Government Performance and Results Act Client/Participant Outcome Measures

Forms and Documents

Document Name	Status
Form GPRA Client Outcom GPRA Client Outcome Form and Instruction	Modified
0208-SS-B 11.14.13.docx Supporting Statement B	2013-11-14
0208-SS-A 11.14.13.docx Supporting Statement A	2013-11-14

IC Document Collections

IC ID	Document Title	Status
187484	GPRA Client Outcome Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0208	ICR Reference No: 201302-0930-003
Status: Historical Active	Previous ICR Reference No: 201109-0930-004
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 18876
Title: Government Performance and Results Act Client/Participant Outcome Measures
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 11/15/2013
	Date Received in OIRA: 02/20/2013
Terms of Clearance: Ninety day from the date of OMB approval for this package, SAMHSA will submit a plan for any proposed future information collection of this type. This plan will include a discussion of census vs. sampling; universal vs. probabilistic or combined approaches for each type of information collected. The plan will also describe how the information collected is used by SAMHSA and HHS for non statistical purposes, and the impact that various sampling strategies may have on this use. Finally, SAMHSA will consider the relative time burdens for respondents and grantees under each approach, and the impacts of that time burden.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2015	36 Months From Approved	11/30/2013
Responses	1,061,956	0	1,061,956
Time Burden (Hours)	85,498	0	85,498
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:
	77 FR 74855	12/18/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	78 FR 11666	02/19/2013
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 Client Outcome	GPRA Client Outcome Instrument	GPRA Client Outcome Instrument

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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	1,061,956	1,061,956	0	0	0	0
Annual Time Burden (Hours)	85,498	85,498	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $74,685

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]? 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: 02/20/2013

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