Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011

Forms and Documents

Document Name	Status
Form Attachment 4 - App Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011 Form and Instruction	Modified
Attachment5-Commissioner Transmittal Ltr OMB Final.doc Supplementary Document	2007-06-06
Attachment5-Commissioner Transmittal Ltr OMB Final.doc Supplementary Document	2007-06-06
Attachments-1-3.doc Supplementary Document	2008-05-05
Attachment-5-Commissioner Transmittal Ltr OMB Final.doc Supplementary Document	2008-05-05
Attachments-1-3.doc Supplementary Document	2008-05-05
Attachment-5-Commissioner Transmittal Ltr OMB Final.doc Supplementary Document	2008-05-05
0168-08-SS-5-5-08 FINAL.doc Supporting Statement A	2008-05-05

IC Document Collections

IC ID	Document Title	Status
7545	Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011 Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0168	ICR Reference No: 200805-0930-001
Status: Historical Active	Previous ICR Reference No: 200706-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/15/2008
	Date Received in OIRA: 05/06/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2011	36 Months From Approved	08/31/2008
Responses	59	0	59
Time Burden (Hours)	15,710	0	16,595
Cost Burden (Dollars)	0	0	0

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Abstract: The Public Health Service Act authorizes block grants to States for the purpose of providing community based mental health services. Under provision of the law, States may receive allotments only after an application is approved by the Secretary. This submission provides the format and instructions for State application and reporting.

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Authorizing Statute(s): US Code: 5 USC 1917 Name of Law: Application for Grant
  

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:
	73 FR 5200	01/28/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 24602	05/05/2008
Did the Agency receive public comments on this ICR? Yes

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

IC Title	Form No.	Form Name
Community Mental Health Services Block Grant Application Guidance and Instructions, FY 2009-2011	Attachment 4 - Application	Attachment 4 - Application

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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	59	59	0	0	0	0
Annual Time Burden (Hours)	15,710	16,595	0	-885	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Currently there are 16,595 hours in the OMB inventory for the Mental Health Block Grant application process. The program is requesting to reduce the inventory by 885 hours to a total of 15,710. The decrease represents approximately 15 (fifteen) hours per State and is based on proposed revisions to the FY 2009-2011 application as described on the supporting statement.

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Annual Cost to Federal Government: $1,336,152

Does this IC contain surveys, censuses, or employ statistical methods? No

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: 05/06/2008

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