Community MH Services BG and SAPT BG Application Guidance and Instructions FY 2019-2021

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form BG Application Block Grant Application	Form and Instruction	Unchanged	Repair queued
2020-2021 Report MHBG edits 8-11-21_.docx	Supplementary Document	Uploaded 2021-08-19	Repair queued
FY 2020-2021SABG Report 8-2021 _.docx	Supplementary Document	Uploaded 2021-08-19	Missing upstream
Block Grant Emergency Change Supporting 8-4-2021.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-08-19	Available
2022 MHBG Table 6- Addition of COVID and ARP columns.docx	Supplementary Document	Uploaded 2021-06-17	Available
2022 MHBG Table 2 ARP Mock up with date change.docx	Supplementary Document	Uploaded 2021-06-17	Missing upstream
Mockups for Tables 4-5a-5b-5c-6 for SABG Application-Plan 6-16-2021.docx	Supplementary Document	Uploaded 2021-06-17	Repair queued
Proposed Change to FY 2022-2023 MHBG-SABG Application Table 2-State Agency Planned Expenditure for COVID-19 Relief Funds 04012021 FINAL edits 4-8-21.docx	Supplementary Document	Uploaded 2021-06-17	Repair queued
MHBG Plan Table 2 mockup for COVID Expeditures.docx	Supplementary Document	Uploaded 2021-06-17	Repair queued
2020-2021 MHBG Table 6- Addition of COVID column.docx	Supplementary Document	Uploaded 2021-06-17	Repair queued
Proposed Change to FY 2022-2023 MHBG-SABG Application Table 2-State Agency Planned Expenditure for COVID-19 Relief Funds 04012021 FINAL.docx	Supplementary Document	Uploaded 2021-04-20	Missing upstream
Block Grant Emergency Change Supporting 4-14-2021_CLEAN.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2021-04-20	Missing upstream
BG Supporting Statement 1.8.19.docx	Supporting Statement A	Uploaded 2019-01-08	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
7545	Block Grant Application	Form and Instruction	Unchanged

ICR Details

OMB Control No: 0930-0168	ICR Reference No: 202108-0930-001
Status: Received in OIRA	Previous ICR Reference No: 202104-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Community MH Services BG and SAPT BG Application Guidance and Instructions FY 2019-2021
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 08/27/2021
Date Submitted to OIRA: 08/23/2021

table that charts list comparision

	Requested	Previously Approved
Expiration Date	6 Months From Approved	12/31/2021
Responses	119	119
Time Burden (Hours)	33,374	33,374
Cost Burden (Dollars)	0	0

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Abstract: SAMHSA's SAPTBG and MHSBG are designed to provide States with the flexibility to design and implement activities and services to address the complex needs of individuals, families, and communities impacted by mental disorders, substance use disorders and associated problems. The goals of the Block Grant programs are consistent with SAMHSA's vision for a high-quality, self-directed, and satisfying life in the community for everyone in America.

Emergency Justfication: The Emergency changes to the 2022 Mental Health and Substance Abuse Block Grant Report are necessary to collect data on the Consolidated Appropriations Act, 2021 (COVID-19) and American Rescue Plan, 2021 (ARP) supplemental funding expenditure during the 2022 reporting period (7/1/2020 – 6/30/2021). Submission of an Emergency Review will ensure that SAMHSA is able to collect data between 9/1/2021 and 12/1/2021 for the 2022 Mental Health and Substance Abuse Block Grant Report due the end of December 2021.

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Authorizing Statute(s): US Code: 42 USC 1932 Name of Law: Application for Grant - SAPT
   US Code: 42 USC 1917 Name of Law: Application for Grant - MH
  

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 53492	10/23/2018
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
Block Grant Application	BG Application	BG Application

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ICR Summary of Burden

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	119	119	0	0	0	0
Annual Time Burden (Hours)	33,374	33,374	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $1,715,368

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? Yes

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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: 08/23/2021

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