Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Attachment 3 - Sur Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)	Form and Instruction	Modified	Available
Certificate of Confidentiality - Consumer Satisfaction (2).tif	Supplementary Document	Uploaded 2009-06-08	Repair queued
NCTSI OMB Renewal Statement_032009.doc	Supporting Statement B	Uploaded 2009-03-23	Available
Other Attachments.zip	Supplementary Document	Uploaded 2009-03-23	Repair queued
NCTSI OMB Renewal Statement_032009.doc	Supporting Statement A	Uploaded 2009-03-23	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7691	Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)	Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0276	ICR Reference No: 200903-0930-002
Status: Historical Active	Previous ICR Reference No: 200709-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)
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: 07/14/2009
	Date Received in OIRA: 03/26/2009
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2012	36 Months From Approved	07/31/2009
Responses	419,720	0	19,599
Time Burden (Hours)	11,333	0	17,222
Cost Burden (Dollars)	0	0	0

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Abstract: The NCTSI comprises of a nationwide network of grantees involved in diverse ways with improving access to care raising the standard of care for children exposed to trauma. Data is collected on information on the traumatized children's events, support they are receiving, and interventions and treatment they are receiving.

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Authorizing Statute(s): US Code: 31 USC 582 Name of Law: Provisions Relating to Services for Children and Adolescents
  

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:
	74 FR 4442	01/26/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 11741	03/19/2009
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
Cross-Site Evaluation of the National Child Traumatic Stress Initiative (NCTSI)	Attachment 3 - Surveys	Attachment 3 - Surveys

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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	419,720	19,599	0	400,121	0	0
Annual Time Burden (Hours)	11,333	17,222	0	-5,889	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: The current hours in the OMB inventory is 17,222. The program is requesting 11,333 annual hours for this submission, a reduction of -5,889 annual hours. This revision responds to a variety of minor changes: (1) revision of the TIS Survey to remove 4 pages of content; (2) a change in the method of data collection for the PDDS, and (3) a change in the recruitment of provider respondents for the GAAS.

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Annual Cost to Federal Government: $3,577,321

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: 03/26/2009

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