National Substance Use and Mental Health Services Survey (N-SUMHSS) [CBHSQ]

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form N-SUMHSS EHR Suppl N-SUMHSS EHR Supplement	Form and Instruction	New	Available
Form N-SUMHSS EHR Suppl N-SUMHSS EHR Supplement	Form and Instruction	New	Repair queued
Form N-SUMHSS VA Supple N-SUMHSS VA Supplement	Form and Instruction	New	Available
Form N-SUMHSS VA Supple N-SUMHSS VA Supplement	Form and Instruction	New	Repair queued
Form N-SUMHSS Questionn N-SUMHSS Questionnaire	Form and Instruction	Modified	Available
Form N-SUMHSS Questionn N-SUMHSS (both SU and MH)	Form and Instruction	Modified	Repair queued
Form N-SUMHSS Questionn N-SUMHSS Questionnaire	Form and Instruction	Modified	Available
Form N-SUMHSS Questionn N-SUMHSS (either SU or MH)	Form and Instruction	Modified	Repair queued
Form N-SUMHSS Between C N-SUMHSS Between Cycle Questionnaire	Form and Instruction	Modified	Available
Form N-SUMHSS Between C N-SUMHSS BC	Form and Instruction	Modified	Repair queued
Form Augmentation Scree Augmentation Screener Questionnaire	Form and Instruction	Modified	Available
Form Augmentation Scree Augmentation Screener	Form and Instruction	Modified	Repair queued
Form I-TF Facility Regi I-TF Facility Registration Application Form	Form and Instruction	Modified	Available
Form I-TF Facility Regi I-TF Facility Registration Application Form	Form and Instruction	Modified	Repair queued
Form I-TF Online State I-TF Online State Add Update Form	Form and Instruction	Modified	Available
Form I-TF Online State I-TF Online State Add Update Form	Form and Instruction	Modified	Repair queued
Attachment 11. N-SUMHSS Web Survey Prototype final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 10. N-SUMHSS CATI Interviewer Instructions final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 9. N-SUMHSS Information Website final.docx	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 8. N-SUMHSS Reminder Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 7. N-SUMHSS Thank-you Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 6. N-SUMHSS Client Counts Worksheet final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 5. N-SUMHSS FAQs final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 4. N-SUMHSS Web Access Instructions final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 3. Sample State Invitation Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 2.3 N-SUMHSS Third Cover Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 2.2 N-SUMHSS Second Cover Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 2.1 N-SUMHSS Cover Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 1.2 N-SUMHSS Between Cycle Advance Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
Attachment 1.1 N-SUMHSS Advance Letter final.pdf	Supplementary Document	Uploaded 2023-11-30	Repair queued
4. Supporting Statement A N-SUMHSS 2023 final _202308.docx	Supporting Statement A	Uploaded 2023-11-30	Repair queued
5. Supporting Statement B N-SUMHSS 2023_final _202308.docx	Supporting Statement B	Uploaded 2023-11-30	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
263749	N-SUMHSS EHR Supplement	Form and Instruction	New	N-SUMHSS EHR Supplement
263749	N-SUMHSS EHR Supplement	Form and Instruction	New
263748	N-SUMHSS VA Supplement	Form and Instruction	New	N-SUMHSS VA Supplement
263748	N-SUMHSS VA Supplement	Form and Instruction	New
243269	N-SUMHSS (both SU and MH)	Form and Instruction	Modified	N-SUMHSS Questionnaire
243269	N-SUMHSS (both SU and MH)	Form and Instruction	Modified
243268	N-SUMHSS (either SU or MH)	Form and Instruction	Modified	N-SUMHSS Questionnaire
243268	N-SUMHSS (either SU or MH)	Form and Instruction	Modified
243267	N-SUMHSS BC	Form and Instruction	Modified	N-SUMHSS Between Cycle Questionnaire
243267	N-SUMHSS BC	Form and Instruction	Modified
243266	Augmentation Screener	Form and Instruction	Modified	Augmentation Screener Questionnaire
243266	Augmentation Screener	Form and Instruction	Modified
243265	I-TF Facility Registration Application Form	Form and Instruction	Modified	I-TF Facility Registration Application Form
243265	I-TF Facility Registration Application Form	Form and Instruction	Modified
243263	I-TF Online State Add Update Form	Form and Instruction	Modified	I-TF Online State Add Update Form
243263	I-TF Online State Add Update Form	Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0386	ICR Reference No: 202311-0930-001
Status: Active	Previous ICR Reference No: 202008-0930-002
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: National Substance Use and Mental Health Services Survey (N-SUMHSS) [CBHSQ]
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/22/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/30/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/2027	36 Months From Approved	03/31/2024
Responses	82,150	0	44,300
Time Burden (Hours)	39,033	0	28,109
Cost Burden (Dollars)	0	0	0

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Abstract: The National Substance Use and Mental Health Services Survey (N-SUMHSS) is a survey that combines the N-MHSS and N-SSATS into a single survey. As a component of the Behavioral Health Services Information System, the N-SUMHSS will update SAMHSA’s online Behavioral Health Treatment Services Locator for use by the general public, behavioral health professionals, and treatment service providers. The survey will annually collect descriptive data on the location, scope of services provided, and operational characteristics of all known substance use and mental health treatment facilities in the United States, territories and jurisdictions, and on utilization of services by means of a single-day count of clients in treatment.

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Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Demonstration Projects
  

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:
	88 FR 63591	09/15/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 82388	11/24/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
Augmentation Screener	Augmentation Screener Questionnaire	Augmentation Screener Questionnaire
I-TF Facility Registration Application Form	I-TF Facility Registration Application Form	I-TF Facility Registration Application Form
I-TF Online State Add Update Form	I-TF Online State Add Update Form	I-TF Online State Add Update Form
N-SUMHSS (both SU and MH)	N-SUMHSS Questionnaire	N-SUMHSS Questionnaire
N-SUMHSS (either SU or MH)	N-SUMHSS Questionnaire	N-SUMHSS Questionnaire
N-SUMHSS BC	N-SUMHSS Between Cycle Questionnaire	N-SUMHSS Between Cycle Questionnaire
N-SUMHSS EHR Supplement	N-SUMHSS EHR Supplement	N-SUMHSS EHR Supplement
N-SUMHSS VA Supplement	N-SUMHSS VA Supplement	N-SUMHSS VA Supplement

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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	82,150	44,300	0	37,850	0	0
Annual Time Burden (Hours)	39,033	28,109	0	10,924	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: SAMHSA proposes a new annualized burden hours of 39,033, an increase of 10,783 hours from the prior estimate of 28,250 annualized burden hours. SAMHSA increases and provides a more accurate estimate on the average burden hours per response. The new N-SUMHSS VA Supplement and N-SUMHSS EHR Supplement lead to additional annualized burden hours. An increase in the number of facilities submitting responses to the I-TF Facility Registration Application Form. Slight increases in the number of respondents to the I-TF Online State Add Update Form and decreases in the number of responses per state, based on the I-TF administrative records in recent years.

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Annual Cost to Federal Government: $7,200,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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: 11/30/2023

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