Government Performance and Results Act Client/Participant Outcome Measures

Forms and Documents

Document Name	Status
Form GPRA Tool GPRA Client Outcome Form and Instruction	Modified
0208 CSAT SSB 8.16.18.docx Supporting Statement B	2018-08-20
Final 0208 CSAT SSA 2 25 19.docx Supporting Statement A	2019-02-26

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: 201802-0930-001
Status: Active	Previous ICR Reference No: 201612-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No: 18876
Title: Government Performance and Results Act Client/Participant Outcome Measures
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: 02/27/2019
	Date Received in OIRA: 08/22/2018
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	02/28/2022	36 Months From Approved	01/31/2020
Responses	885,271	0	1,252,030
Time Burden (Hours)	379,037	0	338,748
Cost Burden (Dollars)	0	0	0

---

Abstract: SAMHSA uses the performance measures to report on the performance of its discretionary services grant programs. This information is collected using a client tool that provides CSAT the capacity to report for all of its discretionary program: particular populations served, numbers of people served, types and locations of particular activities supported, effectiveness across programs for particular populations, the characteristics and effectiveness across programs of activities relative to national, subpopulation and geographic area data and trends.

---

Authorizing Statute(s): US Code: 5 USC 1105(a)(29) Name of Law: GPRA
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 19075	05/01/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 42309	08/21/2018
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
GPRA Client Outcome	GPRA Tool, GPRA Tool	GPRA Tool

---

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	885,271	1,252,030	0	-366,759	0	0
Annual Time Burden (Hours)	379,037	338,748	0	40,289	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 338,748 burden hours in the OMB-approved inventory. SAMHSA is now requesting 379,037 hours. The program change is an increase of 40,289 hours due to the addition of the 13 program-specific questions. The estimated time to complete the client interview with the revised tool has been increased from 31 minutes to 36 minutes.

---

Annual Cost to Federal Government: $74,685

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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

---

Common Form ICR:  No

---

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: 08/22/2018

---