# Agency Information Collection Activities: Submission for OMB Review; Comment Request > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3A04-1169 ## Record - **Collection:** Federal Register - **Document type:** Notice - **Published:** January 21, 2004 - **Citation:** 69 FR 2938 ## Text DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Agency Information Collection Activities: Submission for OMB Review; Comment Request Periodically, the Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information collection requests under OMB review, in compliance with the Paperwork Reduction Act (44 U.S.C. Chapter 35). To request a copy of these documents, call the SAMHSA Reports Clearance Officer on (301) 443-7978. National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, Phase Four —New—SAMHSA's Center for Mental Health Services (CMHS) is conducting Phase IV of this national evaluation project among grantees newly funded in FY 2002 and 2003. The national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program will collect data on child mental health outcomes, family life, and service system development and performance. Data will be collected on 32 service systems, and approximately 7,868 children and families. Data collection for this evaluation will be conducted in each site over a five-year period. The core of service system data will be collected every 18 months throughout the 5-year evaluation period, with a sustainability survey conducted in selected years. Service delivery and system variables of interest include the following: maturity of system of care development, adherence to the system of care program model, and client service experience. The length of time that individual families will participate in the study ranges from 18 to 36 months depending on when they enter the evaluation. Child and family outcomes of interest will be collected at intake and during subsequent follow-up sessions at six-month intervals. The outcome measures include the following: child symptomatology and functioning, family functioning, material resources, and caregiver strain. In addition, an evidence-based treatment study will examine the relative impact of evidence-based treatments focused on substance use prevention within two systems of care. Time-limited studies addressing the cultural competence of services and the role of primary care providers in systems of care will be conducted at selected points during the evaluation period. Internet-based technology will be used for collecting data via Web-based surveys and for data entry and management. The average annual respondent burden is estimated below. Instrument and respondent No. of respondents Avg. # of responses per respondent Hours per response Total burden hours 6.5 yr. avg. annual burden hours System of Care Assessment Interview Guides and Data Collection Forms: Key site informants 672 3 1 2,016 310 Interagency Collaboration Scale: Key site informants 672 3 0.13 269 41 Cross-sectional Descriptive Study Descriptive Interview Questionnaire: Caregiver 7,868 6 0.283 10,097 1,279 Child and Family Outcome Study Caregiver Strain Questionnaire: Caregiver 7,868 6 0.167 7,884 1,213 Child Behavior Checklist: Caregiver 7,868 6 0.333 15,720 2,418 Education Questionnaire: Caregiver 7,868 6 0.1 4,721 726 Living Situations Questionnaire: Caregiver 7,868 6 0.083 3,934 605 The Family Life Questionnaire: Caregiver 7,868 6 0.050 2,360 363 Behavioral and Emotional Rating Scale: Caregiver 7,475 6 0.167 7,490 1,152 Columbia Impairment Scale: Caregiver 7,475 6 0.083 3,737 575 The Vineland Screener: Caregiver 393 6 0.25 590 91 Delinquency Survey: Youth 4,721 6 0.167 4,721 726 Behavioral and Emotional Rating Scale: Youth 4,721 6 0.167 4,721 726 Gain-quick Substance Related Issues: Youth 4,721 6 0.083 2,360 363 Substance Use Scale: Youth 4,721 6 0.100 2,832 436 Revised Children's Manifest Anxiety Scales: Youth 4,721 6 0.050 1,416 218 Reynolds Adolescent Depression Scale-Second Edition: Youth 4,721 6 0.050 1,416 218 Youth Information Questionnaire: Youth 4,721 6 0.167 4,721 629 Service Experience Study Multi-Sector Service Contacts: Caregiver 7,868 5 0.333 13,113 2,017 Cultural Competence and Service Provision Questionnaire: Caregiver 7,868 5 0.167 6,557 1,009 Youth Services Survey—Family: Caregiver 7,868 5 0.083 3,278 504 Youth Services Survey: Youth 4,721 5 0.083 1,967 303 Treatment Effectiveness Study Diagnostic Interview Schedule for Children version IV: Caregiver 262 1 1.000 262 40 Treatment Fidelity Protocol: Caregiver 240 5 0.500 600 92 Treatment Fidelity Protocol: Youth 240 5 0.500 600 92 Treatment Fidelity Protocol: Provider 240 5 0.500 600 92 Treatment Outcome Measure: Caregiver 240 6 1.000 1,440 221 Treatment Outcome Measure: Youth 240 6 1.000 1,440 221 System-of-Care Practice Review: Caregiver 80 1 1.000 80 12 System-of-Care Practice Review: Youth 80 1 0.750 60 9 System-of-Care Practice Review: Provider 80 1 1.000 80 12 System-of-Care Practice Review: Informal Provider 80 1 0.250 20 3 Provider Attitudes Survey-Site Selection Screener: Provider 450 1 0.083 37 6 Provider Attitudes Survey: 240 1 0.083 20 3 Sustainability Study Sustainability Survey: Provider/Administrator 128 3 0.750 288 44 Culturally Competent Practices Study Culturally Competent Practices Survey: Provider 960 1 0.500 480 74 Culturally Competent Practices Focus Group: Caregiver 36 1 1.500 54 8 Culturally Competent Practices Focus Group: Youth 36 1 1.500 54 8 Culturally Competent Practices Focus Group: Provider/Administrator 60 1 1.500 90 14 Primary Care Providers Study Primary Care Providers Survey: Provider 960 1 0.333 320 49 Total 112,447 17,299 Written comments and recommendations concerning the proposed information collection should be sent within 30 days of this notice to: SAMHSA Desk Officer, Human Resources and Housing Branch, Office of Management and Budget, New Executive Office Building, Room 10235, Washington, DC 20503; due to potential delays in OMB's receipt and processing of mail sent through the U.S. Postal Service, respondents are encouraged to submit comments by fax to: 202-395-6974. Dated: January 13, 2004. Anna Marsh, Acting Executive Officer, SAMHSA. [FR Doc. 04-1169 Filed 1-20-04; 8:45 am] BILLING CODE 4162-20-P --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3A04-1169. Public record. Not legal advice.