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 Department of Health and Human Services Substance Abuse and Mental Health Services Administration
 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: National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program: Phase V (OMB No. 0930-0280)—Revision The Substance Abuse and Mental Health Services Administration (SAMHSA) Center for Mental Health Services (CMHS) is responsible for the National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program, which collects data on child mental health outcomes, family life, and service system development and performance. Data will be collected on 30 service systems and roughly 8,810 children and families. The data collection for this evaluation will be conducted for a 3-year period. The core of service system data will be collected twice (every 18 to 24 months) during the 3-year evaluation period. A sustainability survey will be conducted in selected years. Service delivery and system variables of interest include the following: Maturity of system of care development; adherence to the system of care program model; services received by youth and their families, and the costs of those services; and consumer service experience. The length of time that individual families will participate in the study ranges from 18 to 36 months depending on when they enter the evaluation. Child and family outcomes of interest will be collected at intake and during subsequent follow-up interviews at six-month intervals. Client service experience information is collected at these follow-up interviews. Measures included in an outcome interview are determined by the type of assessment (intake or follow-up), child's age, and whether the respondent is the caregiver or a youth. The outcome measures include the following: Child symptomatology and functioning, family functioning, material resources, and caregiver strain. The caregiver interview package includes the Caregiver Information Questionnaire, Child Behavior Checklist, Behavioral and Emotional Rating Scale (BERS), Education Questionnaire, Columbia Impairment Questionnaire, Living Situations Questionnaire, Family Life Questionnaire, and Caregiver Strain Questionnaire at intake, and also includes the Multi-service Sector Contacts Form, Cultural Competence and Service Provision Questionnaire and the Youth Services Survey (a national outcome measurement tool) at follow-up assessments. Caregivers of children under age 6 complete the Vineland Screener to assess development, and do not complete the BERS. The Youth Interview package includes the Youth Information Questionnaire, Revised Children's Manifest Anxiety Scale, Reynolds Depression Scale, BERS (youth version), Delinquency Survey, Substance Use Survey, GAIN-Quick: Substance Dependence Scale, and Youth Services Survey (youth version). The evaluation also includes three special studies: (1) An evidence-based practices study that examines the effects of various factors on the implementation and use of evidence-based treatments and approaches in system of care communities; (2) A cultural and linguistic competence study that examines the extent to which the cultural and linguistic characteristics of communities influence program implementation and provider adaptation of evidence-based treatments, and provider service delivery decisions based on provider culture and language; and (3) an evaluation of the communities' use of reports produced by the national evaluation for continuous quality improvement. The national evaluation measures address the national outcome measures for mental health programs as currently established by SAMHSA. Table 1 summarizes which national evaluation components are unchanged from the original 2006 submission and which are new or changed. Table 1—Study Component and Instrument Revisions for Phase V Re-submission
New or changed for 2009 
                             resubmission
No change
Nature of change**System of Care Assessment**Site Visit Tables

XInterview Protocols

XInter-Agency Collaboration Scale (IACS)

X( print page 38203)**Longitudinal Child and Family Outcome Study**Caregiver Information Questionnaire (CIQ-I)
X

Question 39a skip pattern revised.
                             Question 39d list of medications updated.Caregiver Information Questionnaire (CIQ-F)
X

Question 39a skip pattern revised.
                             Question 39d list of medications updated.Caregiver Strain Questionnaire (CGSQ)

XChild Behavior Checklist (CBCL)/Child Behavior Checklist 1
                            1/2
                            -5 (CBCL 1
                            1/2
                            -5)

XEducation Questionnaire—Revised (EQ-R)
X

Slight wording change to interviewer note and the term “day care” changed to “childcare.”Living Situations Questionnaire (LSQ)

XFamily Life Questionnaire (FLQ)

XBehavioral and Emotional Rating Scale—Second Edition—Parent Rating Scale (BERS-2C)

XColumbia Impairment Scale (CIS)

XVineland Screener (VS)

XDelinquency Survey—Revised (DS-R)

XBehavioral and Emotional Rating Scale—Second Edition, Youth Rating Scale (BERS-2Y)

XGAIN-Quick Substance Related Issues (GAIN Quick-R)

XSubstance Use Survey—Revised (SUS-R)

XRevised Children's Manifest Anxiety Scales (RCMAS)

XReynolds Adolescent Depression Scale—Second Edition (RADS-2)

XYouth Information Questionnaire (YIQ-I)

XYouth Information Questionnaire (YIQ-F)

X**Service Experience Study**Multi-Sector Service Contacts Questionnaire—Revised (MSSC-R)
X

Slight modification to Card 4, and Cards 6 and 7 are new.Evidence-Based Practices Experience Measure (EBPEM)

XCultural Competence and Service Provision Questionnaire (CCSP)

XYouth Services Survey for Families (YSS-F)

XYouth Services Survey (YSS)

X**Services and Costs Study**Flex Funds Data Dictionary
X

New.Services and Costs Data Dictionary
X

New.**Sustainability Study**Sustainability Survey

X**Continuous Quality Improvement (CQI) Initiative Evaluation**CQI Initiative Survey
X

New.CQI Initiative Interview Guide
X

New.**Evidence-Based Practices Study**System-level Implementation Factors Discussion Guide
X

New.Service-level Implementation Factors Discussion Guide
X

New.Consumer-level Implementation Factors Discussion Guide
X

New.**Cultural and Linguistic Competence Study**CCIOSAS—Beneficiaries of Self-Assessment Findings Focus Group Guide—Staff and Partners
X

New.CCIOSAS—Beneficiaries of Self-Assessment Findings Focus Group Guide—Caregivers
X

New.( print page 38204)CCIOSAS—Beneficiaries of Self-Assessment Findings Focus Group Guide—Youth
X

New.CCIOSAS—Participants in Self-Assessments Focus Group Guide—Staff and Partners
X

New.CCIOSAS—Participants in Self-Assessments Focus Group Guide—Caregivers
X

New.CCIOSAS—Participants in Self-Assessments Focus Group Guide—Youth
X

New.CCIOSAS—Users of Self-Assessment Findings Focus Group Guide—Staff and Partners
X

New.CCIOSAS—Users of Self-Assessment Findings Focus Group Guide—Caregivers
X

New.CCIOSAS—Users of Self-Assessment Findings Focus Group Guide—Youth
X

New.CCIOSAS—Telephone Interview—Staff and Partners
X

New.CCEBPS—Managers of EBP Process Focus Group Guide
X

New.CCEBPS—Providers of EBP Focus Group Guide
X

New.CCEBPS—Family Focus Group Guide
X

New.CCEBPS—Youth Focus Group Guide
X

New.CCEBPS—Telephone Interview
X

New.
 Internet-based technology will be used for data entry and management, and for collecting data using Web-based surveys. The average annual respondent burden, with detail provided about burden contributed by specific measures, is estimated below. The 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 for each response, and the total average annual burden for each category of respondent and for all categories of respondents combined. Table 2—Detailed Estimate of Respondent Burden
[Note: Total burden is annualized over a 3-year period.]
Instrument
Respondent
Number of 
                             respondents
Total average number of 
                             responses per respondent
Hours per 
                             response
Total burden hours
3-year average annual burden hours**System of Care Assessment**Interview Guides and Data Collection Forms
Key site informants
1
                             630
1
1.00
630
210Interagency Collaboration Scale (IACS)
Key site informants
630
1
0.13
82
27**Longitudinal Child and Family Outcome Study**Caregiver Information Questionnaire (CIQ-IC)
Caregiver
2
                             8,810
1
0.283
2,493
831Caregiver Information Questionnaire Followup (CIQ-FC)
Caregiver
8,810
3
                             2
0.200
3,524
1,175Caregiver Strain Questionnaire (CGSQ)
Caregiver
8,810
3
0.167
4,414
1,471Child Behavior Checklist (CBCL)/Child Behavior Checklist 1
                            1/2
                            -5 (CBCL 1
                            1/2
                            -5)
Caregiver
8,810
3
0.333
8,801
2,934Education Questionnaire—Revised (EQ-R)
Caregiver
8,810
3
0.333
8,801
2,934Living Situations Questionnaire (LSQ)
Caregiver
8,810
3
0.083
2,194
731The Family Life Questionnaire (FLQ)
Caregiver
8,810
3
0.050
1,322
441Behavioral and Emotional Rating Scale—Second Edition, Parent Rating Scale (BERS-2C)
Caregiver
4
                             7,488
3
0.167
4,193
1,398Columbia Impairment Scale (CIS)
Caregiver
5
                             8,369
3
0.083
2,084
695The Vineland Screener (VS)
Caregiver
6
                             1,321
3
0.250
330
110( print page 38205)Delinquency Survey—Revised (DS-R)
Youth
7
                             5,286
3
0.167
2,648
883Behavioral and Emotional Rating Scale—Second Edition, Youth Rating Scale (BERS-2Y)
Youth
5,286
3
0.167
2,648
883Gain-Quick Substance Related Issues (Gain Quick-R)
Youth
5,286
3
0.083
1,316
439Substance Use Survey—Revised (SUS-R)
Youth
5,286
3
0.100
1,586
529Revised Children's Manifest Anxiety Scales (RCMAS)
Youth
5,286
3
0.050
793
264Reynolds Adolescent Depression Scale—Second Edition (RADS-2)
Youth
5,286
3
0.050
793
264Youth information Questionnaire—Baseline (YIQ-I)
Youth
5,286
1
0.167
883
294Youth information Questionnaire—Follow-up (YIQ-F)
Youth
5,286
2
0.167
1,766
589**Service Experience Study**Multi-Sector Service Contacts—Revised (MSSC-R)
Caregiver
8,810
8
                             2
0.250
4,405
1,468Evidence-Based Practice Measure (EBPEM)
Caregiver
8,810
2
0.167
2,943
981Cultural Competence and Service Provision Questionnaire (CCSP)
Caregiver
8,810
2
0.167
2,943
981Youth Services Survey—Family (YSS-F)
Caregiver
8,810
2
0.117
2,062
687Youth Services Survey (YSS)
Youth
5,286
2
0.083
877
292**Services and Costs Study**Flex Funds Data Dictionary
Local staff compiling/entering data
9
                             2,670
10
                             3
0.033
218
73Services and Costs Data Dictionary
Local staff compiling/entering data
11
                             10,680
12
                             100
0.033
29,073
9,691**Sustainability Study**Sustainability Survey—Caregiver
13
                             Caregiver
52
2
0.75
78
26Sustainability Survey—Provider
13
                             Provider/Administrator
156
2
0.75
234
78**CQI Benchmarking Initiative Evaluation**CQI Initiative Survey
Key community staff
150
1
0.5
75
25CQI Initiative Interview Guide
Key community staff
50
1
1.0
50
17**Evidence-Based Practices Study**The Implementation Factors Discussion Guide
SOC leadership team member
90
1
0.75
68
23The Implementation Factors Discussion Guide
Provider
60
1
0.75
45
15The Implementation Factors Discussion Guide
Caregivers
30
1
0.5
15
5**Cultural and Linguistic Competence Study**CCIOSAS—Beneficiaries of Self-Assessment Findings
Provider
40
1
1.0
40
13CCIOSAS—Beneficiaries of Self-Assessment Findings
Administrators/Managers
20
1
1.5
30
10( print page 38206)CCIOSAS—Beneficiaries of Self-Assessment Findings
Caregivers
40
1
0.75
30
10CCIOSAS—Beneficiaries of Self-Assessment Findings
Youth
40
1
0.75
30
10CCIOSAS—Participants in Self-Assessments
Provider
40
1
1.0
40
13CCIOSAS—Participants in Self-Assessments
Administrators/Managers
20
1
1.5
30
10CCIOSAS—Participants in Self-Assessments
Caregivers
16
1
0.75
12
4CCIOSAS—Participants in Self-Assessments
Youth
16
1
0.75
12
4CCIOSAS—Users of Self-Assessment Findings
Provider
40
1
1.0
40
13CCIOSAS—Users of Self-Assessment Findings
Administrators/Managers
20
1
1.5
30
10CCIOSAS—Users of Self-Assessment Findings
Caregivers
16
1
0.75
12
4CCIOSAS—Users of Self-Assessment Findings
Youth
16
1
0.75
12
4CCIOSAS—Telephone Interview
Providers
2
1
1.0
2
0.67CCIOSAS—Telephone Interview
Administrators/Managers
3
1
1.0
3
1CCEBPS—Managers of EBP Process
Providers
16
1
1.0
16
5CCEBPS—Managers of EBP Process
Administrators/Managers
20
1
1.5
30
10CCEBPS—Providers of EBP
Providers
40
1
1.0
40
13CCEBPS—Families and Youth
Caregivers
40
1
0.75
30
10CCEBPS—Families and Youth
Youth
40
1
0.75
30
10CCEBPS—Telephone Interview
Providers
2
1
1.0
2
0.67CCEBPS—Telephone Interview
Administrators/Managers
3
1
1.0
3
1
 Table 2—Estimate of Respondent Burden (Continued)
Number of 
                             distinct respondents
Number of 
                             responses per year per  
                             respondent
Average annual burden per response 
                             (hours)
Total annual burden
                             (hours)**Summary of Annualized Burden Estimates for 3 Years**Caregivers
8,810
2.46
2.36
51,147Youth
5,286
2.56
0.99
13,397Community staff
870
72.22
0.86
54,035Total Summary
14,996
6.54

118,579Total Annual Average Summary
4,989
2.18

39,5261
                         An average of 21 constituents in up to 30 grant communities will complete the System of Care Assessment interview. These constituents will include site administrative staff, providers, agency representatives, family representatives, and youth.2
                         Number of respondents across 30 grantees. Average based on a 5 percent attrition rate at each data collection point.3
                         Average number of responses per respondent is a weighted average of the possible numbers of responses per respondent for communities beginning data collection in FY2007 and FY2008. The maximum numbers of responses per respondent are for 24 communities beginning data collection in FY2007, 1 follow-up data collection point remaining for children/youth recruited in year 2 (of grant community funding), 3 for children/youth recruited in year 3, 4 for children/youth recruited in year 4, and 4 for children/youth recruited in year 5. The maximum numbers of responses per respondent are, for 6 communities beginning data collection in FY2008, 3 follow-up data collection points remaining for children/youth recruited in year 2 (of grant community funding), 5 for children/youth recruited in year 3, 6 for children/youth recruited in year 4, and 4 for children/youth recruited in year 5.4
                         Approximate number of caregivers with children over age 5, based on Phase V data submitted as of 12/08.5
                         Approximate number of caregivers with children 3 and older, based on Phase V data submitted as of 12/08.6
                         Approximate number of caregivers with children 5 or under, based on Phase V data submitted as of 12/08.7
                         Based on Phase III and IV finding that approximately 60 percent of the children/youth in the evaluation were 11 years old or older.8
                         Respondents only complete Service Experience Study measures at follow-up points. See Footnote #3 for the explanation about the average number of responses per respondent.
                        ( print page 38207)9
                         Staff will enter data on flexible funds expenditures into a Web-based application or will recode existing data on flexible funds expenditures to match the Flex Funds Data Dictionary format. Each community will use flexible funds expenditures on average for approximately one-quarter of the estimated 356 children/youth enrolled, suggesting a total of 89 children/youth will receive services from flexible funds per community. Thus, there will be data entered for 89 × 30 = 2,670 children/youth using the Flex Funds Data Dictionary.10
                         Assumes that three expenditures, on average, will be spent on each child/youth receiving flexible fund benefits.11
                         Staff will collect paper-based forms from agencies and enter them into a Web-based application or will extract data from agencies' existing data systems. Staff will recode data to match the Services and Costs Data Dictionary format. Service and costs records will be compiled for all 356 × 30 = 10,680 children/youth enrolled.12
                         Assumes that each child/youth will have 100 service episodes, on average, during his/her time in a system of care.13
                         This survey will be administered in 5 communities funded in 2006, 25 communities funded in 2005, 2 communities funded in 2000, and 20 communities funded in 1999. For each community, one respondent will be a caregiver and three respondents will be administrators/providers.
 Written comments and recommendations concerning the proposed information collection should be sent by August 31, 2009 to: SAMHSA Desk Officer, Human Resources and Housing Branch, Office of Management and Budget, New Executive Office Building, Room 10235, Washington, DC 20503; due to potential delays in OMB's receipt and processing of mail sent through the U.S. Postal Service, respondents are encouraged to submit comments by fax to: 202-395-6974. Dated: July 27, 2009. Elaine Parry, Director, Office of Program Services.


[FR Doc. E9-18315 Filed 7-30-09; 8:45 am] BILLING CODE 4162-20-P