2012 National Mental Health Services Survey (N-MHSS)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Locator Questionna Primary Data Collection	Form and Instruction	Modified	Available
Form Locator Questionna New Facilities	Form and Instruction	New	Available
OMB Supporting Statement_N-MHSS_B.docx	Supporting Statement B	Uploaded 2012-05-04	Available
Attachment A2 - Web Screens-Questionnaire.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A3 - CATI Questionnaire.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A8 - Expert Panel.docx	Supplementary Document	Uploaded 2012-05-04	Repair queued
Attachment A7 - Information Site Materials.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A6 - Thank You-Reminder Letter.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A5 - Cover Letter.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A4 - Advance Letter.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A2 - Web Screens-Questionnaire.docx	Supplementary Document	Uploaded 2012-05-04	Available
Attachment A3 - CATI Questionnaire.docx	Supplementary Document	Uploaded 2012-05-04	Available
OMB Supporting Statement_N-MHSS_A.docx	Supporting Statement A	Uploaded 2012-05-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7528	Primary Data Collection	Form and Instruction	Modified
202152	New Facilities	Form and Instruction	New

ICR Details

OMB Control No: 0930-0119	ICR Reference No: 201205-0930-001
Status: Historical Active	Previous ICR Reference No: 200912-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: 2012 National Mental Health Services Survey (N-MHSS)
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: 06/28/2012
	Date Received in OIRA: 05/04/2012
Terms of Clearance: SAMHSA shall report on any adjustments in the universe of facilities when the agency revises the package for the 2014 full N-MHSS. The agency shall add the burden of the locator tool to the burden of the full survey.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2015	36 Months From Approved	02/28/2013
Responses	16,500	0	13,000
Time Burden (Hours)	6,930	0	13,000
Cost Burden (Dollars)	0	0	0

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Abstract: The 2010 N-MHSS differs from the previous version of the survey in the following ways: (a) to facilitate completing the survey online, definitions of terms and other survey information will be offered at the survey website; (b) the eligibility criteria for inclusion in the survey, previously outlined in a flyer accompanying the survey, have now been incorporated into the questionnaire as screening questions; and (c) the questionnaire has been reorganized for greater simplicity and shortened by eliminating several questions identified as no longer relevant.

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Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Data Collection
  

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:
	77 FR 12861	03/02/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 26559	05/04/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Primary Data Collection	Locator Questionnaire	Locator Questionnaire
New Facilities	Locator Questionnaire	Locator Questionnaire

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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	16,500	13,000	0	3,500	0	0
Annual Time Burden (Hours)	6,930	13,000	0	630	-6,700	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: No

Burden Reduction Due to:

Short Statement: The total burden hours for the full-scale 2010 N-MHSS was 13,000 hours based on an estimated response time of one hour for an estimated 13,000 facility respondents. For the 2012 N-MHSS-Locator survey, the estimated burden is 6,930 hours based on an estimated 16,500 facility respondents. The increase in the number of mental health facilities is derived from an expanded search of departments/offices within each state with responsibility for the funding or licensing of mental health treatment facilities; of national and regional accreditation entities; and other national provider organizations and associations. The increase is also due to the N-MHSS-Locator update activity which identifies and collects data from new facilities on a rolling basis. Although the facility universe is larger, there will be a net decrease in burden of 6,070 hours due to an adjustment in that the revised N-MHSS survey instrument is substantially reduced in size, and the estimated time to complete the survey has been reduced from 60 minutes to 25 minutes.

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Annual Cost to Federal Government: $2,200,000

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]? No

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: 05/04/2012

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