988 Cooperative Agreements Monitoring Program

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Lifeline Monthly P Lifeline Monthly Progress Reports	Form and Instruction	New	Available
Form Lifeline Key Metri Lifeline Key Metrics (Monthly)	Form and Instruction	New	Available
Form Lifeline Key Metri 988 Lifeline Administrator	Form and Instruction	New	Repair queued
Form Crisis Center Mont Crisis Center Monthly Agenda Template	Form and Instruction	New	Available
Form Crisis Center Data Crisis Center Data Reporting Elements	Form and Instruction	New	Available
Form Crisis Center Data 988 Crisis Center Follow Up Cooperative Agreements	Form and Instruction	New	Repair queued
Form State/Territory: M State/Territory: Mobile Crisis and 988-911 reports	Form and Instruction	New	Available
Form State/Territory: S State/Territory: Sustainability Plan	Form and Instruction	New	Available
Form State/Territory: C State/Territory: Communications Plan	Form and Instruction	New	Available
Form State/Territory: C State/Territory: Chat and Text Report	Form and Instruction	New	Available
Form State/Territory: M State/Territory: Monthly Meeting Call Agenda	Form and Instruction	New	Available
Form State/Territory: P State/Territory: Programmatic QI Plan	Form and Instruction	New	Available
Form State/Territory: Q State/Territory: Quarterly Report	Form and Instruction	New	Available
Form State/Territory: M State/Territory: Monthly Key Metrics	Form and Instruction	New	Available
Form State/Territory: M State and Territory Cooperative Agreements	Form and Instruction	New	Repair queued
Form Tribal Govt: Quali Tribal Govt: Quality Improvement Plan	Form and Instruction	New	Available
Form Tribal Govt: Month Tribal Govt: Monthly Meeting Agenda	Form and Instruction	New	Available
Form Tribal Govt: Semi Tribal Govt: Semi Annual Progress Report	Form and Instruction	New	Available
Form Tribal Govt: Semi Tribal Cooperative Agreements	Form and Instruction	New	Repair queued
0930-NEW_988 Cooperative Agreements Monitoring SSA_ final 5-26-2023.docx	Supporting Statement A	Uploaded 2023-05-26	Repair queued
0930-NEW_988 Cooperative Agreements Monitoring SSA_ final 5-8-2023.docx	Supporting Statement A	Uploaded 2023-05-10	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
260138	988 Lifeline Administrator	Form and Instruction	New	Lifeline Monthly Progress Reports
260138	988 Lifeline Administrator	Form and Instruction	New	Lifeline Key Metrics (Monthly)
260138	988 Lifeline Administrator	Form and Instruction	New
260137	988 Crisis Center Follow Up Cooperative Agreements	Form and Instruction	New	Crisis Center Monthly Agenda Template
260137	988 Crisis Center Follow Up Cooperative Agreements	Form and Instruction	New	Crisis Center Data Reporting Elements
260137	988 Crisis Center Follow Up Cooperative Agreements	Form and Instruction	New
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Mobile Crisis and 988-911 reports
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Sustainability Plan
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Communications Plan
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Chat and Text Report
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Monthly Meeting Call Agenda
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Programmatic QI Plan
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Quarterly Report
260136	State and Territory Cooperative Agreements	Form and Instruction	New	State/Territory: Monthly Key Metrics
260136	State and Territory Cooperative Agreements	Form and Instruction	New
260135	Tribal Cooperative Agreements	Form and Instruction	New	Tribal Govt: Quality Improvement Plan
260135	Tribal Cooperative Agreements	Form and Instruction	New	Tribal Govt: Monthly Meeting Agenda
260135	Tribal Cooperative Agreements	Form and Instruction	New	Tribal Govt: Semi Annual Progress Report
260135	Tribal Cooperative Agreements	Form and Instruction	New

ICR Details

OMB Control No: 0930-0394	ICR Reference No: 202305-0930-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: 988 Cooperative Agreements Monitoring Program
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 05/26/2023
OIRA Conclusion Action: Approved with change	Conclusion Date: 05/26/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/11/2023
Terms of Clearance: In accordance with 5 CFR 1320.13, this information collection is approved for 6 months as a one-time emergency clearance. To continue using this collection after 6 months, the Agency must resubmit an ICR to OMB under the normal PRA clearance process.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2023	6 Months From Approved
Responses	2,147	0	0
Time Burden (Hours)	2,944	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The collection of this information is critical to successfully oversee operational response and quality of service through the 988 Suicide and Crisis Lifeline to ensure connections to care for individuals in suicidal crisis or emotional distress contacting in for 988 phone, chat and text support for connecting local, state/territory and national outcomes and monitoring contractual obligations for current and future 988 grant programs. Much of this information is already embedded in the current 988 Suicide and Crisis Lifeline network administrator grants, the 988 state and territory grant program, or the 988 Tribal Response grant program.

Emergency Justfication: This Emergency ICR is the result of collaboration between SAMHSA and the OIRA Desk officer to obtain approval for instruments related to the 988 Suicide and Crisis Lifeline Notice of Funding Opportunities (NOFOs). The information contained in the instruments was released in the NOFO as required information to be collected from grantees. The Emergency ICR will allow the SAMHSA 988 Program to collect data from grantees while pursuing a permanent ICR approved by OMB for this information collection.

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Authorizing Statute(s): None

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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 4

table that charts list of burden

IC Title	Form No.	Form Name
988 Crisis Center Follow Up Cooperative Agreements	Crisis Center Data Reporting Elements, Crisis Center Monthly Agenda Template	Crisis Center Data Reporting Elements ,   Crisis Center Monthly Agenda Template
988 Lifeline Administrator	Lifeline Key Metrics (Monthly), Lifeline Monthly Progress Reports	Lifeline Key Metrics (Monthly) ,   Lifeline Monthly Progress Reports
State and Territory Cooperative Agreements	State/Territory: Monthly Key Metrics, State/Territory: Quarterly Report , State/Territory: Programmatic QI Plan , State/Territory: Monthly Meeting Call Agenda, State/Territory: Chat and Text Report , State/Territory: Communications Plan , State/Territory: Sustainability Plan , State/Territory: Mobile Crisis and 988-911 reports	State/Territory: Monthly Key Metrics ,   State/Territory: Quarterly Report ,   State/Territory: Programmatic QI Plan ,   State/Territory: Monthly Meeting Call Agenda ,   State/Territory: Chat and Text Report ,   State/Territory: Communications Plan ,   State/Territory: Sustainability Plan ,   State/Territory: Mobile Crisis and 988-911 reports
Tribal Cooperative Agreements	Tribal Govt: Semi Annual Progress Report, Tribal Govt: Monthly Meeting Agenda, Tribal Govt: Quality Improvement Plan	Tribal Govt: Semi Annual Progress Report ,   Tribal Govt: Monthly Meeting Agenda ,   Tribal Govt: Quality Improvement Plan

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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	2,147	0	0	2,147	0	0
Annual Time Burden (Hours)	2,944	0	0	2,944	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: This is a new information collection.

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Annual Cost to Federal Government: $96,421

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: 05/11/2023

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