# Agency Information Collection Activities: Submission for OMB Review; Comment Request > Briefs, arguments, decisions, and more. URL: https://www.frixlaw.com/law-library/documents/fr%3AE9-18317 ## Record - **Collection:** Federal Register - **Document type:** Notice - **Published:** July 31, 2009 - **Citation:** 74 FR 38197 ## 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 (240) 276-1243. Project: National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program: Phase VI-NEW The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services is responsible for the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program (Children's Mental Health Initiative—CMHI) that will collect data on child mental health outcomes, family life, and service system development and performance. Data will be collected on 26 service systems, and approximately 5,541 children and families. Data collection for this evaluation will be conducted over a five-year period. Child and family outcomes of interest will be collected at intake and during subsequent follow-up sessions at six-month intervals. The length of time that individual families will participate in the study ranges from 12 to 24 months depending upon when they enter the evaluation. The outcome measures include the following: Child symptomatology and functioning, family functioning, satisfaction, and caregiver strain. The core of service system data will be collected every 18-24 months throughout the 5-year evaluation period, with a sustainability survey conducted in years 3 and 5. Service utilization and cost data will be tracked and submitted to the national evaluation every six months using two tools, the Flex Fund Tool and the Services and Costs Data Tool, to estimate average cost of treatment per child, distribution of costs, and allocation of costs across service categories. Service delivery and system variables of interest include the following: Maturity of system of care development in funded system of care communities, adherence to the system of care program model, and client service experience. We will also conduct a comprehensive evaluation of the CMHI's data driven technical assistance; this component of the evaluation will employ a mixed-methods approach, combining qualitative and quantitative data to provide a comprehensive assessment of the continuous quality improvement (CQI) process in funded system of care communities. Specifically, data will be gathered through three complementary activities: A baseline survey of key constituents in all funded communities; a subsequent monitoring survey administered every two years to the same constituents; and biennial case studies of four selected communities. In addition, the evaluation will include three special studies: (1) The sector specific assessment and quasi-experimental comparison study will examine in more detail the outcomes and service experience of children from multiple child-serving sectors and, through child-level matching, compare these outcomes with those not receiving system of care services; (2) The Alumni Network Study will examine the effectiveness of the system of care Alumni Network Web site by evaluating end-user satisfaction and usability of the Web site and will also assess the collaboration between communities via a Web-based Networking and Collaboration Survey that will measure the nature and extent of the interaction between communities; (3) The Study of State Strategies for Sustainability will examine the state's role in sustaining communities after federal funding ceases and describe effective strategies for sustaining funded systems of care. A short version of the sustainability survey developed for this evaluation will be used to gather this information. Internet-based technology such as Web-based surveys and data entry and management tools will be used in this evaluation. The measures of the national evaluation address the national outcome measures for mental health programs as currently established by SAMHSA. The average annual respondent burden is estimated below. The estimate reflects the average number of respondents in each respondent category, the average number of responses per respondent per year, the average length of time it will take to complete each response, and the total average annual burden for each category of respondent, and for all categories of respondents combined. Phase VI Estimate of Respondent Burden [Note: Total burden is annualized over a 5-year period] Instrument Respondent Number of respondents Total average number of responses per respondent Hours per response Total burden hours 5-year average annual burden hours System of Care Assessment Interview Guide A. Core Agency Representative Key site informants 1 598 3 1.00 1,794 359 Interview Guide B. Project Director Interview Guide C. Family Representative/Representative of Family/Advocacy Organizations Interview Guide D. Program Evaluator Interview Guide E. Intake Worker Interview Guide F. Care Coordinator Interview Guide G. Direct Service Delivery Staff Interview Guide H. Care Review Participant Interview Guide I. Caregiver of Child or Youth Served by the Program Interview Guide L. Direct Service Staff from Other Public Child-Serving Agencies Interview Guide M. Care Record/Chart Review Interview Guide N. Other Staff Interview Guide O. Debriefing Document Interview Guide P. Youth Respondent Interview Guide Q. Youth Coordinator Interview Guide R. Cultural and Linguistic Competence Coordinator Interview Guide S. Social Marketing Communications Manager Child and Family Outcome Study Caregiver Information Questionnaire, Revised: Caregiver—Intake (CIQ-RC-I) Caregiver 2 5,541 1 0.37 2,032 406 Caregiver Information Questionnaire, Revised: Staff as Caregiver—Intake (CIQ-RS-I) Staff as Caregiver Caregiver Information Questionnaire, Revised: Caregiver—Follow-Up (CIQ-RC-F) Caregiver 5,541 3 4 0.28 6,280 1,256 Caregiver Information Questionnaire, Revised: Staff as Caregiver—Follow-Up (CIQ-RS-F) Staff as Caregiver Caregiver Strain Questionnaire (CGSQ) Caregiver 5,541 5 0.17 4,627 925 Child Behavior Checklist 1 1/2 -5 (CBCL 1 1/2 -5) Caregiver 5,541 5 0.33 9,226 1,845 Child Behavior Checklist 6-18 (CBCL 6-18) Education Questionnaire, Revision 2 (EQ-R2) Caregiver 5,541 5 0.33 9,226 1,845 Living Situations Questionnaire (LSQ) Caregiver 5,541 5 0.08 2,300 460 Behavioral and Emotional Rating Scale—Second Edition, Parent Rating Scale (BERS-2C) Caregiver 4 4,909 5 0.17 4,099 820 Columbia Impairment Scale (CIS) Caregiver 5 5,348 5 0.08 2,219 444 Parenting Stress Index (PSI) Caregiver 6 2,030 5 0.08 846 169 Devereux Early Childhood Assessment for Infants (DECA 1-18M) Caregiver 7 1,528 5 0.08 637 127 Devereux Early Childhood Assessment for Toddlers (DECA 18-36M) Devereux Early Childhood Assessment (DECA 2-5Y) Preschool Behavioral and Emotional Rating (PreBERS) Caregiver 1,528 5 0.10 764 153 Delinquency Survey, Revised (DS-R) Youth 8 3,624 5 0.13 2,416 483 Behavioral and Emotional Rating Scale—Second Edition, Youth Rating Scale (BERS-2Y) Youth 3,624 5 0.17 3,026 605 Gain Quick-R: Substance Problem Scale (GAIN) Youth 3,624 5 0.08 1,504 301 Substance Use Survey, Revised (SUS-R) Youth 3,624 5 0.10 1,812 362 Revised Children's Manifest Anxiety Scales (RCMAS) Youth 3,624 5 0.05 906 181 Reynolds Adolescent Depression Scale—Second Edition (RADS-2) Youth 3,624 5 0.05 906 181 Youth Information Questionnaire, Revised—Intake (YIQ-R-I) Youth 3,624 1 0.25 906 181 Youth Information Questionnaire, Revised—Follow-Up (YIQ-R-F) Youth 3,624 4 0.25 3,624 725 Service Experience Study Multi-Sector Service Contacts, Revised: Caregiver—Intake (MSSC-RC-I) Caregiver 5,541 1 0.25 1,385 277 Multi-Sector Service Contacts, Revised: Staff as Caregiver—Intake (MSSC-RS-I) Staff as Caregiver Multi-Sector Service Contacts, Revised: Caregiver—Follow-Up (MSSC-RC-F) Caregiver 5,541 4 0.25 5,541 1,108 Multi-Sector Service Contacts, Revised: Staff as Caregiver—Follow-Up (MSSC-RS-F) Staff as Caregiver Cultural Competence and Service Provision Questionnaire, Revised (CCSP-R) Caregiver 5,541 9 4 0.13 2,955 591 Youth Services Survey for Families (YSS-F) Caregiver 5,541 4 0.12 2,593 519 Youth Services Survey (YSS) Youth 3,624 4 0.08 1,203 241 Comparison and Sector Study: Juvenile Justice Court Representative Questionnaire (CRQ) Court representatives 10 212 5 0.50 530 106 Electronic Data Transfer of Juvenile Justice Records Key site personnel 212 5 0.03 35 7 Comparison and Sector Study: Education Teacher Questionnaire (TQ) Teacher 212 5 0.50 530 106 School Administrator Questionnaire (SAQ) School administrators 212 5 0.50 530 106 Electronic Data Transfer of Education Records Key site personnel 212 5 0.03 35 7 Comparison and Sector Study: Child Welfare Child Welfare Sector Study Questionnaire—Intake (CWSQ-I) Care coordinators 212 1 0.50 106 21 Child Welfare Sector Study Questionnaire—Follow-Up (CWSQ-F) Care coordinators 212 4 0.50 424 85 Electronic Data Transfer of Child Welfare Records Key site personnel 212 5 0.03 35 7 Sustainability Study Sustainability Survey: Brief Form Project Director 79 2 0.17 26 5 Sustainability Survey Providers 11 126 2 0.75 189 38 Caregiver 11 42 2 0.75 63 13 CQI Initiative Evaluation CQI Baseline Survey, Web-Based Key site personnel 208 1 0.50 104 21 CQI Monitoring Survey, Web-Based Key site personnel 208 2 0.50 208 42 CQI Local Focus Group Guide Key site personnel 30 2 1.00 60 12 CQI National Focus Group Guide National TA providers 20 2 1.00 40 8 Alumni Networking Study Networking and Collaboration Survey Key site personnel 248 2 0.50 248 50 Alumni Network Web Site Satisfaction Survey Key site personnel, National TA providers, Branch staff 458 2 0.25 229 46 Services and Costs Study Flex Funds Data Dictionary/Tool Local programming staff compiling/entering administrative data on children/youth 12 1,306 13 3 0.03 129 26 Services and Costs Data Dictionary/Data Entry Application Local evaluator, staff at partner agencies, and programming staff compiling/entering service and cost records on children/youth 5,541 14 100 0.05 27,705 5,541 Summary of Annualized Burden Estimates for 5 Years Number of distinct respondents Number of responses per respondent Average 5-year burden per response (hours) Total annual burden (hours) Caregivers 5,541 0.9 2.2 10,959 Youth 3,624 0.9 1.0 3,261 Providers/Administrators 598 10.8 1.0 6,593 Total Summary 9,763 13 20,812 1 An average of 23 stakeholders in up to 26 grant communities will complete the System of Care Assessment interview. These stakeholders will include site administrative staff, providers, agency representatives, family representatives, and youth. 2 Number of respondents across 26 grantees (5223), in addition to 318 children/families from the comparison sample. Average based on a 5 percent attrition rate at each data collection point. 3 Number of responses per respondent is five over the course of the study (once every 6 months for 24 months, with one baseline/intake response, and 4 follow-up responses). 4 Approximate number of caregivers with children over age 5, based on Phase IV data submitted as of 12/08. Also includes 318 children/families from the comparison sample. 5 Approximate number of caregivers with children 3 and older, based on Phase IV data submitted as of 12/08. Also includes 318 children/families from the comparison sample. 6 Approximate number of caregivers with either: (1) children served at the roughly 7 early childhood-focused communities, for whom the instrument is required; or (2) children aged 0 to 12 at other communities, where the instrument is optional (we estimate that 1/3 of caregivers will be administered the instrument when it is optional). Estimates are based on Phase IV data submitted as of 12/08. 7 Approximate number of caregivers with either: (1) children served at the roughly 7 early childhood-focused communities, for whom the instrument is required; or (2) children aged 0 to 5 at other communities, where the instrument is optional (we estimate that 1/3 of caregivers will be administered the instrument when it is optional). Estimates are based on Phase IV data submitted as of 12/08. 8 Based on Phase IV finding that approximately 63 percent of the children in the evaluation were 11 years old or older. Also includes 318 children/families from the comparison sample. 9 With the exception of the MSSC-R, respondents only complete Service Experience Study measures at follow-up points. See Footnote #3 for the explanation about the average number of responses per respondent. 10 Approximate number of children/families in each sector, for the Sector and Comparison Study. This includes cases within the communities, as well as within the comparison sample. 11 For each community, 1 respondent will be a caregiver and 3 respondents will be administrators/providers. 12 Assumes that each community will use flexible funds expenditures on average for approximately one quarter of the children/youth enrolled. 13 Assumes that three expenditures, on average, will be spent on each child/youth receiving flexible fund benefits. 14 Assumes that each child/youth in system of care communities and in the comparison sample will have 100 service episodes, on average. Written comments and recommendations concerning the proposed information collection should be sent by August 28, 2009 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: July 27, 2009. Elaine Parry, Director, Office of Program Services. [FR Doc. E9-18317 Filed 7-30-09; 8:45 am] BILLING CODE 4162-20-P --- Source: Frix Law Library, https://www.frixlaw.com/law-library/documents/fr%3AE9-18317. Public record. Not legal advice.