Memo Revision to Questions

TO: Julie Wise

SAMHSA OMB Desk Officer

FROM: Summer King

SAMHSA Clearance Officer

SUBJECT: Non-Substantive Changes to OMB No. 0930-0277

As described in my email on 4/13/10, SAMHSA’s data collection, Transformation Accountability (TRAC) Reporting System (OMB No.0930-0285) updated questions.   This data collection is SAMHSA’s National Outcome Measures (NOMs) for Mental Health.   The NOMS data collection package was approved on 5/6/10. To ensure that SAMHSA is consistent in their data collection efforts, SAMHSA would like to delete/revise some questions to the Jail Diversion and Trauma Recovery Evaluation (OMB No. 0930-0277) to be consistent with the approved NOMs questions.  Your response to this email indicated that SAMHSA should be able to submit this as a non-substantive change to the OMB No. 0903-0277 package.

The following table presents the items from the approved NOMS package (OMB No. 0930-0285) that SAMHSA would like to update in the OMB No. 0930-0277 package to ensure consistency with the NOMS data. This update would affect the 3 Client Interviews in the OMB No. 0930-0277 package.

Action	Data Collection Questions/Source
Update OMB No. 0903-0277 with NOMS OMB No.0930-0285	E4. If employed, is this employment competitive or sheltered? (DELETE QUESTION)
	D3.a Are you paid at or above minimum wage? Are your wages paid directly to you by your employer? Could anyone have applied for this job? (REPLACEMENT QUESTION FOR E4)
ADD approved Questions from NOMS OMB No.0930-0285	B1. How would you rate your overall right now?
	B3a. In the past 30 days, how often did you feel…Nervous? b. Hopeless? c. …Restless or fidgety? d. …So depressed that nothing could cheer you up? e… that everything was an effort? f. …Worthless?
	B4. a. In the past 30 days, how often have you used…Tobacco products (cigarettes, chewing tobacco, cigars) b. …Alcoholic beverages (beer, wine, liquor) b1. (If b>= once or more and respondent male) How many times in the past 30 days have you had five or more drinks in a day? b2. (If b>= once or more and respondent not male) How many times in the past 30 days have you had four or more drinks? c. In the past 30 days, how often have you used…Cannabis (marijuana, pot, grass, hash, etc)? d. …Cocaine (coke, crack, etc)? e. …Prescription stimulants (Ritalin, Concerta, Dexedrine, Adderall, diet pills) f. …Methamphetamine (speed, crystal meth, ice, etc) g. …Inhalants (nitrous oxide, glue, gas, paint thinner, etc) h. …Sedatives or sleeping pills (Valium, Serapax, Ativan, Librium, Xanax, Rohynol, GHB, etc) i. …Hallucinogens (LSD, acid, mushroom, PCP, Special K, ecstasy, etc) j. …Street opioids (heroin, opium, etc) k …Prescription opioids (fentanyl, oxycodone [OxyContin, Percocet], hydrocodone [Vicodin], methadone, buprenorphine, etc)? l…Other drugs-specify? Specify:_______
	C.1. b. In the past 30 days, how many: Nights have you spent in a hospital for mental health care? c. …nights have you spent in a facility for detox/inpatient or residential treatment? d….nights have you spent in a correctional facility, including jail or prison? e…times have you gone to an emergency room for psychiatric or emotional problems
Delete Questions from OMB No. 0903-0277	SA1.a.During the past 30 days, how many days have you used any alcohol (beer, wine, liquor)? b. During the past 30 days how many days have you used alcohol to intoxication (5+ drinks in one setting)? c. During the past 30 days how many days have you used street or illicit drugs(e.g. marijuana, crack, cocaine, heroin, amphetamines, hallucinogens, or other substances)? d. During the past 30 days how many days have you used non-medical use of prescription drugs that were prescribed for your or someone else?
	SV1.iiDuring the past 30 days did you receive inpatient treatment for mental or emotional difficulties?
	SV1.iii During the past 30 days did you receive inpatient treatment for alcohol or substance abuse?

Due to the deletion of questions from OMB No. 0903-0277 in combination with the addition of approved OMB No. 0903-0285 items, SAMHSA does not believe there is a change in burden hours. To ensure that data collection is not interrupted, SAMHSA would like update OMB No. 0930-0277 with the approved OMB No. 0930-0285 as soon as possible. Is it possible for the non-substantive changes to the OMB No. 0930-0277 package to be approved without going through full OMB review? If the SAMHSA Clearance Officer needs to make a formal request through ICRAS; may the program allow three Grantees to collect data using the approved NOMS questions starting June 1^st?