Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Attachment 7 - Ins Attachment 7 - Instruments	Form and Instruction	New	Available
Form Attachment 6 - Con Attachment 6 - Consent Form	Form and Instruction	New	Available
Form Attachment 6 - Con Attachment 6 - Consent Form	Form and Instruction	New	Available
Form Attachment 5 - Ins Attachment 5 - Instruments	Form and Instruction	New	Available
Form Attachment 3 - Ins Attachment 3 - Instruments	Form and Instruction	New	Available
Form Attachments 1a and Attachments 1a and 1b - Instruments	Form and Instruction	New	Available
Form Attachments 1a and Attachments 1a and 1b - Instruments	Form and Instruction	New	Available
TCE-HIV_OMB_Supporting_Statement_07-14-2010_FINAL.docx	Supporting Statement B	Uploaded 2010-07-14	Available
Attachment 8.pdf	Supplementary Document	Uploaded 2010-08-02	Available
Attachment 4.pdf	Supplementary Document	Uploaded 2010-08-02	Available
Attachments 2a, 2b, 2c, and 2d.pdf	Supplementary Document	Uploaded 2010-08-02	Available
Attachments 2a, 2b, 2c, and 2d.pdf	Supplementary Document	Uploaded 2010-08-02	Available
TCE-HIV_OMB_Supporting_Statement_07-14-2010_FINAL.docx	Supporting Statement A	Uploaded 2010-07-14	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
194046	Collaborators/Partners	Form and Instruction	New	Attachment 7 - Instruments
194045	Direct Service - Dosage	Form and Instruction	New	Attachment 6 - Consent Form
194044	Direct Service - Staff	Form and Instruction	New	Attachment 6 - Consent Form
194044	Direct Service - Staff	Form and Instruction	New	Attachment 5 - Instruments
194043	Administrator - PD/PM	Form and Instruction	New	Attachment 3 - Instruments
194042	Client FG	Form and Instruction	New	Attachments 1a and 1b - Instruments
194041	Client Survey	Form and Instruction	New	Attachments 1a and 1b - Instruments

ICR Details

OMB Control No: 0930-0317	ICR Reference No: 201008-0930-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV)
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OIRA Conclusion Action: Withdrawn	Conclusion Date: 10/20/2010
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/03/2010
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This data collection is to study the risk and protective factors related to substance use and HIV. The primary purpose of the Project is to conceptualize, plan, and implement a multi-site valuation to investigate the process, outcome, and effect of substance abuse treatment and HIV/AIDS services provided by 48 SAMHSA grantees. The grantees' focus is on enhancing and expanding substance abuse treatment and/or outreach and pretreatment services in conjunction with HIV/ AIDS services in African American, Hispanic/Latino, and other racial and ethnic minority communities.

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Authorizing Statute(s): US Code: 5 USC 509 Name of Law: Priority Substance Abuse Treatment Needs of Regional and National Significance
  

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 54830	10/23/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 35818	06/23/2010
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Administrator - PD/PM	Attachment 3 - Instruments	Attachment 3 - Instruments
Client FG	Attachments 1a and 1b - Instruments	Attachments 1a and 1b - Instruments
Client Survey	Attachments 1a and 1b - Instruments	Attachments 1a and 1b - Instruments
Collaborators/Partners	Attachment 7 - Instruments	Attachment 7 - Instruments
Direct Service - Dosage	Attachment 6 - Consent Form	Attachment 6 - Consent Form
Direct Service - Staff	Attachment 5 - Instruments, Attachment 6 - Consent Form	Attachment 5 - Instruments ,   Attachment 6 - Consent Form

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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 is a new data collection.

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Annual Cost to Federal Government: $2,531,000

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]? No

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: 08/03/2010

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