Minority AIDS Initiative: Substance Use Disorder Prevention and Treatment Pilot Program (MAI PT Pilot)

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form MAI PORT MAI PORT	Form and Instruction	Modified	Available
Form MAI PORT MAI PORT	Form and Instruction	Modified	Repair queued
Form MAI PPR MAI PPR	Form and Instruction	Modified	Available
Form MAI PPR MAI PPR	Form and Instruction	Modified	Repair queued
Form MAI ORA Tool MAI ORA Tool	Form and Instruction	Modified	Available
Form MAI ORA Tool Minority ORA	Form and Instruction	Modified	Repair queued
MAI Braided Nonsubstantive Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-09-29	Available
MAI Braided Nonsubstantive Change Request.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2025-09-29	Repair queued
Braided MAI Supporting Statement A (2024.10.25)_CLEAN.docx	Supporting Statement A	Uploaded 2024-11-22	Available
Braided MAI Supporting Statement A (2024.10.25)_CLEAN.docx	Supporting Statement A	Uploaded 2024-11-22	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
272606	MAI PORT	Form and Instruction	Modified	MAI PORT
272606	MAI PORT	Form and Instruction	Modified
272605	MAI PPR	Form and Instruction	Modified	MAI PPR
272605	MAI PPR	Form and Instruction	Modified
272577	Minority ORA	Form and Instruction	Modified	MAI ORA Tool
272577	Minority ORA	Form and Instruction	Modified

ICR Details

OMB Control No: 0930-0399	ICR Reference No: 202509-0930-005
Status: Active	Previous ICR Reference No: 202411-0930-006
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Minority AIDS Initiative: Substance Use Disorder Prevention and Treatment Pilot Program (MAI PT Pilot)
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 11/17/2025
Retrieve Notice of Action (NOA)	Date Received in OIRA: 09/30/2025
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2027	12/31/2027	12/31/2027
Responses	56	0	56
Time Burden (Hours)	208	0	208
Cost Burden (Dollars)	0	0	0

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Abstract: Data collected through the MAI-PORT are necessary to ensure SAMHSA and grantees comply with requirements under the Government Performance and Results Act Modernization Act of 2010 (GPRA) that requires regular reporting of performance measures. Additionally, data collected through these tools will provide critical information to SAMHSA’s Government Project Officers (GPOs) related to grant oversight, including barriers and facilitators that the grantees have experienced, and an understanding of the technical assistance needed to help grantees implement their programs. The information also provides a mechanism to ensure grantees are meeting the requirements of the grant funding announcement as outlined in their notice of grant award. In addition, the tools reflect CSAP and CSAT’s desire to elicit pertinent program level data that can be used not only to guide future programs and practices, but also to respond to stakeholder, congressional, and agency inquiries.

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Authorizing Statute(s): US Code: 5 USC 516 Name of Law: Priority Substance Abuse Prevention Needs of Regional and National Significance
  

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:
	89 FR 55631	07/05/2024
30-day Notice:	Federal Register Citation:	Citation Date:
	89 FR 92133	11/21/2024
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
MAI PORT	MAI PORT	MAI PORT
MAI PPR	MAI PPR	MAI PPR
Minority ORA	MAI ORA Tool	MAI ORA Tool

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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	56	56	0	0	0	0
Annual Time Burden (Hours)	208	208	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new submission

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Annual Cost to Federal Government: $1,130,261

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.     Yes

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: 09/30/2025

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