[Federal Register Volume 69, Number 149 (Wednesday, August 4, 2004)]
[Notices]
[Pages 47162-47163]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-17751]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


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

     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 (301) 443-7978.
     National Outcomes Performance Assessment of the Collaborative 
Initiative to Help End Chronic Homelessness--(OMB No. 0930-0247; 
Revision)--This Initiative is coordinated by the U.S. Interagency 
Council on the Homeless and involves the participation of three Council 
members: the Department of Housing and Urban Development (HUD), the 
Department of Health and Human Services (HHS), and the Department of 
Veterans Affairs (VA). Within HHS, SAMHSA's Center for Mental Health 
Services is the lead agency.
     This project will monitor the implementation and effectiveness of 
the Initiative. A national assessment of client outcomes is needed to 
assure a high level of accountability and to identify which models work 
best for which people, using the same methods for all sites. To this 
end, this project will provide a site-by-site description of program 
implementation, as well as descriptive information on clients served; 
services received; housing quality, stability, and satisfaction; and, 
client outcomes in health and functional domains. The VA Northeast 
Program Evaluation Center (NEPEC), based at the VA Connecticut 
Healthcare System in West Haven, Connecticut, is responsible for 
conducting this project.
     Data collection will be conducted over a 36-month period. At each 
site, a series of measures will be used to assess (1) program 
implementation (e.g., number and types of housing units produced and 
intensity and type of treatment and supportive services provided), (2) 
client descriptive information (e.g., demographic and clinical 
characteristics, and housing and treatment services received) and, (3) 
client outcomes.
     Client outcomes will be measured using a series of structured 
instruments administered by evaluation personnel employed and funded by 
the local VA medical center or outpatient clinic involved at each 
Initiative site who will work closely with central NEPEC staff. 
Assessment will be conducted through face-to-face interviews and, when 
needed, telephone interviews. Interviews (approximately one hour in 
length) will be conducted at baseline, defined as the date of entry 
into the clinical treatment program leading to placement into permanent 
housing, and quarterly (every 3 months) thereafter for up to three 
years. Discharge data will be collected from program staff at the time 
of official discharge from the program, or when the client has not had 
any clinical contact from members of the program staff for at least 6 
months. In addition to client interviews, key informant interviews with 
program managers at each site will be conducted annually.
    At most Initiative sites, it is expected that more people will be 
screened and or evaluated for participation in the program than receive 
the full range of core housing and treatment services. Entry into the 
Initiative is conceptualized as a two-phase process involving an 
Outreach/Screening/Assessment Phase (Phase I), and an Active Housing 
Placement/Treatment Phase (Phase II) that is expected to lead to exit 
from homelessness; in some programs these two phases may be described 
as the Outreach and Case Management Phases. It will be important to 
have at least some minimal information on all clients so as to be able 
to compare those who enter Housing/Treatment with those who do not.
    Client-level data at the time of first contact with the program 
(i.e., before the client receives more intensive treatment or housing 
services) will be collected using a screener form. The screener form 
will be completed by a member of the clinical staff when prospective 
clients are first told about the program, and express interest in 
participating in the program (i.e., when they enter Phase I). The 
purpose of this form is to identify the sampling frame of the 
evaluation at each site, or the pool of potential clients from which 
clients are then selected. Program implementation will be measured 
using a series of progress summaries.
    Initiative sites will be responsible for screening potential 
participants, assessing homeless and disabling condition eligibility 
criteria for the program, and documenting eligibility as part of the 
national performance assessment. Each site will identify a limited 
number of portals of entry into the program in a relatively small 
geographic area, so that the evaluator can practically and 
systematically contact clients about participating in the evaluation. 
VA evaluation staff, clinical program staff, and NEPEC will work 
together to establish systematic procedures for assessing eligibility, 
enrolling clients into the Housing/Treatment Activity of the 
Initiative, obtaining written informed consent to participate in the 
national performance assessment, and other evaluation activities.
    The revisions being made are the addition of a comparison group to 
be recruited from all participating sites. A relatively small number (N 
= 61, on average) of individuals can be served at each site due to the 
considerable cost of providing persons who are chronically homeless 
with permanent housing and a comprehensive array of supportive services 
needed to sustain housing tenure and to promote self-sufficiency among 
the target population and limited federal funds available for the 
program. Those in the comparison group (N = 39, on average) will be 
enrolled after client recruitment/enrollment for program

[[Page 47163]]

services is complete. Comparison group participants will receive 
referral/access to housing resources usually available in the community 
or case management and other supportive services routinely available in 
the community for persons who are chronically homeless. The same data 
collection instruments and procedures will be used with both groups.
    In addition, in order to examine the association of program client 
choice in attending mental health services, a ``Consumer Choice'' set 
of six additional items is being added to the client baseline and 
follow-up interviews. These questions are of great importance in 
determining the overall style of the housing first program, whether it 
in fact enhances choice, or in fact constrains choice by forcing people 
to comply with the service system's requirements in order to obtain 
their funds.
    The estimated response burden to collect this information is as 
follows:

----------------------------------------------------------------------------------------------------------------
                                                      No. of       Responses per     Hours per      Total hour
              Respondents form name                 respondents     respondent       response         burden
----------------------------------------------------------------------------------------------------------------
Clients:
  Baseline assessment...........................           1,100               1            1.50           1,650
  Follow-up assessment..........................             880           \1\ 8            1.25           8,800
                                                 -----------------
    Sub-total...................................  ..............  ..............  ..............          10,450
                                                 =================
Clinicians:
  Screening.....................................          \2\ 22             100            0.25             550
  Discharge.....................................          \3\ 22              63            0.40             114
                                                 -----------------
    Sub-total...................................  ..............  ..............  ..............             664
                                                 =================
Administrators:
  Network definition............................              44               1            0.25              11
  Network participation.........................              77               4            0.75             231
    Sub-total...................................  ..............  ..............  ..............             242
                                                 -----------------
        Total...................................           1,243  ..............  ..............     11,356 hrs.
                                                 =================
3-yr. Annual Avg................................           1,243  ..............  ..............     3,785 hrs.
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\1\ Assumes average follow-up period of 2 yrs. due to delayed recruitment at some sites & 20% attrition overall.
 
\2\ Assumes an average of 2 screening clinicians per site, and twice the number of persons screened as enrolled.
 
\3\ Assumes an average of 2 discharge clinicians per site, and discharge rate of 25%.

    Written comments and recommendations concerning the proposed 
information collection should be sent by September 3, 2004 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 28, 2004.
Anna Marsh,
Executive Officer, SAMHSA.
[FR Doc. 04-17751 Filed 8-3-04; 8:45 am]
BILLING CODE 4162-20-M