Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SSA_AOT Evaluation_ASPE Passback_Clean.docx	Supporting Statement A	Uploaded 2018-08-02	Available
AOT 30-DAYFederal Register, Volume 83 Issue 96 (Thursday, May 17, 2018).htm	Supplementary Document	Uploaded 2018-05-18	Available
Attachment A_PAMA 224_AOTEvaluation.pdf	Supplementary Document	Uploaded 2018-05-18	Available
SSB_AOT Evaluation_ASPE Passback_Clean.docx	Supporting Statement B	Uploaded 2018-08-02	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
231549	Cost Questionnaire- Other Site Representatives	Other-questionnaire	New
231499	AOT Characteristics Form	Other-Form	New
231497	Docket Case Monitoring Form	Other-form	New
231496	Cost Questionnaire-Program Administrator	Other-null	New
231495	Family Satisfaction Survey	Other-survey	New
231494	Client Interview Instrument-Comparison Subjects	Other-evaluation	New
231492	Client Interview Instrument-Program Participant	Other-interview	New

ICR Details

OMB Control No: 0990-0465	ICR Reference No: 201805-0990-002
Status: Active	Previous ICR Reference No:
Agency/Subagency: HHS/HHSDM	Agency Tracking No:
Title: Evaluation of the Assisted Outpatient Treatment Grant Program for Individuals with Serious Mental Illness
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 with change	Conclusion Date: 08/24/2018
	Date Received in OIRA: 05/29/2018
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2021	36 Months From Approved
Responses	5,723	0	0
Time Burden (Hours)	3,456	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (HHS) is requesting Office of Management and Budget (OMB) approval for data collection activities to support the evaluation of the Substance Abuse and Mental Health Services Administration’s (SAMHSA’s) Assisted Outpatient Treatment (AOT) Grant Program for Individuals with Serious Mental Illness. Enacted into law on April 1, 2014, Section 224 of the Protecting Access to Medicare Act (PAMA) (Public Law 113-93) mandated a 4-year pilot program of grants to implement AOT programs nationwide [Attachment A]. Section 224(e) required a program evaluation to examine the impact of AOT on cost savings and public health outcomes, incarceration, homelessness, and patient and family satisfaction with program participation.

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Authorizing Statute(s): PL: Pub.L. 113 - 93 224 Name of Law: Protecting Access to Medicare Act (PAMA)
  

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:
	83 FR 4496	01/31/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 22985	05/17/2018
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Client Interview Instrument-Comparison Subjects
Family Satisfaction Survey
Cost Questionnaire- Other Site Representatives
Client Interview Instrument-Program Participant
Cost Questionnaire-Program Administrator
Docket Case Monitoring Form
AOT Characteristics 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	5,723	0	0	5,723	0	0
Annual Time Burden (Hours)	3,456	0	0	3,456	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: NEW COLLECTION

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Annual Cost to Federal Government: $387,574

Does this IC contain surveys, censuses, or employ statistical methods? No

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

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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: 05/29/2018

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