Transformation Accountability (TRAC) Reporting System

Forms and Documents

Document Name	Status
Form Child Measures Client-Level Form and Instruction	Modified
Form Result Form Infrastructure, Development, Prevention MH Abstraction Form and Instruction	Modified
0285-SS_B-CMHS 9.1.15.doc Supporting Statement B	2015-12-11
0285-SS_A-CMHS 12.11.15.doc Supporting Statement A	2015-12-11

IC Document Collections

IC ID	Document Title	Status
46632	Client-Level Form and Instruction	Modified
192393	Infrastructure, Development, Prevention MH Abstraction Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0285	ICR Reference No: 201512-0930-002
Status: Historical Active	Previous ICR Reference No: 201302-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 18877
Title: Transformation Accountability (TRAC) Reporting System
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 03/03/2016
	Date Received in OIRA: 12/22/2015
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2019	36 Months From Approved	03/31/2016
Responses	102,076	0	19,449
Time Burden (Hours)	41,815	0	29,298
Cost Burden (Dollars)	0	0	0

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Abstract: This data activity is to provide a level of consistency with the NOMs domain in SAMHSA-wide data collection and reporting of performance measures across all of its Centers and programs. This particular activity will promote the use of consistent measures among CMHS programs, grantees and contractors funded through the Programs of Regional and National Significance (PRNS) and the Children Mental Health Initiative (CMHI) budget lines. The Consumer NOMs recommended by CMHS are a result of extensive examination and recommendations, by panels of staff, experts, and grantees. Wherever feasible, the proposed measures are consistent with or build upon previous data development efforts within CMHS.

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Authorizing Statute(s): US Code: 5 USC 1105 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:
	80 FR 57197	09/22/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 76554	12/09/2015
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Client-Level	Child Measures, Adult Measures	Child Measures ,   Adult Measures
Infrastructure, Development, Prevention MH Abstraction	Result Form	Result Form

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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	102,076	19,449	0	0	82,627	0
Annual Time Burden (Hours)	41,815	29,298	0	0	12,517	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: Currently, there are 29,298 total burden hours in the OMB inventory and CMHS is requesting 48,815 burden hours. The increase of 19,517 is a program change in burden due to the number of overall grant programs and number of respondents receiving mental health treatment services.

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Annual Cost to Federal Government: $1,991,161

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: 12/22/2015

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