Government Performance and Results Act Client/Participant Outcome Measures

Forms and Documents

Document	Type	Status	Availability
Form Attachment 1-1 CSA Government Performance and Results Act Client/Participant Outcome Measures	Form and Instruction	Removed	Available
Form CSAT GPRA Form and GPRA/NOMs	Form and Instruction	New	Repair queued
Form Attachment 1-1 CSA CSAP/CSAT GPRA	Form and Instruction	Removed	Repair queued
Form Attachment 1-1 CSA CSAP/CSAT GPRA	Form and Instruction	Removed	Available
Form Attachment 1-2 CSA CSAP/CSAT GPRA	Form and Instruction	Removed	Repair queued
0208-SS-10-15-08.doc	Supporting Statement B	Uploaded 2008-12-01	Available
Attachment 5 Sample Reports.doc	Supplementary Document	Uploaded 2008-12-01	Repair queued
Attachment 4 Consent Form.doc	Supplementary Document	Uploaded 2008-12-01	Repair queued
Attachment 3 Data Entry Screens.doc	Supplementary Document	Uploaded 2008-12-01	Repair queued
Attachment 2 GPRA Matrix.doc	Supplementary Document	Uploaded 2008-12-01	Repair queued
1 0208Terms Memo 1-3-07.doc	Supplementary Document	Uploaded 2007-01-08	Available
6 Attachment 6 Reports.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
5 Attachment 5 Consent Form.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
4 Attachment 4 Data Entry Screens.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
3 Attachment 3 GPRA Matrix.doc	Supplementary Document	Uploaded 2007-01-08	Available
1 0208Terms Memo 1-3-07.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
6 Attachment 6 Reports.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
5 Attachment 5 Consent Form.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
4 Attachment 4 Data Entry Screens.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
3 Attachment 3 GPRA Matrix.doc	Supplementary Document	Uploaded 2007-01-08	Available
1 0208Terms Memo 1-3-07.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
6 Attachment 6 Reports.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
5 Attachment 5 Consent Form.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
4 Attachment 4 Data Entry Screens.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
3 Attachment 3 GPRA Matrix.doc	Supplementary Document	Uploaded 2007-01-08	Available
1 0208Terms Memo 1-3-07.doc	Supplementary Document	Uploaded 2007-01-08	Available
6 Attachment 6 Reports.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
5 Attachment 5 Consent Form.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
4 Attachment 4 Data Entry Screens.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
3 Attachment 3 GPRA Matrix.doc	Supplementary Document	Uploaded 2007-01-08	Repair queued
0208-SS-10-15-08.doc	Supporting Statement A	Uploaded 2008-12-01	Repair queued

IC Document Collections

IC ID	Collection	Type	Status	Form
7607	Government Performance and Results Act Client/Participant Outcome Measures	Form and Instruction	Removed
187484	GPRA/NOMs	Form and Instruction	New
178311	CSAP/CSAT GPRA	Form and Instruction	Removed
178310	CSAP/CSAT GPRA	Form and Instruction	Removed
178309	CSAP/CSAT GPRA	Form and Instruction	Removed

ICR Details

OMB Control No: 0930-0208	ICR Reference No: 200812-0930-001
Status: Historical Active	Previous ICR Reference No: 200701-0930-004
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Government Performance and Results Act Client/Participant Outcome Measures
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: 04/28/2009
	Date Received in OIRA: 12/09/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2012	36 Months From Approved	06/30/2010
Responses	1,050,236	0	224,906
Time Burden (Hours)	66,326	0	20,170
Cost Burden (Dollars)	0	0	0

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Abstract: SAMHSA uses the performance measures to report on the performance of its discretionary services grant programs. The information is used by individuals at three different levels: the SAMHSA administrator and staff, the Center administrators and government project officers, and grantees.

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Authorizing Statute(s): US Code: 5 USC 1105(a)(29) Name of Law: GPRA
  

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 51311	09/02/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 72810	12/01/2008
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
GPRA/NOMs	CSAT GPRA Form and Instructions	CSAT GPRA Form and Instructions
Government Performance and Results Act Client/Participant Outcome Measures	Attachment 1-1 CSAT Instructions, Attachment 2-1 CSAP Instructions, Attachment 1-2 CSAT Instruments, Attachment 2-2 CSAP Instruments	Attachment 1-1 CSAT Instructions ,   Attachment 2-1 CSAP Instructions ,   Attachment 1-2 CSAT Instruments ,   Attachment 2-2 CSAP Instruments
CSAP/CSAT GPRA	Attachment 1-1 CSAT Instructions, Attachment 2-1 CSAP Instructions, Attachment 1-2 CSAT Instruments, Attachment 2-2 CSAP Instruments	Attachment 1-2 CSAT Instruments ,   Attachment 2-2 CSAP Instruments ,   Attachment 1-1 CSAT Instructions ,   Attachment 2-1 CSAP Instructions
CSAP/CSAT GPRA	Attachment 1-1 CSAT Instructions, Attachment 2-1 CSAP Instructions, Attachment 1-2 CSAT Instruments, Attachment 2-2 CSAP Instruments	Attachment 1-1 CSAT Instructions ,   Attachment 2-1 CSAP Instructions ,   Attachment 1-2 CSAT Instruments ,   Attachment 2-2 CSAP Instruments
CSAP/CSAT GPRA	Attachment 1-1 CSAT Instructions, Attachment 2-1 CSAP Instructions, Attachment 1-2 CSAT Instruments, Attachment 2-2 CSAP Instruments	Attachment 1-1 CSAT Instructions ,   Attachment 2-1 CSAP Instructions ,   Attachment 1-2 CSAT Instruments ,   Attachment 2-2 CSAP Instruments

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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	1,050,236	224,906	0	825,330	0	0
Annual Time Burden (Hours)	66,326	20,170	0	46,156	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: Currently there are 20,170 hours in the OMB inventory. SAMHSA is requesting a total of 66,326 burden hours, an overall increase of 46,156 hours in the inventory. The program change is due to an increase in burden of 49,720 hours (16,606 to 66,326) due to the addition of clients served by the ATR grantees and an increase of one minute to the current data collection activity.

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Annual Cost to Federal Government: $7,274,685

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)? No

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: 12/09/2008

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