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[Federal Register Volume 89, Number 234 (Thursday, December 5, 2024)]
[Notices]
[Pages 96658-96660]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-28440]

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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration

Agency Information Collection Activities: Proposed Collection; 
Comment Request

    In compliance with section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995 concerning opportunity for public comment on proposed 
collections of information, Substance Abuse and Mental Health Services 
Administration (SAMHSA) will publish periodic summaries of proposed 
projects. To request more information on the proposed projects or to 
obtain a copy of the information collection plans, call the SAMHSA 
Reports Clearance Officer at (240) 276-0361. Comments are invited on: 
(a) whether the proposed collections of information are necessary for 
the proper performance of the functions of the agency, including 
whether the information shall have practical utility; (b) the accuracy 
of the agency's estimate of the burden of the proposed collection of 
information; (c) ways to enhance the quality, utility, and clarity of 
the information to be collected; and (d) ways to minimize the burden of 
the collection of information on respondents, including leveraging 
automated data collection techniques or other forms of information 
technology.

Proposed Project: Revision to the Community Mental Health Services 
Block Grant and Substance Use Prevention, Treatment, and Recovery 
Services Block Grant FY 2026-2027 Application Plan and Report Guide 
(OMB No. 0930-0168)

    SAMHSA is requesting approval from the Office of Management and 
Budget (OMB) to revise the 2026-2027 Community Mental Health Services 
Block Grant (MHBG) and Substance Use Prevention, Treatment, and 
Recovery Services (SUPTRS) Block Grant Application Plan and Report 
Guide.
    Currently, the SUPTRS BG and the MHBG differ on a number of their 
practices (e.g., data collection at individual or aggregate levels) and 
statutory authorities (e.g., method of calculating MOE, stakeholder 
input requirements for planning, set asides for specific populations or 
programs, etc.). Historically, the Centers within SAMHSA that 
administer these block grants have had different approaches to 
application requirements and reporting. To compound this variation, 
states have different structures for accepting, planning, and 
accounting for the block grants and the prevention set aside within the 
SUPTRS BG. As a result, how these dollars are spent and what is known 
about the services and clients that receive these funds varies by block 
grant and by State.
    SAMHSA has conveyed that block grant funds must be directed toward 
four purposes: (1) to fund priority treatment and support services for 
individuals without insurance or who cycle in and out of health 
insurance coverage; (2) to fund those priority treatment and support 
services not covered by Medicaid, Medicare, or private insurance 
offered through the exchanges and that demonstrate success in improving 
outcomes and/or supporting recovery; (3) to fund universal, selective 
and indicated prevention activities and services that align with 
SAMHSA's six prevention strategies; and (4) to collect performance and 
outcome data to determine the ongoing effectiveness of behavioral 
health prevention, treatment and recovery support services and to plan 
the implementation of new services on a nationwide basis.
    States will need help to meet future challenges associated with, 
the implementation and management of an integrated physical health, 
mental health, and substance use disorder service system. SAMHSA has 
established standards and expectations that will lead to an improved 
system of care for individuals with or at risk of mental and substance 
use disorders. Therefore, this application package continues to fully 
exercise SAMHSA's existing authority regarding states, U.S. 
territories, freely associated states, and the Red Lake Band of 
Chippewa Indians' (subsequently referred to as ``states'') use of block 
grant funds as they fully integrate behavioral health services into the 
broader health care continuum.
    Consistent with previous applications, the FY 2026-2027 application 
has required sections and other sections where additional information 
is requested. The FY 2026-2027 application requires states to submit a 
face sheet, a table of contents, a behavioral health assessment and 
plan, reports of expenditures and persons served, an executive summary, 
and funding agreements and certifications. In addition, SAMHSA is 
requesting information on key areas that are critical to the states' 
success in addressing health care equity. Therefore, as part of this 
block grant planning process, states should identify promising or 
effective strategies as well as technical assistance needed to 
implement the strategies identified in their plans for FYs 2026 and 
2027. SAMHSA has made changes to the Block Grant Plan and Report 
requirements for FFY 2026 and 2027. These changes are necessary to 
ensure that funds are spent in an appropriate and timely manner. 
Adjustments were made to pre-existing tables in the plan and report.
    On the BG narrative portion of the Block Grant Plan document 
changes include editorial changes and minor language clarifications 
throughout the document. Examples include changing ``call centers'' to 
``contact centers'' and ``paraprofessionals'' to ``peer support 
specialists and recovery coaches, prevention specialists'' as 
appropriate throughout the document. In addition, updated guidance on 
best practices and conditions under which states may use BG funds for 
improvements to their health information technology (IT) and systems 
have been made. On the MHBG

[[Page 96659]]

application, one new planning table has been added (Table 4a) to 
collect planned MHBG budget for direct services, other capacity 
building/systems development, and administrative costs. In addition, a 
new data section has been added to the Environmental Factors and Plan 
section.
    Both MHBG and SUPTRS BG reports adopted HHS recommended Sexual 
Orientation and Gender Identity (SOGI) measures for reporting. Key 
modifications included the addition of ``Two-Spirit'' for both sexual 
orientation and gender identity for individuals who identify as 
American Indian or Alaska Native, and an update of terms used. Changes 
to these measures were applied to MHBG Tables: 8A-8D, 9, 10A-10B, 13A-
13B, 14, 15A-15B, 18, 19A-9B, 21, 22 23A-23B, and 24; and SUPTRS BG 
Tables: 10B, 11A, 11B, 11C.
    On the MHBG report there are changes with the addition of one new 
table to the state agency expenditures section (Table 4b on the MHBG). 
With the addition of this new table, the original MHBG table 4 has been 
relabeled 4a. In addition, an appendix with a list of definitions have 
been added to the aid states in reporting data. The additional tables 
should not require excessive effort as all data will already be 
collected by the states on how MHBG funds are spent on direct and 
system development. Minor revisions were made for clarification to 
other sections. Proposed revisions for substance use disorder treatment 
services in the FY 26-27 SUPTRS BG Plan and Report include revisions 
related to removal of stigmatizing language, with the deletion of the 
term `abuse', and replacement with the term `use', per the Consolidated 
Appropriations Act, 2023. The Plan and Report also include the 
universal adoption of `Recovery Support Services' as a stand-alone 
category for SUPTRS BG Plan and Report tables. These changes affect 
Plan Tables 1, 2b, 4b, and 6b, and Report Tables 1, 2, 4, 6, 7.
    Editorial and minor stylistic changes have been made to tables and 
language. Footnotes have been revised that define the COVID-19 and ARP 
Supplemental Funding expenditure periods, including the addition of 
explicit instructions on the second No Cost Extension (NCE) for the 
COVID-19 funding, and the expiration date for the ARP funding. Finally, 
the SUPTRS BG Report Table 11c has been revised to reflect the Number 
of Persons Admitted to Treatment by Sexual Orientation and Race/
Ethnicity, in a reporting format that is compatible with the format and 
content of the comparable CMHS table for the MHBG.
    Similarly, modifications to SUPTRS BG reports were made to allow 
for the accurate capture of information for the FY 2026/2027 reporting 
period and SUPTRS BG priorities.
    Proposed revisions for prevention services in the FY 26-27 SUPTRS 
BG Plan include those revisions that are related to a more intentional 
use of language, with strengthened statements with the addition of 
statistics, and added language to reinforce the interrelatedness 
between mental health and substance use. There is also reinforcement of 
SUPTRS BG primary prevention set-aside funds to support universal, 
selective, and/or indicated substance use prevention strategies.
    Updated tables ensure consistency in Tables 5a-5c for both Plans 
and Reports, and updated language for substances in Table 5c. Table 5b 
(Primary Prevention Expenditures by IOM Categories) was added to align 
with Table 5b (Primary Prevention Planned Expenditures by IOM 
Categories) in the application.
    The term `abstinence' has been removed from the Prevention National 
Outcome Measures (NOMs) to better reflect current terminology. Report 
Tables 31 and 32 have been combined into a new Report Table 31, which 
reduces burden for grantees and removes redundant, obsolete reporting 
requirements. Gender categories in Table 31 have been updated to align 
with CSAT gender categories.
    While the statutory deadlines and block grant award periods remain 
unchanged, SAMHSA encourages states to turn in their application as 
early as possible to allow for a full discussion and review by SAMHSA. 
Applications for the MHBG-only are due no later than September 2, 2025. 
The application for SUPTRS BG-only is due no later than October 1, 
2025. A single application for MHBG and SUPTRS BG combined is due no 
later than September 2, 2025.

Estimates of Annualized Hour Burden

    The estimated annualized burden for the uniform application will 
remain 33,493 hours, since most revisions have been made for 
clarification and the combining of tables will not change the burden. 
Burden estimates are broken out in the following tables showing burden 
separately for Year 1 and Year 2. Year 1 includes the estimates of 
burden for the uniform application and annual reporting. Year 2 
includes the estimates of burden for the recordkeeping and annual 
reporting. The reporting burden remains constant for both years.

                                            Table 1--Estimates of Application and Reporting Burden for Year 1
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             Substance Use Prevention, Treatment, and Recovery Services (SUPTRS BG) and Community Mental Health Services (MHBG) Block Grants
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                                                                                                                          Number of   Number of
                                       Authorizing statute     Authorizing statute        Implementing       Number of    responses   hours per   Total
                                            SUPTRS BG                 MHBG                 regulation        respondent   per year    response    hours
--------------------------------------------------------------------------------------------------------------------------------------------------------
Reporting..........................  Standard Form and       ......................  .....................  ...........  ..........  ..........  .......
                                      Content.
                                     42 U.S.C. 300x-32(a)..  ......................  .....................  ...........  ..........  ..........  .......
SUPTRS BG..........................  Annual Report.........  ......................  .....................  ...........  ..........  ..........   11,190
                                     42 U.S.C. 300x-52(a)..  ......................  45 CFR 96.122(f).....           60           1  ..........  .......
                                     42 U.S.C. 300x-30-b...  ......................  .....................            5           1  ..........  .......
                                     42 U.S.C. 300x-         ......................  45 CFR 96.134(d).....           60           1  ..........  .......
                                      30(d)(2).
MHBG...............................  Annual Report.........  ......................  .....................  ...........  ..........  ..........   11,003
                                                             42 U.S.C. 300x-6(a)...  .....................           59           1  ..........  .......
                                                             42 U.S.C. 300x-52(a)..  .....................  ...........  ..........  ..........  .......
                                                             42 U.S.C. 300x-         .....................           59           1  ..........  .......
                                                              4(b)(3)B.
                                     State Plan (Covers 2    ......................  .....................  ...........  ..........  ..........  .......
                                      years).
SUPTRS BG elements.................  42 U.S.C. 300x-22(b)..  ......................  45 CFR 96.124(c)()1).           60           1  ..........  .......
                                     42 U.S.C. 300x-23.....  ......................  45 CFR 96.126(f).....           60           1  ..........  .......
                                     42 U.S.C. 300x-27.....  ......................  45 CFR 96.131(f).....           60           1  ..........  .......
                                     42 U.S.C. 300x-32(b)..  ......................  45 CFR 96.122(g).....           60           1         120    7,230
MHBG elements......................  ......................  42 U.S.C. 300x-1(b)...  .....................           59           1         120    7,109
                                                             42 U.S.C. 300x-1(b)(2)  .....................           59           1  ..........  .......
                                                             42 U.S.C. 300x-2(a)...  .....................           59           1  ..........  .......
                                     Waivers...............  ......................  .....................  ...........  ..........  ..........    3,240
                                     42 U.S.C. 300x-         ......................  .....................           20           1  ..........  .......
                                      24(b)(5)(B).

[[Page 96660]]

 
                                     42 U.S.C. 300x-28(d)..  ......................  45 CFR 96.132(d).....            5           1  ..........  .......
                                     42 U.S.C. 300x-30(c)..  ......................  45 CFR 96.134(b).....           10           1  ..........  .......
                                     42 U.S.C. 300x-31(c)..  ......................  .....................            1           1  ..........  .......
                                     42 U.S.C. 300x-32(c)..  ......................  .....................            7           1  ..........  .......
                                     42 U.S.C. 300x-32(e)..  ......................  .....................           10  ..........  ..........  .......
                                                             42 U.S.C. 300x-2(a)(2)  .....................           10  ..........  ..........  .......
                                                             42 U.S.C 300x-4(b)(3).  .....................           10  ..........  ..........  .......
                                                             42 U.S.C 300x-6(b)....  .....................            7  ..........  ..........  .......
Recordkeeping......................  42 U.S.C. 300x-23.....  42 U.S.C. 300x-3......  45 CFR 96.126(c).....        60/59           1          20    1,200
                                     42 U.S.C. 300x-25.....  ......................  45 CFR 96.129(a)(13).           10           1          20      200
                                     42 U.S.C 300x-65......  ......................  42 CFR part 54.......           60           1          20    1,200
                                                                                                           ---------------------------------------------
    Combined Burden................  ......................  ......................  .....................  ...........  ..........  ..........   42,373
--------------------------------------------------------------------------------------------------------------------------------------------------------
Report.
300x-52(a)--Requirement of Reports and Audits by States--Report.
300x-30(b)--Maintenance of Effort (MOE) Regarding State Expenditures--Exclusion of Certain Funds (SUPTRS BG).
300x-30(d)(2)--MOE--Noncompliance--Submission of Information to Secretary (SUPTRS BG).
State Plan--SUPTRS BG.
300x-22(b)--Allocations for Women.
300x-23--Intravenous Substance Abuse.
300x-27--Priority in Admissions to Treatment.
300x-29--Statewide Assessment of Need.
300x-32(b)--State Plan.
State Plan--MHBG.
42 U.S.C. 300x-1(b)--Criteria for Plan.
42 U.S.C. 300x-1(b)(2)--State Plan for Comprehensive Community Mental Health Services for Certain Individuals--Criteria for Plan--Mental Health System
  Data and Epidemiology.
42 U.S.C. 300x-2(a)--Certain Agreements--Allocations for Systems Integrated Services for Children.
Waivers--SUPTRS BG.
300x-24(b)(5)(B)--Human Immunodeficiency Virus--Requirement Regarding Rural Areas.
300x-28(d)--Additional Agreements.
300x-30(c)--MOE.
300x-31(c)--Restrictions on Expenditure of Grant--Waiver Regarding Construction of Facilities.
300x-32(c)--Certain Territories.
300x-32(e)--Waiver Amendment for 1922, 1923, 1924 and 1927.
Waivers--MHBG.
300x-2(a)(2)--Allocations for Systems Integrated Services for Children.
300x-6(b)--Waiver for Certain Territories.
Recordkeeping.
300x-23--Waiting list.
300x-25--Group Homes for Persons in Recovery From Substance Use Disorders.
300x-65--Charitable Choice.

                        Table 2--Estimates of Application and Reporting Burden for Year 2
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                                                                     Number of       Number of
                                                     Number of     responses per     hours per      Total hours
                                                    respondent         year          response
----------------------------------------------------------------------------------------------------------------
Reporting:
    SUPTRS BG...................................              60               1             187          11,220
    MHBG........................................              59               1             187          11,033
Recordkeeping...................................           60/59               1              40           2,360
                                                 ---------------------------------------------------------------
        Combined Burden.........................  ..............  ..............  ..............          24,613
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    The total annualized burden for the application and reporting is 
33,493 hours (42,373 + 24,613 = 66,986/2 years = 33,493).
    Link for the application: http://www.samhsa.gov/grants/block-grants.
    Written comments and recommendations for the proposed information 
collection should be sent within 30 days of publication of this notice 
to www.reginfo.gov/public/do/PRAMain. Find this particular information 
collection by selecting ``Currently under 30-day Review--Open for 
Public Comments'' or by using the search function.

Krishna Palipudi,
Social Science Analyst.
[FR Doc. 2024-28440 Filed 12-4-24; 8:45 am]
BILLING CODE P
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