Strategic Prevention Framework State Incentive Grant (SPF SIG) Program, Cohorts IV and V

Forms and Documents

Document Name	Status
Form Community Outcomes Community Outcomes Module Form and Instruction	New
SPF-SIG Community Outcomes_SS-B-3_3_16.docx Supporting Statement B	2016-03-04
SPF-SIG Community Outcomes SS-A_3_3_16.docx Supporting Statement A	2016-03-04

IC Document Collections

IC ID	Document Title	Status
220477	Community Outcomes Module Form and Instruction	New

ICR Details

OMB Control No: 0930-0358	ICR Reference No: 201603-0930-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Strategic Prevention Framework State Incentive Grant (SPF SIG) Program, Cohorts IV and V
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: Approved without change	Conclusion Date: 06/17/2016
	Date Received in OIRA: 03/07/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2019	36 Months From Approved
Responses	34	0	0
Time Burden (Hours)	136	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The SPF SIG is a major SAMHSA grant program that supports an array of activities to help grantees and subrecipient communities build a solid foundation for delivering and sustaining substance abuse prevention services that are effective in reducing the incidence and prevalence of substance use as well as improving risk and protective factors associated with substance use. CSAP provides funding to states/territories, jurisdictions, and tribal entities to implement the five steps of the strategic prevention framework (SPF), which are: Step 1: Profile population needs, resources, and readiness to address the problems and gaps in service delivery; Step 2: Mobilize and/or build capacity to address needs; Step 3: Develop a comprehensive strategic plan; Step 4: Implement evidence-based prevention programs, policies, practices and infrastructure development activities; and Step 5: Monitor process, evaluate effectiveness, sustain effective programs/activities, and improve or replace those that fail.

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Authorizing Statute(s): US Code: 42 USC 501 Name of Law: SAMHSA
  

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 75869	12/04/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 10643	03/01/2016
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
Community Outcomes Module	Community Outcomes Module	Community Outcomes Module

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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	34	0	0	34	0	0
Annual Time Burden (Hours)	136	0	0	136	0	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: This is a new data collection.

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Annual Cost to Federal Government: $256,472

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: 03/07/2016

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