Social Network Analysis of a Service System for Transition Aged Youth

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Instrument Instrument	Form and Instruction	New	Available
CC-06-SS.doc	Supporting Statement B	Uploaded 2006-09-15	Available
reqSAMHSAnewSocial.rtf	Supplementary Document	Uploaded 2006-10-03	Available
CC-06-SS.doc	Supporting Statement A	Uploaded 2006-09-15	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
45603	Social Network Analysis of a Service System for Transition Aged Youth	Form and Instruction	New	Instrument

ICR Details

OMB Control No: 0930-0283	ICR Reference No: 200610-0930-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Social Network Analysis of a Service System for Transition Aged Youth
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: 01/16/2007
Retrieve Notice of Action (NOA)	Date Received in OIRA: 10/06/2006
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	36 Months From Approved
Responses	110	0	0
Time Burden (Hours)	138	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Social Network Analysis Questionnaire obtains information about the relationships between a wide array of organizations that provide services and include individuals with serious mental health conditions between the ages of 16 and 25 in their clientele. The objective of this questionnaire is to assess changes in the relationships between these organizations in one community, Clark County Washington, as a result of a Center for Mental Health Services funded grant initiative, the Partnership for Youth Transition Program (PYT).

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Authorizing Statute(s): US Code: 5 USC 561 Name of Law: comprehensive Community Mental Health Services for Children with Serious Emotional Distrubances
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 6081	02/06/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 52810	08/07/2006
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Social Network Analysis of a Service System for Transition Aged Youth	Instrument	Instrument

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ICR Summary of Burden

table that charts list 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	110	0	0	110	0	0
Annual Time Burden (Hours)	138	0	0	138	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This new project.

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Annual Cost to Federal Government: $101

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: 10/03/2006

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