Division of State Programs—Management Reporting Tool (DSP-MRT)

Forms and Documents

Document Name	Status
Form STOP Act Supplemen STOP Act Supplemental Form and Instruction	New
Form PFS Supplemental PFS Supplemental Form and Instruction	Modified
Form PDO/FR CARA Supple PDO/FR CARA Supplemental Form and Instruction	Modified
Form SPF-RX SPF-Rx Supplemental Form and Instruction	Modified
Form DSP-MRT Standard T DSP-MRT Standard Tool Form and Instruction	Modified
DSP_MRT_SS_A_DSP_MRT 2021_CLEAN.docx Supporting Statement A	2021-09-24

IC Document Collections

IC ID	Document Title	Status
249487	STOP Act Supplemental Form and Instruction	New
232354	PFS Supplemental Form and Instruction	Modified
227196	PDO/FR CARA Supplemental Form and Instruction	Modified
227195	SPF-Rx Supplemental Form and Instruction	Modified
219387	DSP-MRT Standard Tool Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0354	ICR Reference No: 202109-0930-002
Status: Received in OIRA	Previous ICR Reference No: 201807-0930-001
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Division of State Programs—Management Reporting Tool (DSP-MRT)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 09/27/2021

	Requested	Previously Approved
Expiration Date	36 Months From Approved	11/30/2021
Responses	2,792	708
Time Burden (Hours)	6,960	1,786
Cost Burden (Dollars)	0	0

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Abstract: The Division of State Program -Monitoring and Reporting Tool will air to address underage drinking (UAD; age 12 to 20) and prescription drug misuse and abuse (PDM; age 12 to 25) . This data collection will allow all DSP programs to report into a standard tool that aligns with the Strategic Prevention Framework model. This request for data collection includes a revision from a previously approved OMB instrument formally known as Partnerships for Success-Management and Reporting Tool.

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Authorizing Statute(s): US Code: 42 USC 516 Name of Law: Priority SAP Needs of Regional and National Significance
  

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:
	86 FR 38107	07/19/2021
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 52917	09/23/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
DSP-MRT Standard Tool	DSP-MRT Standard Tool	DSP-MRT Standard Tool
PDO/FR CARA Supplemental	PDO/FR CARA Supplemental	PDO/FR CARA Supplemental
PFS Supplemental	PFS Supplemental	PFS Supplemental
SPF-Rx Supplemental	SPF-RX	SPF-RX
STOP Act Supplemental	STOP Act Supplemental	STOP Act Supplemental

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ICR Summary 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	2,792	708	0	2,084	0	0
Annual Time Burden (Hours)	6,960	1,786	0	5,174	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: Changing Regulations

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

Burden Reduction Due to:

Short Statement: Currently there are 1,786 burden hours in the OMB inventory. The program is requesting 6,960 hours, an increase of 5,164 hours. This increase is primarily due to the significant increase in the number of grants funded, from 117 to 521, and subsequent increase in the number of respondents. The increase in burden is also attributable to the addition of the STOP act survey and the new performance metrics but these increases are partially offset with removal of requirement to submit meeting minutes.

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Annual Cost to Federal Government: $832,086

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? 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: 09/27/2021

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