Recovery Services for Adolescents and Families (RSAF)

ICR 200912-0930-003

OMB: 0930-0311

Federal Form Document

ICR Details
0930-0311 200912-0930-003
Historical Inactive
HHS/SAMHSA
Recovery Services for Adolescents and Families (RSAF)
New collection (Request for a new OMB Control Number)   No
Regular
Withdrawn 03/01/2010
Retrieve Notice of Action (NOA) 12/12/2009
Withdrawn at the request of HHS/SAMHSA dated 3/1/2010.
  Inventory as of this Action Requested Previously Approved
36 Months From Approved
0 0 0
0 0 0
0 0 0

There will be 28 data collection forms used for gathering baseline and clinical data, monitoring preliminary outcomes, and monitoring implementation of the project's recovery support services. Adolescent participants will be asked to complete 3 forms, and collateral participants (parent/guardians) will be asked to complete 6 forms. Staff (consisting of Project Coordinators, Telephone Support Volunteers, Social Networking Site Moderators, Family Support Clinicians, and Support Services Supervisors) will be asked to complete 19 unique forms, with no individual completing more than 7 forms.

US Code: 5 USC 501 Name of Law: SAMHSA
  
None

Not associated with rulemaking

  74 FR 22936 05/15/2009
74 FR 59549 11/18/2009
No

7
IC Title Form No. Form Name
RSAF - Adolescent Adolescent Instruments Adolescent Instruments
RSAF - Collateral Collateral Instruments Collateral Instruments
RSAF - Project Coordinator Project Coordinator Instruments Project Coordinator Instruments
RSAF - Telephone Support Volunteer Telephone Support Volunteer Instruments Telephone Support Volunteer Instruments
RSAD - Social Network Site Moderator Social Network Site Moderator Social Network Site Moderator
RSAF - Family Program Clinician Family Program Clinician Instruments Family Program Clinician Instruments
RSAF - Support Services Supervisor Support Services Supervisor Instruments Support Services Supervisor Instruments

Yes
Miscellaneous Actions
No
This is a new data collection.

$1,197,336
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
No
Uncollected
Summer King 2402761243

  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
12/12/2009


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