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Agency Information Collection Activities: Submission for OMB Review; Comment Request

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Periodically, the Substance Abuse and Mental Health Services Administration (SAMHSA) will publish a summary of information collection requests under OMB review, in compliance with the Paperwork Reduction Act (44 U.S.C. Chapter 35). To request a copy of these documents, call the SAMHSA Reports Clearance Officer on (240) 276-1243.

Project: Children's Mental Health Initiative National Evaluation—NEW

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS) is requesting approval from the Office of Management and Budget (OMB) for the new collection of data for the Children's Mental Health Initiative (CMHI) National Evaluation.

Evaluation Plan and Data Collection Activities. The purpose of the Children's Mental Health Initiative (CMHI) National Evaluation is to assess the success of the CMHI grants in expanding and sustaining the reach of SOC values, principles, and practices. These include maximizing system-level coordination and planning, offering a comprehensive array of services, and prioritizing family and youth involvement. In order to obtain a clear picture of CMHI grant activities, this longitudinal, multi-level evaluation will measure activities and performance of grantees essential to building and sustaining effective Systems of Care (SOC)'s.

Data collection activities will occur through four evaluation components. Each component includes data collection activities and analyses involving similar topics. Each component has one or more instruments that will be used to address various aspects. The four components with their corresponding data collection activities are as follows:

(1) The Implementation Assessment is designed using a strategic framework that provides five analytic dimensions: (1) Policies, (2) services/supports, (3) financing, (4) training/workforce, and (5) strategic communications. These dimensions cut across the State System, Local System and Service Delivery levels and together link to a range of proximal and distal outcomes. The evaluation will identify and assess the mechanisms and strategies employed to implement and expand systems of care, and explore the impact on system performance and child and family outcomes. Evaluation activities are framed by the five strategic areas to examine whether specific mechanisms and strategies lead to proximal and distal outcomes. System of care principles are woven throughout the framework at both the State and Local levels. Data collection activities include: (A) Key Partner Interviews with high-level administrators, youth and family representatives, and child agencies to organize qualitative data collection into these five areas and to allow within and across grantee evaluation of the implementation and impact of activities in these areas; and (B) the System of Care Expansion and Sustainability Survey (SOCESS), a self-report survey administered to representatives from grantee organizations, family and youth organizations, child-serving sectors, advocacy organizations for diverse populations, provider organizations, and financial officers, among others. The SOCESS is designed to capture self-report implementation data in the five analytic dimensions adopted by the 2015 CMHI National Evaluation.

(2) The Network and Geographic Analysis Component will use Network Analysis Surveys to determine the depth and breadth of the SOC collaboration across agencies and organization. Geographic Information Systems (GIS) will measure the geographic coverage and spread of the SOC, including reaching underserved areas and populations. At the child/youth and family level, Census block groups (derived from home addresses) will be used to depict the geographic spread of populations served by SOCs.

(3) The Financial Component involves the review of implementation grantees' progress in developing financial sustainability and expansion plans. The Financial Mapping Interview and Financing Plan Survey and Interviews will be conducted with financial administrators of Medicaid Agencies, Mental Health Authorities, mental health provider trade associations, and family organizations. The Financial Plan Interview will focus on how the financial planning process supported or hindered attainment of sustainable financing. The Benchmarking Analysis will compare relative rates of access, utilization, and costs for children's mental health services using the Benchmarking Tool and administrative data requested from financial administrators and personnel working with Medicaid Agency and Mental Health Authority reporting and payment systems.

(4) The Child and Family Outcome Component will collect longitudinal data on child clinical and functional outcomes, family outcomes, and child and family background. Data will be collected at intake, 6-months, and 12-months post service entry (as long as the child/youth is still receiving services). Data will also be collected at discharge if the child/youth leaves services before the 12-month data collection point. Data will be collected using the following scales for youth age five and older: (A) a shortened version of the Caregiver Strain Questionnaire, (B) the Columbia Impairment Scale, (C) the Pediatric Symptom Checklist-17, and (D) background information gathered through SAMHSA National Outcomes Measures (NOMS). Data for youth age 0-4 will be collected using the: (A) Baby Pediatric Symptom Checklist; (B) Brief Start Printed Page 12980Infant and Toddler Emotional Assessment; (C) Pre-School Pediatric Symptom Checklist and (D) background information from the NOMS.

Estimated Burden. Data will be collected from 69 grantee sites. Data collection for this evaluation will be conducted over a 4-year period. The average annual respondent burden estimate reflects the average number of respondents in each respondent category, the average number of responses per respondent per year, the average length of time it will take to complete each response, and the total average annual burden for each category of respondent for all categories of respondents combined. Table 1 shows the estimated annual burden estimate by instrument and respondent. Burden is summarized in Table 2.

Table 1—Estimated Annual Burden

Instrument/data collection activityRespondentNumber of respondentsResponses per respondentTotal number of responsesHours per responseTotal annual burden hours
Implementation Assessment
Key Partner InterviewsProject Director8421681.5252
Family Organization Representative5421081.5162
Youth Organization Representative5421081.5162
MH Agency Director5421081.5162
Core Agency Partners b16223240.75243
Quality Monitor5421080.3336
SOCESSProject Director8443360.5168
Family Organization Representative10844320.5216
Youth Organization Representative10844320.5216
Core Agency Partners43241,7280.5864
Network Analysis Survey
Network Analysis SurveyKey Agency Partners69021,3800.5690
Financial Mapping and Benchmark Components
Financial Mapping InterviewFinancial administrators at: Medicaid Agencies & MH Authorities10822160.75162
Financial administrators at: Trade associations & Family organizations10822160.5108
Tribal Financial Administrators92180.7514
Benchmark ToolPayment personnel at Medicaid Agencies & MH Authorities1222440960
Financial Plan InterviewsFinancial Planning Directors5431620.697
Child and Family Outcome Component
Administrative MeasuresCaregivers of clients age 0-17 c4,13614,1360.05207
Clients age 11-261,68511,6850.0584
Client FunctioningCaregivers of clients age 0-17 c4,136312,4080.151,861
Clients age 11-26 d97032,9100.15437
Caregiver Strain QuestionnaireCaregivers of clients age 0-17 c4,136312,4080.151,861
Columbia Impairment ScaleCaregivers of clients age 5-17 e2,85938,5770.08686
Clients age 11-26 d2,65537,9650.08637
Pediatric Symptom Checklist-17Caregivers of clients age 5-17 e2,85938,5770.05429
Clients age 11-26 d2,65537,9650.05398
New Tools in 2015
Brief Infant and Toddler Emotional Assessment (BITSEA)Caregivers of children and youth 0 to 5 years of age f1,27733,8310.08306
Baby Pediatric Symptom Checklist (BPSC)Caregivers of children and youth for ages 1 month to 18 months f63831,9140.0596
Preschool Pediatric Symptom Checklist (PPSC)Caregivers of children and youth for ages 18 months to 66 months f63931,9170.0596
Total Annual Burden:
AllAll g12,10736,35412,990
a Based on the average hourly wages for Community and Social Service Specialists, All Other (21-1099; $22.47) and Social Workers (21-1020; $29.83) from the May 2015 National Industry-Specific Occupational Employment and Wage Estimates, 621330—Offices of Mental Health Practitioners; the Federal minimum wage of $7.25; and an estimated average hourly wage of $11.60 for a family of four living 25% below poverty level.
b Core agency partners include (1) representatives from MH, child welfare, and juvenile justice and (2) CMHI quality monitors.
c Assumes 81% of clients will be age 0 to 17.
d Assumes 52% of clients will be age 11 to 26.
e Assumes 56% of clients will be age 5 to 17.
f Assumes 25% of clients will be age 0 to 5, with 12.5% of clients age 0 to 2.5, and 12.5% age 2.6 to 5).
g Sums shown indicate unduplicated respondents and responses per respondent.
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Table 2—Total Estimated Annual Burden

Instrument/data collection activityNumber of respondentsTotal number of responsesAverage annual burden (hours)
Key Partner Interview462924339
Network Analysis Survey6901,380230
Financial Mapping Interview22545095
Benchmark Tool1224320
Financial Planning5416232
Child and family instruments9,24227,7262,366

Written comments and recommendations concerning the proposed information collection should be sent by April 7, 2017 to the SAMHSA Desk Officer at the Office of Information and Regulatory Affairs, Office of Management and Budget (OMB). To ensure timely receipt of comments, and to avoid potential delays in OMB's receipt and processing of mail sent through the U.S. Postal Service, commenters are encouraged to submit their comments to OMB via email to: Although commenters are encouraged to send their comments via email, commenters may also fax their comments to: 202-395-7285. Commenters may also mail them to: Office of Management and Budget, Office of Information and Regulatory Affairs, New Executive Office Building, Room 10102, Washington, DC 20503.

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Summer King,


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[FR Doc. 2017-04488 Filed 3-7-17; 8:45 am]