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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form N-SUMHSS 2021 Ques N-SUMHSS 2021 Questionnaire	Form and Instruction	New	Available
Form N-SUMHSS 2021 Ques N-SUMHSS (both SU and MH)	Form and Instruction	New	Repair queued
Form N-SUMHSS 2021 CATI N-SUMHSS 2021 CATI Questionnaire	Form and Instruction	New	Repair queued
Form N-SUMHSS 2021 Web N-SUMHSS 2021 Web Survey Prototype	Form and Instruction	New	Available
Form N-SUMHSS 2021 Ques N-SUMHSS 2021 Questionnaire	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 2021 Between Cycles Questionnaire	Form and Instruction	New	Available
Form N-SUMHSS 2021 Betw N-SUMHSS BC	Form and Instruction	New	Repair queued
Form Augmentation Scree Augmentation Screener Questionnaire	Form and Instruction	New	Repair queued
Form Augmentation Scree Augmentation Screener	Form and Instruction	New	Repair queued
Form I-BHS Facility App I-BHS Facility Application Form	Form and Instruction	New	Available
Form I-BHS Facility App I-BHS Facility Application	Form and Instruction	New	Repair queued
Form I-BHS Online State I-BHS Online State Add Update Form	Form and Instruction	New	Available
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 ID	Collection	Type	Status	Form
243269	N-SUMHSS (both SU and MH)	Form and Instruction	New	N-SUMHSS 2021 Questionnaire
243269	N-SUMHSS (both SU and MH)	Form and Instruction	New
243268	N-SUMHSS (either SU or MH)	Form and Instruction	New	N-SUMHSS 2021 CATI Questionnaire
243268	N-SUMHSS (either SU or MH)	Form and Instruction	New	N-SUMHSS 2021 Web Survey Prototype
243268	N-SUMHSS (either SU or MH)	Form and Instruction	New	N-SUMHSS 2021 Questionnaire
243268	N-SUMHSS (either SU or MH)	Form and Instruction	New
243267	N-SUMHSS BC	Form and Instruction	New	N-SUMHSS 2021 Between Cycles Questionnaire
243267	N-SUMHSS BC	Form and Instruction	New
243266	Augmentation Screener	Form and Instruction	New	Augmentation Screener Questionnaire
243266	Augmentation Screener	Form and Instruction	New
243265	I-BHS Facility Application	Form and Instruction	New	I-BHS Facility Application Form
243265	I-BHS Facility Application	Form and Instruction	New
243263	I-BHS	Form and Instruction	New	I-BHS Online State Add Update Form
243263	I-BHS	Form and Instruction	New

ICR Details

OMB Control No: 0930-0386	ICR Reference No: 202008-0930-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: National Substance Use and Mental Health Services Survey (N-SUMHSS)
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: 03/16/2021
Retrieve Notice of Action (NOA)	Date Received in OIRA: 08/24/2020
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2024	36 Months From Approved
Responses	44,300	0	0
Time Burden (Hours)	28,109	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Substance Use and Mental Health Services Survey (N-SUMHSS) is a survey that combines the N-MHSS and N-SSATS into a single survey. As a component of the Behavioral Health Services Information System, the N-SUMHSS will update SAMHSA’s online Behavioral Health Treatment Services Locator for use by the general public, behavioral health professionals, and treatment service providers. The survey will annually collect descriptive data on the location, scope of services provided, and operational characteristics of all known substance use and mental health treatment facilities in the United States, territories and jurisdictions, and on utilization of services by means of a single-day count of clients in treatment.

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Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Demonstration Projects
  

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:
	85 FR 36224	06/15/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 51456	08/20/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Augmentation Screener	Augmentation Screener Questionnaire	Augmentation Screener Questionnaire
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
N-SUMHSS (both SU and MH)	N-SUMHSS 2021 Questionnaire	N-SUMHSS 2021 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 BC	N-SUMHSS 2021 Between Cycles Questionnaire	N-SUMHSS 2021 Between Cycles Questionnaire

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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	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

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: It is estimated that completing the N-SSATS or the N-MHSS will take about 40 minutes (0.67 hours) each, which translates into an average of 80 minutes (1.33 hours) for those facilities that provide both substance use and mental health treatment services. For these facilities that would have responded to both surveys, the combined survey is estimated to take 70 minutes (1.17 hours). Therefore, the N-SUMHSS combined reduces the total number of burden hours by 834 hours to due facilities that provide both mental health and substance use completing only one survey annually.

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Annual Cost to Federal Government: $7,200,000

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? No

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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: 08/24/2020

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