practices and interventions.
Currently the integration of evidencebased practices into service delivery
organizations is being accomplished
through subcontracts. One such
intervention which integrates diagnosis
and intervention strategies into existing
service delivery organizations is the
FASD Diagnosis and Intervention
programs targeting children 0–18 years
of age. The Diagnosis and Intervention
programs use the following 11 data
collection tools.
Since 2001, SAMHSA’s Center for
Substance Abuse Prevention has been
DESCRIPTION OF INSTRUMENTS/ACTIVITY FOR THE DIAGNOSIS AND INTERVENTION PROGRAMS
Instrument/Activity
Description
Screening and Diagnosis Tool ...........................................
The purpose of the screening and diagnosis tool is to determine eligibility to participate in the SAMHSA FASD Center Diagnosis and Treatment Intervention. The
form includes demographic, screening, and diagnostic data.
The Positive Monitor Tracking form is to monitor the outcome of placing a child (ages
0–3 years) on a positive monitor.
The Services Child is Receiving at the time of the FASD Diagnosis form is to record
services the child is receiving at the time of an FASD diagnosis.
The Services Planned and Provided based on Diagnostic Evaluation form is to
record services planned and received based on the diagnostic evaluation.
The Services Delivery Tracking form is for the services provided during every visit.
The End of Intervention/Program Improvement Measure—Case Manager form is for
the case manager to report on the overall improvement in the child as a result of
receiving services.
The End of Intervention/Program Improvement Measure—Parent/Guardian form is for
the parent/guardian to report on the overall improvement in the child as a result of
receiving services.
The End of Intervention/Program Customer Satisfaction with Service form is to determine customer satisfaction (parents) with the SAMHSA FASD Center Diagnosis
and Intervention project.
The Outcome Measures (Children 0–7 years) form is an outcomes measure checklist
used to record measures every six months from start of service to end of service,
at end of intervention, at 6 months follow-up, and 12 months follow-up.
The Outcome Measures (Children 8–18 years) form is an outcomes measure checklist used to record measures every six months from start of service to end of service, at end of intervention, at 6 months follow-up, and 12 months follow-up.
The Lost to follow-up form is used if the child is no longer accessible for follow-up.
Positive Monitor Tracking ...................................................
Services Child is Receiving at the time of the FASD Diagnosis.
Services Planned and Provided based on Diagnostic
Evaluation.
Services Delivery Tracking Form .......................................
End of Intervention/Program Improvement Measure—
Case Manager.
End of Intervention/Program Improvement Measure—
Parent/Guardian.
End of Intervention/Program Customer Satisfaction with
Service.
Outcome Measures (Children 0–7 years) ..........................
Outcome Measures (Children 8–18 years) ........................
mstockstill on DSKH9S0YB1PROD with NOTICES
Lost to follow-up .................................................................
Eight subcontracts were awarded in
February 2008 to integrate the FASD
Diagnosis and Intervention program
within existing service delivery
organization sites. Using an integrated
service delivery model all sites are
screening children using an FASD
screening tool, obtaining a diagnostic
evaluation, and providing services/
interventions as indicated by the
diagnostic evaluation. Specific
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20:50 Nov 16, 2009
Jkt 220001
interventions are based upon the
individual child’s diagnosis. Six of the
sites are integrating the FASD Diagnosis
and Intervention projects either in a
child mental health provider setting or
in a dependency court setting and serve
children ages 0–7 years. Two of the sites
are delinquency courts and serve
children 10–18 years of age.
Data collection at all sites involves
administering the screening and
diagnosis tool, recording process level
PO 00000
Frm 00078
Fmt 4703
Sfmt 4703
indicators such as type and units of
service provided; improvement in
functionality and outcome measures
such as school performance, stability in
housing/placement, and adjudication
measures (10–18 yrs only). Data will be
collected at baseline, monthly, every six
months from start of service to end of
service, at end of intervention, at 6
months follow-up, and 12 months
follow-up.
E:\FR\FM\17NON1.SGM
17NON1
59191
Federal Register / Vol. 74, No. 220 / Tuesday, November 17, 2009 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS
Number of respondents
Instrument/Activity
Number of responses per
respondent
1400
450
750
750
750
750
750
750
750
135
1
1
1
1
12
1
1
1
3
1
0.17
0.03
0.17
0.33
0.08
0.02
0.02
0.03
0.08
0.03
238
14
128
248
720
15
15
23
180
4
100
50
50
50
50
50
50
50
15
7,700
1
1
1
12
1
1
1
3
1
45
0.17
0.17
0.33
0.08
0.02
0.02
0.03
0.08
0.03
—
17
9
17
48
1
1
2
12
1
1,693
Client Surveys: Children 0–7.
Screening and Diagnosis Tool ........................................................................
Positive Monitor Tracking .........................................................................
Services Child is Receiving at the time of the FASD Diagnosis .............
Services Planned and Provided based on Diagnostic Evaluation ...........
Services Delivery Tracking Form .............................................................
End of Intervention/Program Improvement Measure—Case Manager ....
End of Intervention/Program Improvement Measure—Parent/Guardian
End of Intervention/Program Customer Satisfaction with Service ...........
Outcome Measures (Children 0–7 years) ................................................
Lost to follow-up .......................................................................................
Client Surveys: Children 8–18:
Screening and Diagnosis Tool .................................................................
Services Child is Receiving at the time of the FASD Diagnosis .............
Services Planned and Provided based on Diagnostic Evaluation ...........
Services Delivery Tracking Form .............................................................
End of Intervention/Program Improvement Measure—Case Manager ....
End of Intervention/Program Improvement Measure—Parent/Guardian
End of Intervention/Program Customer Satisfaction with Service ...........
Outcome Measures (Children 8–18 years) ..............................................
Lost to follow-up .......................................................................................
TOTAL ...................................................................................................
Send comments to Summer King,
SAMHSA Reports Clearance Officer,
Room 7–1044, One Choke Cherry Road,
Rockville, MD 20857 AND e-mail her a
copy at summer.king@samhsa.hhs.gov.
Written comments should be received
within 60 days of this notice.
Dated: November 4, 2009.
Elaine Parry,
Director, Office of Program Services.
[FR Doc. E9–27524 Filed 11–16–09; 8:45 am]
BILLING CODE 4162–20–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Substance Abuse and Mental Health
Services Administration
mstockstill on DSKH9S0YB1PROD with NOTICES
Agency Information Collection
Activities: Proposed Collection;
Comment Request
In compliance with Section
3506(c)(2)(A) of the Paperwork
Reduction Act of 1995 concerning
opportunity for public comment on
proposed collections of information, the
Substance Abuse and Mental Health
Services Administration (SAMHSA)
will publish periodic summaries of
proposed projects. To request more
information on the proposed projects or
to obtain a copy of the information
collection plans, call the SAMHSA
Reports Clearance Officer on (240) 276–
1243.
Comments are invited on: (a) Whether
the proposed collections of information
are necessary for the proper
VerDate Nov<24>2008
20:50 Nov 16, 2009
Jkt 220001
performance of the functions of the
agency, including whether the
information shall have practical utility;
(b) the accuracy of the agency’s estimate
of the burden of the proposed collection
of information; (c) ways to enhance the
quality, utility, and clarity of the
information to be collected; and (d)
ways to minimize the burden of the
collection of information on
respondents, including through the use
of automated collection techniques or
other forms of information technology.
Proposed Project: Substance Abuse
Prevention and Treatment (SAPT)
Block Grant Uniform Application
Guidance and Instructions FY 2011–
2013 and Regulations (OMB No. 0930–
0080)—Revision
Sections 1921 through 1935 of the
Public Health Service Act (U.S.C. 300x–
21 to 300x–35) provide for annual
allotments to assist States to plan, carry
out and evaluate activities to prevent
and treat substance abuse and for
related activities. Under the provisions
of the law, States may receive
allotments only after an application is
submitted and approved by the
Secretary, DHHS. For the Federal fiscal
years (FY) 2011–FY 2013 Substance
Abuse Prevention and Treatment
(SAPT) Block Grant application cycles,
SAMHSA will provide States with
revised application guidance and
instructions to implement changes made
in accordance with recommendations
from the National Association of State
Alcohol and Drug Abuse Directors
(NASADAD) and their member States in
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Frm 00079
Fmt 4703
Sfmt 4703
Average burden per response
Total burden
hours per collection
the revisions and clarification of data
reporting requirements and instructions.
During negotiations with the States
resulting in agreement on the National
Outcome Measures (NOMs) for
substance abuse treatment and
prevention, SAMHSA pledged to the
States to:
1. Reduce respondent burden;
2. Work with the States to improve
performance management of the SAPT
Block Grant;
3. Improve the availability, timeliness,
and quality of data available to Federal,
State, and provider administrators of
block grant funded programs.
This revision of the Uniform
Application and Regulation for the
SAPT Block Grant takes additional steps
toward implementing these
commitments. SAMHSA, in
consultation with NASADAD, has
provided States the ability to reduce
their application burden by
consolidating the FY 2011–FY 2013
State Plan into a 3-year plan. With the
exception of the projected annual
budget form, States only would be
expected to submit any proposed
revisions to its approved three-year plan
but would otherwise not have to
resubmit a State Plan during FY 2012
and FY 2013. Individual States may
reduce their respondent burden further
by selecting the option of using
SAMHSA pre-populated tables for
Section IVa and IVb. The data for these
tables would be drawn from SAMHSA
data sets known as Drug and Alcohol
Services Information System (DASIS)
Treatment Episode Data Set (TEDS) and
E:\FR\FM\17NON1.SGM
17NON1
]]>Agencies
[Federal Register Volume 74, Number 220 (Tuesday, November 17, 2009)]
[Notices]
[Pages 59190-59191]
From the Federal Register Online via the Government Printing Office [www.gpo.gov]
[FR Doc No: E9-27524]
[[Page 59190]]
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
In compliance with Section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995 concerning opportunity for public comment on proposed
collections of information, the Substance Abuse and Mental Health
Services Administration (SAMHSA) will publish periodic summaries of
proposed projects. To request more information on the proposed projects
or to obtain a copy of the information collection plans, call the
SAMHSA Reports Clearance Officer on (240) 276-1243.
Comments are invited on: (a) Whether the proposed collections of
information are necessary for the proper performance of the functions
of the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on respondents,
including through the use of automated collection techniques or other
forms of information technology.
Proposed Project: FASD Diagnosis and Intervention Programs in the Fetal
Alcohol Spectrum Disorder (FASD) Center of Excellence--New
Since 2001, SAMHSA's Center for Substance Abuse Prevention has been
operating a Fetal Alcohol Spectrum Disorder (FASD) Center of Excellence
which addresses FASD mainly by providing trainings and technical
assistance; and developing and supporting systems of care that respond
to FASD using effective evidence based practices and interventions.
Currently the integration of evidence-based practices into service
delivery organizations is being accomplished through subcontracts. One
such intervention which integrates diagnosis and intervention
strategies into existing service delivery organizations is the FASD
Diagnosis and Intervention programs targeting children 0-18 years of
age. The Diagnosis and Intervention programs use the following 11 data
collection tools.
Description of Instruments/Activity for the Diagnosis and Intervention
Programs
------------------------------------------------------------------------
Instrument/Activity Description
------------------------------------------------------------------------
Screening and Diagnosis Tool...... The purpose of the screening and
diagnosis tool is to determine
eligibility to participate in the
SAMHSA FASD Center Diagnosis and
Treatment Intervention. The form
includes demographic, screening,
and diagnostic data.
Positive Monitor Tracking......... The Positive Monitor Tracking form
is to monitor the outcome of
placing a child (ages 0-3 years) on
a positive monitor.
Services Child is Receiving at the The Services Child is Receiving at
time of the FASD Diagnosis. the time of the FASD Diagnosis form
is to record services the child is
receiving at the time of an FASD
diagnosis.
Services Planned and Provided The Services Planned and Provided
based on Diagnostic Evaluation. based on Diagnostic Evaluation form
is to record services planned and
received based on the diagnostic
evaluation.
Services Delivery Tracking Form... The Services Delivery Tracking form
is for the services provided during
every visit.
End of Intervention/Program The End of Intervention/Program
Improvement Measure--Case Manager. Improvement Measure--Case Manager
form is for the case manager to
report on the overall improvement
in the child as a result of
receiving services.
End of Intervention/Program The End of Intervention/Program
Improvement Measure--Parent/ Improvement Measure--Parent/
Guardian. Guardian form is for the parent/
guardian to report on the overall
improvement in the child as a
result of receiving services.
End of Intervention/Program The End of Intervention/Program
Customer Satisfaction with Customer Satisfaction with Service
Service. form is to determine customer
satisfaction (parents) with the
SAMHSA FASD Center Diagnosis and
Intervention project.
Outcome Measures (Children 0-7 The Outcome Measures (Children 0-7
years). years) form is an outcomes measure
checklist used to record measures
every six months from start of
service to end of service, at end
of intervention, at 6 months follow-
up, and 12 months follow-up.
Outcome Measures (Children 8-18 The Outcome Measures (Children 8-18
years). years) form is an outcomes measure
checklist used to record measures
every six months from start of
service to end of service, at end
of intervention, at 6 months follow-
up, and 12 months follow-up.
Lost to follow-up................. The Lost to follow-up form is used
if the child is no longer
accessible for follow-up.
------------------------------------------------------------------------
Eight subcontracts were awarded in February 2008 to integrate the
FASD Diagnosis and Intervention program within existing service
delivery organization sites. Using an integrated service delivery model
all sites are screening children using an FASD screening tool,
obtaining a diagnostic evaluation, and providing services/interventions
as indicated by the diagnostic evaluation. Specific interventions are
based upon the individual child's diagnosis. Six of the sites are
integrating the FASD Diagnosis and Intervention projects either in a
child mental health provider setting or in a dependency court setting
and serve children ages 0-7 years. Two of the sites are delinquency
courts and serve children 10-18 years of age.
Data collection at all sites involves administering the screening
and diagnosis tool, recording process level indicators such as type and
units of service provided; improvement in functionality and outcome
measures such as school performance, stability in housing/placement,
and adjudication measures (10-18 yrs only). Data will be collected at
baseline, monthly, every six months from start of service to end of
service, at end of intervention, at 6 months follow-up, and 12 months
follow-up.
[[Page 59191]]
Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
Number of Total burden
Instrument/Activity Number of responses per Average burden hours per
respondents respondent per response collection
----------------------------------------------------------------------------------------------------------------
Client Surveys: Children 0-7....................
Screening and Diagnosis Tool.................... 1400 1 0.17 238
Positive Monitor Tracking................... 450 1 0.03 14
Services Child is Receiving at the time of 750 1 0.17 128
the FASD Diagnosis.........................
Services Planned and Provided based on 750 1 0.33 248
Diagnostic Evaluation......................
Services Delivery Tracking Form............. 750 12 0.08 720
End of Intervention/Program Improvement 750 1 0.02 15
Measure--Case Manager......................
End of Intervention/Program Improvement 750 1 0.02 15
Measure--Parent/Guardian...................
End of Intervention/Program Customer 750 1 0.03 23
Satisfaction with Service..................
Outcome Measures (Children 0-7 years)....... 750 3 0.08 180
Lost to follow-up........................... 135 1 0.03 4
Client Surveys: Children 8-18:
Screening and Diagnosis Tool................ 100 1 0.17 17
Services Child is Receiving at the time of 50 1 0.17 9
the FASD Diagnosis.........................
Services Planned and Provided based on 50 1 0.33 17
Diagnostic Evaluation......................
Services Delivery Tracking Form............. 50 12 0.08 48
End of Intervention/Program Improvement 50 1 0.02 1
Measure--Case Manager......................
End of Intervention/Program Improvement 50 1 0.02 1
Measure--Parent/Guardian...................
End of Intervention/Program Customer 50 1 0.03 2
Satisfaction with Service..................
Outcome Measures (Children 8-18 years)...... 50 3 0.08 12
Lost to follow-up........................... 15 1 0.03 1
TOTAL..................................... 7,700 45 -- 1,693
----------------------------------------------------------------------------------------------------------------
Send comments to Summer King, SAMHSA Reports Clearance Officer,
Room 7-1044, One Choke Cherry Road, Rockville, MD 20857 AND e-mail her
a copy at summer.king@samhsa.hhs.gov. Written comments should be
received within 60 days of this notice.
Dated: November 4, 2009.
Elaine Parry,
Director, Office of Program Services.
[FR Doc. E9-27524 Filed 11-16-09; 8:45 am]
BILLING CODE 4162-20-P
