State Prevention Needs Assessment Surveys: Alcohol and Other Drugs - Cohort V

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
7614	State Prevention Needs Assessment Surveys: Alcohol and Other Drugs - Cohort V	Migrated

ICR Details

OMB Control No: 0930-0213	ICR Reference No: 200004-0930-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: State Prevention Needs Assessment Surveys: Alcohol and Other Drugs - Cohort V
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: 06/23/2000
	Date Received in OIRA: 04/24/2000
Terms of Clearance: Approval is granted for use in concept of the information collection entitled, "State Prevention Needs Assessment Surveys: Alcohol and Other Drugs - Cohort V" through June 2003 under the following conditions: 1. The agency must submit to OMB in writing its revised methodology to increase the response rate to 80% or higher for the Michigan sites, no later than 2 weeks before the agency plans to collect the information. 2. The agency may not collect or sponsor any information collections for the Alabama or Tennessee sites until the State- specific protocols for those states are submitted to OMB in writing and OMB has had at least 3 weeks to review the information. OMB reserves the right to ask for amendments and/or deletions based on the results of the agency's response.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2003	06/30/2003
Responses	41,578	0	0
Time Burden (Hours)	31,226	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The primary purpose of the needs assessment studies is to obtain information that planners can use to set priorities for resource distribution. CSAP's needs assessment contracts with States require the conduct of two surveys: a statewide student survey and community resource assessment survey. This package includes the common model protocols to be used by the three Cohort V states, along with the State-specific protocols for Michigan. State-specific protocols for Alabama and Tennessee will be transmitted as supplementary materials upon their development.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
State Prevention Needs Assessment Surveys: Alcohol and Other Drugs - Cohort V

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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	41,578	0	0	41,578	0	0
Annual Time Burden (Hours)	31,226	0	0	31,226	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:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 04/24/2000

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