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Request for Approval under the “Fast Track Generic Clearance for the Collection of Routine Customer Feedback” (OMB Control Number: 0704-0553)

TITLE OF INFORMATION COLLECTION: Counseling on Access to Lethal Means (CALM) Annual Survey Instrument

PURPOSE: The purpose of this survey is to understand the experience of Military Family-Life Counselors (MFLCs) who receive Counseling on Access to Lethal Means (CALM) training, including their knowledge of CALM techniques following training. CALM trains mental health professionals on how to counsel their clients to reduce the availability of lethal means if they are at heightened risk for suicide. The survey also asks MFLCs about any experience they have administering CALM to clients, including reasons why they may choose not talking about access to lethal means during an engagement, and their perceptions of how clients react to CALM techniques that are discussed. The information collected from the survey is designed to improve future training and implementation of CALM for all MFLCs. The survey also includes a section for MFLC managers or supervisors to respond to that includes questions designed to understand the level of knowledge and skills MFLCs have with CALM and the percentage of MFLCs that have used CALM during their sessions with Service members or their family members.

DESCRIPTION OF RESPONDENTS: Military Family-Life Counselors (MFLCs) are contracted military non-clinical providers, who provide a range of services (e.g., financial, educational, relationship) to Service members and families. The target population includes MFLCs who have received CALM training and Manager/Supervisors of MFLCs who have received training.

TYPE OF COLLECTION: (Check one)

[ ] Customer Comment Card/Complaint Form [X] Customer Satisfaction Survey

[ ] Usability Testing (e.g., Website or Software [ ] Small Discussion Group

[ ] Focus Group [X] Other: Online Survey

CERTIFICATION:

I certify the following to be true:

1. The collection is voluntary.

2. The collection is low-burden for respondents and low-cost for the Federal Government.

3. The collection is non-controversial and does not raise issues of concern to other federal agencies.

4. The results are not intended to be disseminated to the public.

5. Information gathered will not be used for the purpose of substantially informing influential policy decisions.

6. The collection is targeted to the solicitation of opinions from respondents who have experience with the program or may have experience with the program in the future.

Name: Dr. Towanda Street

To assist review, please provide answers to the following question:

Personally Identifiable Information:

1. Is personally identifiable information (PII) collected? [ ] Yes [X] No

2. If Yes, will any information that is collected be included in records that are subject to the Privacy Act of 1974? [ ] Yes [ ] No

3. If Yes, has an up-to-date System of Records Notice (SORN) been published? [ ] Yes [ ] No

Gifts or Payments:

Is an incentive (e.g., money or reimbursement of expenses, token of appreciation) provided to participants? [ ] Yes [X] No

BURDEN HOURS

Category of Respondent	No. of Respondents	Participation Time	Burden
Military Family-Life Counselors (MFLCs)	2500	.25	625
Totals

PUBLIC COST: The estimated annual cost to the public is $13,837.50 if we assume a 100% response rate.

To compute the total estimated annual cost, the total burden hours were multiplied by the average hourly wage for each participant according to wage data compiled by the Bureau of Labor Statistics. For Military Family-Life Counselors, we used data for 2019 on the median hourly wage for “Mental Health Counselors” ($22.14 per hour).

If you are conducting a focus group, survey, or plan to employ statistical methods, please provide answers to the following questions:

The selection of your targeted respondents

1. Do you have a customer list or something similar that defines the universe of potential respondents and do you have a sampling plan for selecting from this universe? [X] Yes [ ] No

If the answer is yes, please provide a description of both below (or attach the sampling plan)? If the answer is no, please provide a description of how you plan to identify your potential group of respondents and how you will select them?

Yes, the employer maintains a list of MFLC employees that have received CALM training. The employer will use this information to survey employees regarding their experiences administering the CALM techniques.

Administration of the Instrument

1. How will you collect the information? (Check all that apply)

[X] Web-based or other forms of Social Media

[ ] Telephone

[ ] In-person

[ ] Mail

[ ] Other, Explain

2. Will interviewers or facilitators be used? [ ] Yes [X] No