[Federal Register Volume 75, Number 101 (Wednesday, May 26, 2010)]
[Notices]
[Pages 29551-29552]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-12643]


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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: FASD Diagnosis and Intervention Programs in the Fetal Alcohol 
Spectrum Disorder (FASD) Center of Excellence--New

    Since 2001, SAMHSA's Center for Substance Abuse Prevention has been 
operating a Fetal Alcohol Spectrum Disorder (FASD) Center of Excellence 
which addresses FASD mainly by providing trainings and technical 
assistance and developing and supporting systems of care that respond 
to FASD using effective evidence-based practices and interventions.
    Currently the integration of evidence-based practices into service 
delivery organizations is being accomplished through subcontracts. One 
such intervention which integrates diagnosis and intervention 
strategies into existing service delivery organizations is the FASD 
Diagnosis and Intervention programs targeting children 0-18 years of 
age. The Diagnosis and Intervention programs use the following 11 data 
collection tools.

 Description of Instruments/Activity for the Diagnosis and Intervention
                                Programs
------------------------------------------------------------------------
          Instrument/Activity                      Description
------------------------------------------------------------------------
Screening and Diagnosis Tool...........  The purpose of the screening
                                          and diagnosis tool is to
                                          determine eligibility to
                                          participate in the SAMHSA FASD
                                          Center Diagnosis and Treatment
                                          Intervention. The form
                                          includes demographic,
                                          screening, and diagnostic
                                          data.
Positive Monitor Tracking..............  The Positive Monitor Tracking
                                          form is to monitor the outcome
                                          of placing a child (ages 0-3
                                          years) on a positive monitor.
Services Child is Receiving at the time  The Services Child is Receiving
 of the FASD Diagnosis.                   at the time of the FASD
                                          Diagnosis form is to record
                                          services the child is
                                          receiving at the time of an
                                          FASD diagnosis.
Services Planned and Provided based on   The Services Planned and
 Diagnostic Evaluation.                   Provided based on Diagnostic
                                          Evaluation form is to record
                                          services planned and received
                                          based on the diagnostic
                                          evaluation.
Services Delivery Tracking Form........  The Services Delivery Tracking
                                          form is for the services
                                          provided during every visit.
End of Intervention/Program Improvement  The End of Intervention/Program
 Measure--Case Manager.                   Improvement Measure--Case
                                          Manager form is for the case
                                          manager to report on the
                                          overall improvement in the
                                          child as a result of receiving
                                          services.
End of Intervention/Program Improvement  The End of Intervention/Program
 Measure--Parent/Guardian.                Improvement Measure--Parent/
                                          Guardian form is for the
                                          parent/guardian to report on
                                          the overall improvement in the
                                          child as a result of receiving
                                          services.
End of Intervention/Program Customer     The End of Intervention/Program
 Satisfaction with Service.               Customer Satisfaction with
                                          Service form is to determine
                                          customer satisfaction
                                          (parents) with the SAMHSA FASD
                                          Center Diagnosis and
                                          Intervention project.
Outcome Measures (Children 0-7 years)..  The Outcome Measures (Children
                                          0-7 years) form is an outcomes
                                          measure checklist used to
                                          record measures every six
                                          months from start of service
                                          to end of service, at end of
                                          intervention, at 6 months
                                          follow-up, and 12 months
                                          follow-up.
Outcome Measures (Children 8-18 years).  The Outcome Measures (Children
                                          8-18 years) form is an
                                          outcomes measure checklist
                                          used to record measures every
                                          six months from start of
                                          service to end of service, at
                                          end of intervention, at 6
                                          months follow-up, and 12
                                          months follow-up.
Lost to follow-up......................  The Lost to follow-up form is
                                          used if the child is no longer
                                          accessible for follow-up.
------------------------------------------------------------------------

    Eight subcontracts were awarded in February 2008 to integrate the 
FASD Diagnosis and Intervention program within existing service 
delivery organization sites. Using an integrated service delivery model 
all sites are screening children using an FASD screening tool, 
obtaining a diagnostic evaluation, and providing services/interventions 
as indicated by the diagnostic evaluation. Specific interventions are 
based upon the individual child's diagnosis. Six of the sites are 
integrating the FASD Diagnosis and Intervention projects either in a 
child mental health provider setting or in a dependency court setting 
and serve children ages 0-7 years. Two of the sites are delinquency 
courts and serve children 10-18 years of age. Data collection at all 
sites involves administering the screening and diagnosis tool, 
recording process level indicators such as type and units of service 
provided; improvement in functionality and outcome measures such as 
school performance, stability in housing/placement, and adjudication 
measures (10-18 yrs only). Data will be collected at baseline, monthly, 
every six months from start of service to end of service, at end of 
intervention, at 6 months follow-up, and 12 months follow-up.

Estimated Annualized Burden Hours

[[Page 29552]]



----------------------------------------------------------------------------------------------------------------
                                                     Number of                        Average      Total burden
       Instrument/Activity           Number of     responses per   Total number     burden per       hours per
                                    respondents     respondent     of responses      response       collection
----------------------------------------------------------------------------------------------------------------
Client Surveys: Children 0-7:
    Screening and Diagnosis Tool            1400               1            1400            0.17             238
    Positive Monitor Tracking...             450               1             450            0.03              14
    Services Child is Receiving              750               1             750            0.17             128
     at the time of the FASD
     Diagnosis..................
    Services Planned and                     750               1             750            0.33             248
     Provided based on
     Diagnostic Evaluation......
    Services Delivery Tracking               750              12            9000            0.08             720
     Form.......................
    End of Intervention/Program              750               1             750            0.02              15
     Improvement Measure--Case
     Manager....................
    End of Intervention/Program              750               1             750            0.02              15
     Improvement Measure--Parent/
     Guardian...................
    End of Intervention/Program              750               1             750            0.03              23
     Customer Satisfaction with
     Service....................
    Outcome Measures (Children 0-            750               5            3750            0.08             300
     7 years)...................
    Lost to follow-up...........             135               1             135            0.03               4
Client Surveys: Children 8-18:
    Screening and Diagnosis Tool             100               1             100            0.17              17
    Services Child is Receiving               50               1              50            0.17               9
     at the time of the FASD
     Diagnosis..................
    Services Planned and                      50               1              50            0.33              17
     Provided based on
     Diagnostic Evaluation......
    Services Delivery Tracking                50              12             600            0.08              48
     Form.......................
    End of Intervention/Program               50               1              50            0.02               1
     Improvement Measure--Case
     Manager....................
    End of Intervention/Program               50               1              50            0.02               1
     Improvement Measure--Parent/
     Guardian...................
    End of Intervention/Program               50               1              50            0.03               2
     Customer Satisfaction with
     Service....................
    Outcome Measures (Children 8-             50               5             250            0.08              20
     18 years)..................
    Lost to follow-up...........              15               1              15            0.03               1
                                 -------------------------------------------------------------------------------
        TOTAL...................           7,700              49          19,700  ..............           1,821
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    Written comments and recommendations concerning the proposed 
information collection should be sent by June 25, 2010 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: 202-395-5806.

     Dated: May 17, 2010.
Elaine Parry,
Director, Office of Program Services.
[FR Doc. 2010-12643 Filed 5-25-10; 8:45 am]
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