Transformation Accountability (TRAC) Reporting System

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Adult Tool with Re Client-Level	Form and Instruction	Modified	Available
Form Result Form Infrastructure, Development, Prevention MH Abstraction	Form and Instruction	Unchanged	Repair queued
0285-SS_A-CMHS 12-12-16.doc	Supporting Statement A	Uploaded 2016-12-12	Available
0285-SS_B-CMHS 9-7-16.doc	Supporting Statement B	Uploaded 2016-12-08	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
46632	Client-Level	Form and Instruction	Modified
192393	Infrastructure, Development, Prevention MH Abstraction	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0930-0285	ICR Reference No: 201612-0930-003
Status: Historical Active	Previous ICR Reference No: 201512-0930-002
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 without change	Conclusion Date: 01/23/2017
	Date Received in OIRA: 12/12/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved	03/31/2019
Responses	148,882	0	102,076
Time Burden (Hours)	78,096	0	41,815
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:
	81 FR 69838	10/07/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 89125	12/09/2016
Did the Agency receive public comments on this ICR? No

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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
Client-Level	Adult Tool with Recovery Measures, Child Combined Tool	AdultTool with Recovery Measures ,   Child Combined Tool
Infrastructure, Development, Prevention MH Abstraction	Result Form	Result Form

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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	148,882	102,076	0	46,806	0	0
Annual Time Burden (Hours)	78,096	41,815	0	36,281	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: Currently, there are 48,815 total burden hours in the OMB inventory and CMHS is requesting 78,096 burden hours. The increase of 29,281 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: 12/12/2016

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