Survey of Current and Alumni SAMHSA Fellows of the Minority Fellowship Program (MFP)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form Alumni Fellows Alumni Fellows	Form and Instruction	Modified	Available
Form Alumni Fellows Alumni Fellows Survey	Form and Instruction	Modified	Repair queued
Form Current Fellows Current Fellows	Form and Instruction	Modified	Repair queued
Form Current Fellows Current Fellows Survey	Form and Instruction	Modified	Repair queued
ATTACHMENT C-MFP Reminders-Surveys-3-week and 5-week Reminder emails 2023 _5-2-2023_CLEAN_MTC_9-28-23.docx	Supplementary Document	Uploaded 2024-01-05	Repair queued
MFP_0304-SS-B_8-24-2023-bma-csat-mtc_CLEAN_mtc_9-13-23_CLEAN_MTC_9-28-23.docx	Supporting Statement B	Uploaded 2024-01-05	Repair queued
MFP_0304-SS-A_LN_3.14.23_CLEAN_MTC_9-28-23.docx	Supporting Statement A	Uploaded 2024-01-05	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
212643	Alumni Fellows Survey	Form and Instruction	Modified	Alumni Fellows
212643	Alumni Fellows Survey	Form and Instruction	Modified
189380	Current Fellows Survey	Form and Instruction	Modified	Current Fellows
189380	Current Fellows Survey	Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0304	ICR Reference No: 202401-0930-001
Status: Active	Previous ICR Reference No: 201603-0930-007
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Survey of Current and Alumni SAMHSA Fellows of the Minority Fellowship Program (MFP)
Type of Information Collection: Reinstatement without change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 03/04/2024
Retrieve Notice of Action (NOA)	Date Received in OIRA: 01/08/2024
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
Responses	3,411	0	0
Time Burden (Hours)	1,433	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The current SAMHSA MFP Fellows currently receiving support during their master’s-level program, doctoral-level training or psychiatric residency will be asked about their experiences in the MFP (from recruitment into the program through their participation in the various activities provided by the Grantees). The MFP Alumni who participated in the MFP during the time the program was administered by SAMHSA will be asked about their previous experiences as Fellows in the MFP and also about their subsequent involvement and leadership in their professions.

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Authorizing Statute(s): US Code: 42 USC 505 Name of Law: Data Collection
  

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 72771	10/23/2023
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 83	01/02/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

table that charts list of burden

IC Title	Form No.	Form Name
Alumni Fellows Survey	Alumni Fellows	Alumni Fellows
Current Fellows Survey	Current Fellows	Current Fellows

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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	3,411	0	0	2,983	0	428
Annual Time Burden (Hours)	1,433	0	0	1,253	0	180
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: Currently, there are 2,000 burden hours in the OMB inventory. SAMHSA is requesting 1,433 hours. This adjustment is due to reduction in burden for future surveys because the attrition among alumni fellows and the same time to complete the alumni survey based on previous years remains the same at .42 hours.

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Annual Cost to Federal Government: $49,098

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: 01/08/2024

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