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[Federal Register Volume 74, Number 93 (Friday, May 15, 2009)]
[Notices]
[Pages 22936-22939]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E9-11377]

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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, the 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) 276-1243.
    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 through the use of automated collection techniques or other 
forms of information technology.

Proposed Project: Recovery Services for Adolescents and Families--New

    The Substance Abuse and Mental Health Services Administration's 
(SAMHSA) Center for Substance Abuse Treatment will conduct a data 
collection on the helpfulness of recovery support services for young 
people and their families after leaving substance abuse treatment. 
Specifically, the Recovery Services for Adolescents and Families (RSAF) 
project is trying to understand whether or not young people and their 
families find the following recovery support services helpful: (1) 
Telephone/text message support; (2) a recovery-oriented social 
networking site; and (3) a family program. Approximately 200 adolescent 
respondents will be asked to complete 4 data collection forms (some 
repeated) during 5 interviews (baseline and 4 follow-ups) over a 12 
month period after enrollment or discharge from treatment. 
Approximately 200 collateral respondents (i.e., a parent/guardian/
concerned other) will be asked to complete 7 data collection forms 
(some repeated) during 5 interviews (baseline and 4 follow-ups) over a 
12 month period after their adolescent's enrollment or discharge from 
treatment. Approximately 15 to 20 project staff respondents, including 
Project Coordinators, Telephone Support Volunteers, a Social Network 
Site Moderator, Family Program Clinicians, and a Support Services 
Supervisor, will be asked to complete between 2 and 5 data collection 
forms at varying intervals during the delivery of recovery support 
services. Across all respondents, a total of 26 data collection forms 
will be used. Depending on the time interval and task, information 
collections will take anywhere from about 5 minutes to 2 hours to 
complete. A description of each data collection form follows:
    Follow-Up Locator Form--Participant (FLF-P; Adolescent Respondent). 
The FLF-P contains over 50 items that are a combination of yes/no, 
multiple choice, and open-ended formats. Data are gathered about an 
adolescent's contact information, personal contacts, criminal justice 
contacts, school/job contacts, hang-out information, internet contacts, 
and identifying information in order to locate and interview that 
adolescent over multiple follow-up intervals.
    Global Appraisal of Individual Needs--Initial (GAIN-I 5.6.0 Full; 
Adolescent Respondent). The GAIN is an evidence-based assessment used 
with both adolescents and adults and in outpatient, intensive 
outpatient, partial hospitalization, methadone, short-term residential, 
long-term residential, therapeutic community, and correctional 
programs. There are over 1,000 questions in this initial version that 
are in multiple formats, including multiple choice, yes/no, and open-
ended. Eight content areas are covered: Background, Substance Use, 
Physical Health, Risk Behaviors and Disease Prevention, Mental and 
Emotional Health, Environment and Living Situation, Legal, and 
Vocational. Each section contains questions on the recency of problems, 
breadth of

[[Page 22937]]

symptoms, and recent prevalence as well as lifetime service 
utilization, recency of utilization, and frequency of recent 
utilization.
    Global Appraisal of Individual Needs--Monitoring 90 Days (GAIN-M90 
5.6.0 Full; Adolescent Respondent). The GAIN is an evidence-based 
assessment used with both adolescents and adults and in outpatient, 
intensive outpatient, partial hospitalization, methadone, short-term 
residential, long-term residential, therapeutic community, and 
correctional programs. There are over 500 questions in this follow-up 
version that are in multiple formats, including multiple choice, yes/
no, and open-ended. Eight content areas are covered: Background, 
Substance Use, Physical Health, Risk Behaviors and Disease Prevention, 
Mental and Emotional Health, Environment and Living Situation, Legal, 
and Vocational. Each section contains questions on the recency of 
problems, breadth of symptoms, and recent prevalence as well as 
lifetime service utilization, recency of utilization, and frequency of 
recent utilization.
    Supplemental Assessment Form (SAF 0309; Adolescent Respondent). The 
SAF contains 72 questions that are a combination of multiple choice, 
yes/no, and open-ended formats. Content areas include: Race, happiness 
with parent or caregiver in several life areas, participation in 
prosocial activities, receipt of and satisfaction with telephone 
support services, and usage of and satisfaction with the project's 
social networking site.
    Follow-Up Locator Form--Collateral (FLF-C; Collateral Respondent). 
The FLF-C contains over 50 items that are a combination of yes/no, 
multiple choice, and open-ended formats. Data are gathered about a 
collateral's contact information, personal contacts, and job contacts 
in order to locate and interview that collateral over multiple follow-
up intervals.
    Global Appraisal of Individual Needs--Collateral Monitoring (GCI; 
Collateral Respondent). The GCI contains over 200 items in this initial 
version that are in multiple formats, including multiple choice, yes/
no, and open-ended. The following content areas are covered: 
Relationship to the adolescent respondent, background, and the 
adolescent's background and substance use, environment and living 
situation, and vocational information. There are questions on the 
recency of problems, breadth of symptoms, and recent prevalence as well 
as lifetime service utilization, recency of utilization, and frequency 
of recent utilization.
    Global Appraisal of Individual Needs--Collateral Monitoring (GCM 
5.3.3; Collateral Respondent). The GCM contains over 200 items in this 
follow-up version that are in multiple formats, including multiple 
choice, yes/no, and open-ended. The following content areas are 
covered: Relationship to the adolescent respondent, background, and the 
adolescent's background and substance use, environment and living 
situation, and vocational information. There are questions on the 
recency of problems, breadth of symptoms, and recent prevalence as well 
as lifetime service utilization, recency of utilization, and frequency 
of recent utilization.
    Supplemental Assessment Form--Collateral (SAF--Collateral; 
Collateral Respondent). The SAF contains 72 questions that are a 
combination of multiple choice, yes/no, and open-ended formats. Content 
areas include: Knowledge about the adolescent's participation in 
prosocial activities, receipt of and satisfaction with telephone 
support services, and usage of and satisfaction with the project's 
social networking site.
    Self-Evaluation Questionnaire (SEQ; Collateral Respondent). The SEQ 
contains 40 multiple choice items that ask the collateral about 
feelings and symptoms of anxiety.
    Family Environment Scale (FES; Collateral Respondent). The FES 
contains 18 yes/no items that measure family cohesion and conflict.
    Relationship Happiness Scale (Caregiver Version) (Collateral 
Respondent). The Relationship Happiness Scale contains 8 items that ask 
the collateral about happiness with his/her relationship with the 
adolescent respondent in various life areas.
    Eligibility Checklist (Project Coordinator). The Eligibility 
Checklist contains 12 yes/no items that are used to determine whether 
or not an adolescent meets inclusion/exclusion criteria for the project 
and is eligible to be approached for informed consent.
    Follow-Up Contact Log (Project Coordinator). The Follow-Up Contact 
Log is open-ended and provides space for all data collected during 
attempted and completed follow-up contacts, over the phone and in-
person, to be recorded.
    Volunteer/Staff Survey (Project Coordinator). The Volunteer/Staff 
Survey contains 10 items in fill-in-the-blank, yes/no, and multiple 
choice formats. Items ask about background, demographic information, 
and role in the project.
    Telephone Support Case Review Form (Telephone Support Volunteer). 
The Telephone Support Case Review Form contains multiple rows that 
allow a volunteer to record 5 pieces of data about adolescents that 
they make phone calls to: Initials, treatment discharge status/date, 
weeks since treatment discharge, date of last telephone session, and 
number of completed telephone sessions since discharge. This allows the 
volunteer and supervisor to monitor the progress of active cases.
    Telephone Support Call Log (Telephone Support Volunteer). The 
Telephone Support Call Log is open-ended and provides space for all 
data collected during attempted and completed support contacts to be 
recorded.
    Adolescent Telephone Support Documentation Form (Telephone Support 
Volunteer). The Adolescent Telephone Support Documentation Form 
contains 22 items that are asked of an adolescent during a telephone 
support contact by a volunteer. The form is used to record yes/no and 
open-ended responses to questions asking about substance use and 
recovery-related activities.
    Telephone Support Discharge Form (Telephone Support Volunteer). The 
Telephone Support Discharge Form contains 10 fields to record the 
following information at the end of an adolescent's participation in 
telephone support: Adolescent name, today's date, volunteer name, 
notification date, telephone support intake date, telephone support 
discharge date, reason for discharge, number of completed sessions, 
referral for more intervention, and successful contact for more 
intervention.
    Volunteer/Staff Survey (Telephone Support Volunteer)--See 
Volunteer/Staff Survey (Project Coordinator) above.
    Social Networking Moderator Log (Social Network Site Moderator). 
The Social Networking Moderator Log contains 11 fields for the 
moderator to record usage data for the project's social networking 
site. The moderator tracks number of visits to the site, number of 
unique visitors, messages posted, chat room attendance, and problems 
with users.
    Volunteer/Staff Survey (Social Network Site Moderator)--See 
Volunteer/Staff Survey (Project Coordinator) above.
    Family Program Progress Notes (Family Program Clinician). The 
Family Program Progress Notes form is open-ended and provides space for 
all data collected during attempted and completed family program 
contacts to be recorded.
    Family Program Attendance Log (Family Program Clinician). The 
Family

[[Page 22938]]

Program Attendance Log is used to record 6 pieces of information about 
each attempted session: Session number, scheduled date, was the session 
rescheduled (yes/no), was the family member a no-show (yes/no), did the 
family member attend the session (yes/no), and comments.
    Family Program Case Review Report (Family Program Clinician). The 
Family Program Case Review Report contains multiple rows that allow a 
clinician to record information that allows the clinician and 
supervisor to monitor the progress of active cases. Areas asked about 
include: Family program procedures delivered, date of last session, and 
weeks in family program.
    Family Program Discharge Form (Family Program Clinician). The 
Family Program Discharge Form contains 9 fields to record the following 
information at the end of participation in the family program: 
Caregiver name, today's date, adolescent name, notification date, 
clinician name, family program intake date, family program discharge 
date, reason for discharge, and number of completed sessions.
    Volunteer/Staff Survey (Family Program Clinician)--See Volunteer/
Staff Survey (Project Coordinator) above.
    Adolescent Telephone Support Quality Assurance Checklist (Support 
Services Supervisor). This checklist contains 43 items that ask the 
supervisor to rate how well a telephone support volunteer delivered 
required service components to adolescents. Volunteers are rated on a 
scale of 1 through 5 in the following areas: Substance use since last 
call (no use), substance use since last call (use), substance use since 
last call (still using), substance use since last call (stopped using), 
attendance at 12-step meetings, recovery-related activities, activities 
related to global health, follow-up since last call, closing the call, 
overall, general clinical skills, and overall difficulty of session.
    Social Networking Quality Assurance Checklist (Support Services 
Supervisor). This checklist contains 17 items that ask the supervisor 
to rate how well a social networking site moderator delivered required 
service components to adolescents. The moderator is rated on a scale of 
1 through 5 in the following areas: Group discussions, administrative 
tasks, overall, and general skills.
    Family Program QA Checklist (Support Services Supervisor). This 
checklist contains 72 items that ask the supervisor to rate how well a 
family program clinician delivered required service components to 
family members. The clinician is rated on a scale of 1 through 5 in the 
following areas: Initial meeting motivational strategies, domestic 
violence precautions, functional analysis of substance use, positive 
communication skills, use of positive reinforcement, time out from 
positive reinforcement, allowing the identified patient to experience 
the natural consequences of substance use, helping concerned 
significant others' enrich their own lives, maintaining the identified 
patient in recovery-oriented systems of care, and general.
    Volunteer/Staff Survey (Support Services Supervisor)--See 
Volunteer/Staff Survey (Project Coordinator) above.
    The following table is a list of the hour burden of the information 
collection by form and by respondent:

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                                                                                                       Total
                                                                                                    annualized
         Instrument/form             Number of     Responses per       Total         Hours per      hour burden
                                    respondents     respondent       responses       response     per respondent
                                                                                                         *
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                                              Adolescent Respondent
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FLF-P...........................             200               1             200             .32             .32
GAIN-I 5.6.0 Full...............             200               1             200            2               2
GAIN-M90 5.6.0 Full.............             200               4             800            1               4
SAF.............................             200               5            1000             .25            1.25
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                             Collateral (parent/guardian/concerned other) Respondent
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FLF-C...........................             200               1             200             .25             .25
GCI.............................             200               1             200             .25             .25
GCM 5.3.3.......................             200               4             800             .25            1
SAF-Collateral..................             200               5            1000             .25            1.25
SEQ.............................             200               5            1000             .16             .8
FES.............................             200               5            1000             .08             .4
Relationship Happiness Scale                 200               5            1000             .08             .4
 (Caregiver)....................
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                                                  Project Staff
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Project Coordinator:
    Eligibility Checklist.......               4              50             200             .25           12.5
    Follow-Up Contact Log.......               4              50             200             .16            8
    Volunteer/Staff Survey......               4               1               4             .25             .25
Telephone Support Volunteer:
    Telephone Support Case                     8             450            3600             .25          112.5
     Review Form................
    Telephone Support Call Log..               8              25             200             .16            4
    Adolescent Telephone Support               8             450            3600             .5           225
     Documentation Form.........
    Telephone Support Discharge                8              25             200             .16            4
     Form.......................
    Volunteer/Staff Survey......               8               1               8             .25             .25
Social Network Site Moderator:
    Social Networking Moderator                1              52              52             .5            26
     Log........................
    Volunteer/Staff Survey......               1               1               1             .25             .25
Family Program Clinician:
    Family Program Progress                    4             650            2600             .16          104
     Notes......................
    Family Program Attendance                  4              50             200             .08            4
     Log........................
    Family Program Case Review                 4             650            2600             .25          162.5
     Report.....................

[[Page 22939]]

 
    Family Program Discharge                   4              50             200             .16            8
     Form.......................
    Volunteer/Staff Survey......               4               1               4             .25             .25
Support Services Supervisor:
    Adolescent Telephone Support               1              12              12            1              12
     QA Checklist...............
    Social Networking QA                       1              12              12             .5             6
     Checklist..................
    Family Program QA Checklist.               1              12              12            1              12
    Volunteer/Staff Survey......              18               1              18             .25             .25
                                 -------------------------------------------------------------------------------
        Column Total............             418            2580  ..............  ..............          713.67
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* Total Annualized Hour Burden Per Respondent = Responses Per Respondent x Hours Per Response.

    Send comments to Summer King, SAMHSA Reports Clearance Officer, 
Room 7-1044, 1 Choke Cherry Road, Rockville, MD 20857 AND e-mail her a 
copy at [email protected]. Written comments should be received 
within 60 days of this notice.

    Dated: May 11, 2009.
Elaine Parry,
Director, Office of Program Services.
[FR Doc. E9-11377 Filed 5-14-09; 8:45 am]
BILLING CODE 4162-20-P
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