School Based Mental Health Application

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
School Based Mental Health Application	Form and Instruction	Modified	Available
1810-0773_SBMH - Supporting Statement A.docx	Supporting Statement A	Uploaded 2022-10-04	Available
2022-21634NFP84.184H SBMH.pdf	Supplementary Document	Uploaded 2022-10-04	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
254613	School Based Mental Health Application	Form and Instruction	Modified

ICR Details

OMB Control No: 1810-0773	ICR Reference No: 202210-1810-002
Status: Active	Previous ICR Reference No: 202207-1810-005
Agency/Subagency: ED/OESE	Agency Tracking No: ED-2022-OESE-0080
Title: School Based Mental Health Application
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: 10/04/2022
	Date Received in OIRA: 10/04/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2025	36 Months From Approved
Responses	300	0	0
Time Burden (Hours)	12,000	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Office of Elementary and Secondary Education (OESE) in the US Department of Education (ED) requests clearance for a new information collection for the discretionary grant application for the School-Based Mental Health Services grant program (SBMH). The SBMH grant program provides grants to local educational agencies (LEAs), State educational agencies (SEAs), and consortia of LEAs. to the number of qualified (i.e., licensed, certified, well-trained, or credentialed) mental health service providers providing school-based mental health services to students in local LEAs with demonstrated need. This program is authorized under section 4631(a)(1)(B) of the Elementary and Secondary Education Act (20 U.S.C. 7281), as amended. The first SBMH grant competition was held in 2020 and was exempt from rulemaking under Section 437(d)(1) of the General Education Provisions Act (GEPA). The Department finalized proposing priorities, requirements, and definitions under the SBMH grant program. The final requirements contain information collection requirements that we are requesting approval for through this request.

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Authorizing Statute(s): US Code: 20 USC 7281 Name of Law: ESEA
  

Citations for New Statutory Requirements: US Code: 20 USC 7281 Name of Law: ESEA

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
1810-AB68	Final or interim final rulemaking	87 FR 60092	10/04/2022

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Federal Register Notices & Comments

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
School Based Mental Health Application	N/A	N/A

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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	300	0	0	300	0	0
Annual Time Burden (Hours)	12,000	0	0	12,000	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: This is new rulemaking collection, therefore, all burden is considered new.

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Annual Cost to Federal Government: $115,760

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: 10/04/2022

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