Information Collection Request

National Substance Use and Mental Health Services Survey (N-SUMHSS)

ICR 202008-0930-002 · OMB 0930-0386 · Received in OIRA

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form N-SUMHSS 2021 Ques N-SUMHSS (both SU and MH) Form and Instruction New Repair queued
Form N-SUMHSS 2021 Ques N-SUMHSS (either SU or MH) Form and Instruction New Repair queued
Form N-SUMHSS 2021 Betw N-SUMHSS BC Form and Instruction New Repair queued
Form Augmentation Scree Augmentation Screener Form and Instruction New Missing upstream
Form I-BHS Facility App I-BHS Facility Application Form and Instruction New Repair queued
Form I-BHS Online State I-BHS Form and Instruction New Repair queued
OMB SS-A N-SUMHSS v082020.docx Supporting Statement A Uploaded 2020-08-20 Repair queued
OMB SS-B N-SUMHSS_06-25-20.docx Supporting Statement B Uploaded 2020-08-14 Repair queued

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
243269 N-SUMHSS (both SU and MH) Form and Instruction New
243268 N-SUMHSS (either SU or MH) Form and Instruction New
243267 N-SUMHSS BC Form and Instruction New
243266 Augmentation Screener Form and Instruction New
243265 I-BHS Facility Application Form and Instruction New
243263 I-BHS Form and Instruction New

ICR Details

Reginfo record details
table that charts list comparision
  Requested Previously Approved
36 Months From Approved
44,300 0
28,109 0
0 0





Reginfo record details
6
table that charts list of burden
IC Title Form No. Form Name
I-BHS I-BHS Online State Add Update Form I-BHS Online State Add Update Form
I-BHS Facility Application I-BHS Facility Application Form I-BHS Facility Application Form
Augmentation Screener Augmentation Screener Questionnaire Augmentation Screener Questionnaire
N-SUMHSS BC N-SUMHSS 2021 Between Cycles Questionnaire N-SUMHSS 2021 Between Cycles Questionnaire
N-SUMHSS (either SU or MH) N-SUMHSS 2021 Questionnaire, N-SUMHSS 2021 Web Survey Prototype, N-SUMHSS 2021 CATI Questionnaire N-SUMHSS 2021 Questionnaire ,   N-SUMHSS 2021 Web Survey Prototype ,   N-SUMHSS 2021 CATI Questionnaire
N-SUMHSS (both SU and MH) N-SUMHSS 2021 Questionnaire N-SUMHSS 2021 Questionnaire

table that charts list of burden
  Total Request 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 44,300 0 0 44,300 0 0
Annual Time Burden (Hours) 28,109 0 0 28,109 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No