[Federal Register Volume 72, Number 182 (Thursday, September 20, 2007)]
[Notices]
[Pages 53781-53784]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: E7-18555]


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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 (240) 276-1243.

Project: Independent Evaluation of the Substance Abuse Prevention and 
Treatment Block Grant Program--NEW

    The Substance Abuse and Mental Health Services Administration 
(SAMHSA), Center for Substance Abuse Treatment (CSAT), Division of 
State and Community Assistance administers the Substance Abuse 
Prevention and Treatment Block Grant (SAPT BG) in collaboration with 
the Center for Substance Abuse Prevention (CSAP), Division of State 
Programs. The Substance Abuse Prevention and Treatment Block Grant is 
funded by Congress to provide monies to States, Territories, and one 
Native American Tribe for the purpose of planning, carrying out, and 
evaluating activities to prevent and treat substance abuse and other 
allowable activities. The SAPT BG constitutes approximately 40 percent 
of all States budgets for substance abuse prevention and treatment 
services and activities, and is the primary Federal source of funding. 
States have flexibility in determining how funds should be allocated, 
but there are specific set-aside and maintenance of effort requirements 
that must be met in order to receive funding. These requirements, 
introduced by both the ADAMHA Reorganization Act of 1992 and the 
Children's Health Act of 2000, are listed below:

               Table 1.--SAPT BG Set-Aside Provisions \a\
------------------------------------------------------------------------
           Category                       Set-aside provision
------------------------------------------------------------------------
Prevention and treatment       Not less than 35 percent of SAPT BG
 activities regarding alcohol.  funding*.
Prevention and treatment       Not less than 35 percent of SAPT BG
 activities regarding other     funding*.
 drugs.
Primary prevention programs..  Not less than 20 percent of SAPT BG
                                funding.
Pregnant women and women with  Not less than amount equal to expenditure
 dependent children.            in FY 1994.
Tuberculosis services........  No set amount but services must be
                                provided to receive SAPT BG funds.
HIV services \b\.............  No more than 5 percent increase over
                                State allotment for HIV services in FY
                                1991.

[[Page 53782]]

 
Prohibition of sale of         State must enforce law against sale of
 tobacco to individuals under   tobacco to underage individuals to
 age of 18 (Synar amendment).   receive SAPT BG funds--noncompliance
                                leads to a 10 percent reduction in funds
                                the first applicable fiscal year; 20
                                percent, the second year; 30 percent,
                                the third year; and 40 percent, the
                                fourth year.
Maintenance of effort (MOE)    State will maintain funding at no less
 for State expenditures.        than the average level of expenditures
                                for the 2 years preceding the fiscal
                                year for which the State is applying.
Administrative expenses......  Limited to 5 percent of SAPT BG funding.
------------------------------------------------------------------------
\a\ These set-asides shown in this table were included in the 1992 SAPT
  BG authorizing legislation 42 U.S.C. 300x-21 to 42 U.S.C. 300x-62). In
  the Children's Health Act of 2000 (Pub. L. 106-310) Sec. 3303(a)(1)),
  however, the set-asides marked with asterisks were removed.
\b\ For designated States whose rate of AIDS cases is 10 or more per
  100,000 individuals as confirmed by the Centers for Disease Control
  and Prevention.

    In addition to the set-asides, the SAPT BG Program has identified 
17 goals which must be met by States in order to receive this Federal 
funding:

Table 2.--Federal Goals for the Substance Abuse Prevention and Treatment
                               Block Grant
------------------------------------------------------------------------
 
------------------------------------------------------------------------
GOAL 1: Continuum of  The State shall expend block grant funds
 substance abuse treatment      to maintain a continuum of substance
 services.                      abuse treatment services that meet these
                                needs for the services identified by the
                                state (see 42 U.S.C. 300x-21(b) and 45
                                CFR 96.122(f)(g)).
GOAL 2: Spending on   The State agrees to spend not less than
 primary prevention programs.   20 percent on primary prevention
                                programs for individuals who do not
                                require treatment for substance abuse,
                                specifying the activities proposed for
                                each of the six strategies (see 42
                                U.S.C. 300x-22(b)(1) and 45 CFR
                                96.124(b)(1)).
GOAL 3: Spending on   The State agrees to expend not less than
 services for pregnant women    an amount equal to the amount expended
 and children.                  by the State for FY 1994 to establish
                                new programs or expand the capacity of
                                existing programs to make available
                                treatment services designed for pregnant
                                women and children with dependent
                                children; and, directly or through
                                arrangements with other public or
                                nonprofit entities, to make available
                                prenatal care to women receiving such
                                treatment services, and, while the women
                                are receiving services, child care (see
                                42 U.S.C. 300x-22(c)(1) and 45 CFR
                                96.124(c)(e)).
GOAL 4: Treatment     The State agrees to provide treatment to
 for intravenous drug abusers.  intravenous drug abusers that fulfills
                                the 90 percent capacity reporting, 14-
                                120 day performance requirement, interim
                                services, outreach activities and
                                monitoring requirements (see 42 U.S.C.
                                300x-23 and 45 CFR 96.126).
GOAL 5: Tuberculosis  The State agrees, directly or through
 services for people in         arrangements with other public or
 substance abuse treatment.     nonprofit private entities, to routinely
                                make available tuberculosis services to
                                each individual receiving treatment for
                                substance abuse and to monitor such
                                service delivery (see 42 U.S.C. 300x-24
                                and 45 CFR 96.127).
GOAL 6: Early         Designated States agree to provide
 intervention services for      treatment for persons with substance
 HIV for people in substance    abuse problems with an emphasis on
 abuse treatment.               making available within existing
                                programs early intervention services for
                                HIV in areas of the state that have the
                                greatest need for such services and to
                                monitor such service delivery (see 42
                                U.S.C. 300x-24(b) and 45 CFR 96.128).
GOAL 7: Group homes   Designated States agree to provide for
 for recovering substance       and encourage the development of group
 abusers.                       homes for recovering substance abusers
                                through the operation of a revolving
                                loan fund (see 42 U.S.C. 300x-25 and 45
                                CFR 96.129).
GOAL 8: State         The State agrees to continue to have in
 efforts to reduce the          effect a State law that makes it
 availability of tobacco        unlawful for any manufacturer, retailer,
 products.                      or distributor of tobacco products to
                                sell or distribute any such product to
                                any individual under the age of 18; and,
                                to enforce such laws in a manner than
                                can reasonably be expected to reduce the
                                extent to which tobacco products are
                                available to individuals under age 18
                                (see 42 U.S.C. 300x-26 and 45 CFR
                                96.130).
GOAL 9: Preferential  The State agrees to ensure that each
 admission of pregnant women    pregnant woman be given preference in
 to substance abuse treatment.  admission to treatment facilities; and,
                                when the facility has insufficient
                                capacity, to ensure that the pregnant
                                woman be referred to the State, which
                                will refer the woman to a facility that
                                does have the capacity to admit the
                                woman, or if no such facility has the
                                capacity to admit the woman, will make
                                available interim services within 48
                                hours (see 42 U.S.C. 300x-27 and 45 CFR
                                96.131).
GOAL 10: Improved     The State agrees to improve the process
 process for referring          in the State for referring individuals
 individuals to substance       to the treatment modality that is most
 abuse treatment.               appropriate for the individual (see 42
                                U.S.C. 300x-28 and 45 CFR 96.132(a)).
GOAL 11: Continuing   The State agrees to provide continuing
 education for employees at     education for the employees of
 substance abuse prevention     facilities which provide prevention
 and/or treatment facilities.   activities or treatment services (or
                                both) (see 42 U.S.C. 300x-28(b) and 45
                                CFR 96.132(b)).
GOAL 12:              The State agrees to coordinate prevention
 Coordination of services.      activities and treatment services with
                                the provision of other appropriate
                                services (see 42 U.S.C. 300x-28(c) and
                                45 CFR 96.132(c)).
GOAL 13: Needs        The State agrees to submit an assessment
 assessment by State and        of the need for both treatment and
 locality.                      prevention in the State for authorized
                                activities, both by locality and by the
                                State in general (see 42 U.S.C. 300x-29
                                and 45 CFR 96.133).
GOAL 14: Ensuring     The State agrees to ensure that no
 that needles and syringes      program funded through the block grant
 are not provided for illegal   will use funds to provide individuals
 drug use.                      with hypodermic needles or syringes so
                                that such individuals may use illegal
                                drugs (see 42 U.S.C. 300x-31(a)(1)(F)
                                and 45 CFR 96.135(a)(6)).

[[Page 53783]]

 
GOAL 15: Improving    The State agrees to assess and improve,
 the quality and                through independent peer review, the
 appropriateness of treatment   quality and appropriateness of treatment
 services.                      services delivered by provider that
                                receive funds from the block grant (see
                                42 U.S.C. 300x-53(a) and 45 CFR 96.136).
GOAL 16: Protecting   The State agrees to ensure that the State
 patient records from           has in effect a system to protect
 inappropriate disclosure.      patient records from inappropriate
                                disclosure (see 42 U.S.C. 300x-53(b), 45
                                CFR 6.132(e), and 42 CFR part 2).
GOAL 17: Compliance   The State agrees to ensure that the State
 with 42 CFR part 54            has in effect a system to comply with 42
 Charitable Choice Provisions   CFR part 54 (see 42 CFR 54.8(c)(4) and
 and Regulations.               54.8(b)) Charitable Choice Provisions
                                and Regulations).
------------------------------------------------------------------------
Source: Performance Partnership Grant Branch, Division of State and
  Community Assistance, Center for Substance Abuse Treatment, Substance
  Abuse and Mental Health Services Administration, ``Uniform
  Application, FY 2007, Substance Abuse Prevention and Treatment Block
  Grant (42 U.S.C. 300x-21 through 300x-64),'' Rockville, MD, 2004.

    The FY 2003 Office of Management and Budget (OMB) Program 
Assessment Rating Tool (PART) assessment of the SAPT BG Program rated 
the program as ``Ineffective.'' The SAPT BG received high scores on 
three of four PART areas rated, including Program Purpose and Design, 
Strategic Planning, and Program Management. However, the scores could 
have been even higher in these areas if data were available to document 
that the resources were reaching the intended beneficiaries or the 
program had ambitious targets and long-term measures. In the fourth 
area, Program Results/Accountability, where a low rating was achieved, 
it was found that ``no independent evaluation of the program has been 
completed'' to establish that the SAPT BG Program is effective and 
fulfilling its legislative mandates.
    In direct response to this OMB finding, a contract was developed 
and awarded in FY 2003 to conduct an Evaluability Assessment (EA) to 
determine the feasibility of conducting an independent evaluation of 
the SAPT BG Program, and subsequently, to fund such an evaluation 
effort. EA is a recognized program evaluation methodology which 
involves collaboration with multiple stakeholders and development of a 
program logic model used to plan formal evaluations of large and/or 
complex programs, such as the SAPT BG Program. The findings of the EA 
were used as a foundation in the development and awarding of a multi-
year contract in FY 2004 to conduct an independent, comprehensive 
evaluation of the SAPT BG Program.
    As noted in the OMB PART Assessment, the legislative intent of the 
SAPT BG is to provide funding to States by formula to plan, carry out, 
and evaluate activities to prevent and treat substance abuse. 
Therefore, the evaluation is designed to examine the system-level 
activities, outputs, and outcomes associated with the program in 
relation to its goals.
    In this evaluation, a multi-method evaluation approach is being 
used to examine Federal and State performance with regard to the SAPT 
BG and its identified goals. This approach emphasizes a qualitative and 
quantitative examination of both the SAPT BG process (e.g., activities 
and outputs in the logic model) and system-level outcomes whereby 
Federal and State stakeholder perspectives on the SAPT BG, as captured 
through semi-structured interviews and surveys, are corroborated and 
compared to the considerable amount of already-collected source 
documents and data provided by States, CSAT, and CSAP (e.g., Web Block 
Grant Application System (BGAS), Treatment Episode Data Set (TEDS), 
National Survey on Drug Use and Health (NSDUH), the Minimum Data Set 
(MDS), Technical Review Reports, State Prevention and Synar System 
Reports).
    The purpose of the evaluation is to determine the extent to which 
States and the Federal Government are implementing the SAPT BG 
according to the authorizing legislation and implementing regulations. 
The evaluation will cover the following domains: The State SAPT BG 
planning process, Federal review of SAPT BG applications including 
annual reports, progress reports and intended use plans, Federal 
technical assistance, State SAPT BG implementation, Federal oversight 
and management, State SAPT BG reporting, and State-level outcomes. The 
results of this evaluation will not only document the effectiveness of 
the SAPT BG Program in supporting the Substance Abuse Prevention and 
Treatment system, they will also help guide CSAT and CSAP and the 
States to improve the methods by which they implement the SAPT BG, 
including the capacity to collect, analyze, and interpret the National 
Outcome Measures (NOMs). As a separate, parallel SAMHSA initiative, the 
NOMs project began after the SAPT BG Evaluation contract inception and 
was not used in the SAPT BG EA or the development of the evaluation 
framework and logic model. However, selected NOMs items that relate to 
the evaluation framework and logic model will be examined in the 
independent evaluation. These selected NOMs items include:

 Increase in number of persons reporting a reduction in 30-day 
drug/alcohol use
 Increase in number of persons employed or in school
 Reduction in number of drug or alcohol-related arrests
 Increase in number of persons in stable housing situations 
(reduction in homelessness)
 Increase in access to services measured by unduplicated counts 
of persons served and numbers served compared to those in need
 Increase in number of persons receiving evidence-based 
services.

    In addition, the evaluators will attempt to collect information on 
system-wide client perception of care. Statistical tests for 
association between outcome measures and a number of independent 
variables will be conducted. Examples of independent variables include, 
but are not limited to, level of funding, level of the Single State 
Agency (SSA) for substance abuse services within State government, 
degree of SSA partnership with other State agencies and community 
organizations, and amount of State-funded support available for 
research and training activities.
    In addition to information about the selected NOMs domains, the 
evaluation will also examine systemic measures related to 
infrastructure. Infrastructure refers to the resources, systems, and 
policies that support the nation's public substance abuse prevention 
and treatment system, and is a potential contributor to significant 
State behavioral health system outcomes. Examples of infrastructure 
include staff training, policy changes, and service availability.
    Because this is the first-ever comprehensive evaluation of the SAPT 
BG Program, the data collection activities are more extensive (and time 
intensive) than would be expected of a

[[Page 53784]]

program that has been regularly evaluated. These data will serve as a 
baseline for future evaluations. The two primary data collection 
strategies will include open-ended interviews and web-based surveys. 
Interviews will be conducted with Federal staff involved in the 
administration of the SAPT BG and State staff from all States and 
Territories involved in their State's implementation of the SAPT BG 
Program. Two web-based surveys will be administered to all individuals 
who formally participate in monitoring the SAPT BG as part of the 
Technical Review or State Prevention and Synar System Review Teams.
    The interview protocol for Federal staff includes 80 questions 
(mostly open-ended), and, on average, should take 90 minutes to 
complete. The interview protocol for the State staff includes 99 
questions (again, mostly open-ended), and should take, on average, 3 
hours to complete. Both the Federal staff interviews and the State 
staff interviews will be conducted as in-person interviews. While the 
Federal staff will each be interviewed individually, a single group 
State staff interview will be conducted for all relevant State staff. 
The SSA Directors will be asked to select those State staff who they 
believe are most knowledgeable about the SAPT BG for participation in 
the interviews. It is anticipated that, at a minimum, the State 
Planner, the State Data Analyst, the State Prevention Lead, the State 
Treatment Lead, one additional State staff member, and the State SSA 
Director will participate.
    The two web-based surveys will be distributed to the two current 
sets of formal reviewers for the SAPT BG: Technical Reviewers and State 
Prevention and Synar System Reviewers. The web-based surveys are 
designed so that each stakeholder group receives survey questions 
designed to capture their specific knowledge of and experience with the 
SAPT BG. The Technical Reviewer survey contains 47 questions and the 
State Prevention and Synar System Reviewer survey has 27 questions. 
Each survey should take approximately 1 hour or less to complete. 
Reviewers will submit their responses to the survey online over a 3-
week period.
    Table 3 summarizes the estimated annual total burden hours for the 
in-person and web-based surveys for the Federal and State staff 
stakeholders and Technical Reviewers, Synar Reviewers.

                    Table 3.--Estimated Reporting Burden of Interviews and Web-Based Surveys
----------------------------------------------------------------------------------------------------------------
                                                                                 Average hours
                          Respondents                              Number of     per interview/  Estimated total
                                                                  respondents        survey       burden (hours)
----------------------------------------------------------------------------------------------------------------
In-person Interviews:
    State Substance Abuse Prevention and Treatment Agency                   60              3              180
     Commissioner.............................................
    State Planners............................................              60              3              180
    State Data Analysts.......................................              60              3              180
    State Prevention Lead.....................................              60              3              180
    State Treatment Lead......................................              60              3              180
    Additional State Staff....................................              60              3              180
    Federal SAPT Block Grant Staff............................              35              1.5             52.5
ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
        Subtotal..............................................             395  ...............          1,132
ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
Web-based Interviews:
    Technical Reviewers.......................................              15              1               15
    State Prevention and Synar System Reviewers...............              30              1               30
                                                               -------------------------------------------------
        Subtotal..............................................              45  ...............             45
ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½ï¿½
            Total.............................................             440  ...............          1,177
----------------------------------------------------------------------------------------------------------------

    This Federal Register Notice is focused on the interviews and 
surveys that will be administered to the SAPT BG stakeholders as those 
methods of data collection require OMB approval. It is anticipated that 
in future independent evaluations of the SAPT BG Program focus will be 
given to the NOMs and their implications for program performance and 
goals.
    Written comments and recommendations concerning the proposed 
information collection should be sent by October 22, 2007 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: September 12, 2007.
Elaine Parry,
Acting Director, Office of Program Services.
[FR Doc. E7-18555 Filed 9-19-07; 8:45 am]
BILLING CODE 4162-20-P