[Federal Register Volume 76, Number 165 (Thursday, August 25, 2011)]
[Notices]
[Pages 53138-53141]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2011-21713]


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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: National Child Traumatic Stress Initiative (NCTSI) 
Evaluation--(OMB No. 0930-0276)--Revision

    The Substance Abuse and Mental Health Services Administration's 
(SAMHSA), Center for Mental Health Services (CMHS), will conduct the 
National Child Traumatic Stress Initiative (NCTSI) Evaluation. This 
evaluation serves multiple practical purposes: (1) To collect and 
analyze descriptive, outcome, and service experience information about 
the children and families served by the NCTSI centers; (2) to assess 
the NCTSI's impact on access to high-quality, trauma-informed care; (3) 
to evaluate NCTSI centers' training and consultation activity designed 
to promote evidence-based, trauma-informed services and the impact of 
such activity on child-serving systems; and (4) to assess the 
sustainability of the grant-funded activities to improve access to and 
quality of care for trauma-exposed children and their families beyond 
the grant period.
    Data will be collected from caregivers and youth served by NCTSI 
centers, NCTSI and non-NCTSI administrators, NCTSI trainers, service 
providers trained by NCTSI centers and other training participants, 
administrators of mental health and non-mental health professionals 
from state and national child-serving organizations, and administrators 
of affiliate centers. Data collection will take place in all Community 
Treatment and Services Programs (CTS) and Treatment and Service 
Adaptation Centers (TSA) active during the three-year approval period. 
Currently, there are 45 CTS centers and 17 TSA centers active (i.e., 62 
active centers). After the first year, in September 2011, the 15 
grantees funded in 2007 will reach the end of their data collection. At 
that point, additional centers may be funded or funded again. Because 
of this variability, the estimate of 62 centers is used to calculate 
burden.
    The NCTSI Evaluation is composed of four distinct study components, 
each of which involves data collection, which are described below.

Descriptive and Clinical Outcomes

    In order to describe the children served, their trauma histories 
and their clinical and functional outcomes, nine instruments will be 
used to collect data from children and adolescents who are receiving 
services in the NCTSI, and from caregivers of all children who are 
receiving NCTSI services. Data will be collected when the child/youth 
enters services and during subsequent follow-up sessions at three-month 
intervals over the course of one year. This study relies upon the use 
of data already being collected as a part of the Core Data Set, and 
includes the following instruments:
     The Core Clinical Characteristics Form, which collects 
demographic, psychosocial and clinical information about the child 
being served including information about the child's domestic 
environment and insurance status, indicators of the severity of the 
child's problems, behaviors and symptoms, and use of non-Network 
services;
     The Trauma Information/Detail Form, which collects 
information on the history of trauma(s) experienced by the child served 
by the NCTSI center including the type of trauma experienced, the age 
at which the trauma was experienced, type of exposure, whether or not 
the trauma is chronic, and the setting and

[[Page 53139]]

perpetrator(s) associated with the traumatic experience;
     The Child Behavior Checklist (CBCL) 1.5-5 and 6-18, which 
measure symptoms in such domains such as emotionally reactive, anxious/
depressed, somatic complaints, withdrawn, attention problems, 
aggressive behavior, sleep problems, rule-breaking behavior, social 
problems, thought problems, and withdrawn/depressed;
     The UCLA PTSD Short Form, which screens for exposure to 
traumatic events and for all DSM-IV PTSD symptoms in children who 
report traumatic stress experiences; and the
     The Trauma Symptoms Checklist for Children, which 
evaluates acute and chronic posttraumatic stress symptoms in children's 
responses to unspecified traumatic events across several symptom 
domains.
     The Trauma Symptoms Checklist for Young Children (TSCYC), 
which is a 90-item caretaker-report instrument developed for the 
assessment of trauma-related symptoms in children ages 3 to 12.
     The Parenting Stress Index Short Form (PSI-SF), which 
yields a total stress score from three scales: Parental distress, 
parent-child dysfunctional interaction, and difficult child. The PSI-SF 
was developed from factor analysis of the PSI-Full-Length Version.
     The Children's Depression Inventory-2 Short (CDI-2S), 
which is a comprehensive multi-rater assessment of depressive symptoms 
in youth aged 7 to 17 years. Depressive symptomatology is quantified by 
the CDI 2 based on reports from children/adolescents, teachers and 
parents.
     The Global Appraisal of Individual Needs Modified Shore 
Screener (GAIN-MSS), which is designed primarily as a screener in 
general populations, ages 12 and older, to quickly and accurately 
identify clients who have 1 or more behavioral health disorders (e.g., 
internalizing or externalizing psychiatric disorders, substance use 
disorders, or crime/violence problems).
    Approximately 6,000 youth and 9,700 caregivers will participate in 
the descriptive and clinical outcomes study over the clearance period.

Access to High Quality, Trauma-Informed Services

    The NCTSI mission is to expand access to high quality, trauma-
informed services for trauma-exposed children and adolescents and their 
families nationwide. This component of the evaluation is designed to 
assess NCTSI program progress in achieving this mission by collecting 
and analyzing data from a variety of sources addressing the question of 
whether access to high quality, trauma-informed services has improved 
and for which demographic groups. Instruments used as a part of this 
study component include:
     Evidence-based Practice (EBP) and Trauma-informed Systems 
Change Survey (ETSC), which assesses the extent to which NCTSI training 
and other dissemination activities have enhanced the knowledge base and 
use of trauma-informed services (TIS) within child-serving agencies, 
centers and organizations that are not a part of the NCTSI but rather 
have received training from the NCTSI as well as to assess the extent 
to which such services are evidence-based. The survey branches into two 
versions adapted for project directors/administrators and human service 
providers (e.g., mental health providers, child welfare case workers, 
teachers, primary care health care providers and others), allowing for 
questions tailored to the professional orientation and activities of 
each group. The ETSC survey will be used to assess the extent to which 
NCTSI training and dissemination activities have improved access to 
high quality, trauma-informed services for trauma-exposed children and 
their families that are served through such child-serving systems.
     The National Reach Survey, which assesses the extent to 
which the NCTSI has impacted the knowledge and awareness, policies, 
planning, programs, and practices related to trauma-informed care among 
state and national child-serving organizations external to the NCTSI 
centers.
     The Online Performance Monitoring Report (OPMR), which is 
primarily a mechanism for SAMHSA to monitor centers' progress towards 
achieving stated goals and a fulfillment of SAMHSA requirements for 
accountability and performance monitoring. In addition, this form will 
also serve as an important data source informing several components of 
the NCTSI evaluation.
    Approximately 496 service providers and 186 administrators from 
NCTSI centers and organizations or agencies trained by NCTSI centers 
will participate in the ETSC survey. Approximately 4,000 individuals 
will be participating in the National Reach Survey, while approximately 
62 individuals will participate in the OPMR.

Training, Evidence-Based Practices (EBPs), and Family/Consumer 
Partnerships

    A major goal of the NCTSI is to enhance the capacity of 
administrators and service providers from agencies, centers and 
organizations associated with child-serving systems (including mental 
health, child welfare, juvenile justice, education and primary care) to 
use trauma-informed services (TIS) with trauma-exposed children and 
their families. NCTSI centers promote the use of TIS within child-
serving systems to increase public awareness and knowledge about trauma 
exposure, trauma impact, and the range of trauma-informed assessments 
and services that are available. For this component, the ETSC Survey 
will be used to assess whether agencies, schools, and organizations 
that are a part of child-serving systems trained by the NCTSI have 
become more evidence-based and trauma-informed. Two additional forms 
will be used including:
     The Training Summary Form (TSF), which will be completed 
by trainers and will collect information on the number of participants 
trained, the type of training (including the trauma types addressed in 
the training), and the topics emphasized in the training.
     The Training Sign-In Sheet (TSIS), which will be completed 
by this participants of NCTSI-sponsored trainings. Participants will 
provide their names; agency, organization or center for which they 
work; their roles; and contact information including an email 
addresses. In addition, they will be asked to indicate whether the 
evaluation may contact them for participation.
    Approximately 124 trainers will complete and submit the TSF, while 
approximately 12,400 trainees will complete the TSIS.

Sustainability

    Assessing the sustainability of the progress made by the NCTSI and 
its partners is a key evaluation priority identified by stakeholders 
advising on the redesign of the NCTSI Evaluation. Therefore, while this 
issue was not addressed as part of the previous evaluation design, it 
has been included as a new area of importance for future NCTSI 
evaluation. This component of the evaluation focuses on understanding 
the degree to which NCTSI grant activities continue after funding has 
ended and the factors associated with the continuation of--or lapse 
in--grant activities such as the implementation of evidence-based 
practices or approaches to strengthen trauma-informed service 
provision. This component collects

[[Page 53140]]

sustainability data as part of the OPMR in the case of funded centers 
and, in the case of affiliate centers (centers that no longer receive 
SAMHSA funding but have continued involvement with the NCTSI and are 
defined by SAMHSA as affiliates), the following survey will be 
implemented:
     Sustainability Survey for Affiliate Centers, which 
assesses sustainability of NCTSI grant activities by collecting data on 
domains including grant history, funding sources and fiscal strategies, 
program mission, infrastructure, service delivery and continuation of 
practices and programs. Approximately 45 administrators of affiliate 
centers are expected to participate in this survey.
    The revision to the currently approved information collection 
activities includes the extension of NCTSI Evaluation information 
collection activities for an additional three years. This revision also 
addresses the following programmatic changes:
     The number of centers for which burden was calculated is 
62, which represents the number of currently active grantees (the 
number of centers at the time of the previous submission was 44).
     As a result of efforts to address updated evaluation 
priorities, reduce redundancy and consolidate multiple data collection 
efforts focused on national monitoring and evaluating of the NCTSI 
program, the request discontinues ten surveys, forms or interviews that 
are currently OMB-approved.
     In place of the ten surveys, forms or interviews that are 
currently OMB-approved that are being discontinued, and as part of the 
redesigned evaluation, three new data collection efforts will be 
implemented, including:
    [cir] Online Performance Monitoring Report Form (OPMR)
    [cir] Evidence-based Practice and Trauma-informed System Change 
Survey (ETSC)
    [cir] Sustainability Survey for affiliate centers
     This request also enhances the existing Core Data Set by 
revising the Core Clinical Characteristics Forms and adding new 
instruments to address existing gaps in knowledge including:
    [cir] Trauma Symptom Checklist for Young Children (TSCYC)
    [cir] Parenting Stress Index Short Form (PSI-SF)
    [cir] Children's Depression Inventory-2 Short (CDI-2S)
    [cir] Global Appraisal of Needs Modified Short Screener (GAIN-MSS)
     A Training Sign-in Sheet (TSIS) has been developed for use 
at each training event sponsored by NCTSI centers. The purpose of the 
form is to collect brief information about NCTSI training participants.
    The average annual respondent burden is estimated below.

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                                                  Average number                                  3-year average
           Instrument                Number of     of responses      Hours per     Total burden      of annual
                                    respondents   per respondent     response          hours       burden hours
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                                       Caregivers Served by NCTSI Centers
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Child Behavior Checklist 1.5-5/6-      \1\ 9,729           \2\ 4            0.33          12,842           4,281
 18 (CBCL 1.5-5/6-18)...........
Trauma Information/Detail Form..           9,729               4            0.22           8,562           2,854
Core Clinical Characteristics              9,729               4             0.5          19,458           6,486
 Form...........................
UCLA-PTSD Short Form (UCLA-PTSD)       \3\ 7,394               4            0.17           5,028           1,676
Trauma Symptoms Checklist for          \4\ 2,724               4            0.33           3,596           1,199
 Young Children (TSCYC).........
Parenting Stress Index Short           \5\ 2,919               4            0.08             934             311
 Form (PSI-SF)..................
----------------------------------------------------------------------------------------------------------------
                                      Youth Served by NCTSI Centers Centers
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Trauma Symptoms Checklist for          \6\ 6,129               4            0.33           8,090           2,697
 Children-Abbreviated (TSCC-A)..
Children's Depression Inventory-       \7\ 2,140               4            0.08             685             228
 2 Short (CDI-2S)...............
Global Appraisal of Individual         \8\ 3,989               4            0.08           1,276             425
 Needs Modified Shore Screener
 (GAIN-MSS).....................
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                          Funded NCTSI Center Project Directors of Other Administrators
----------------------------------------------------------------------------------------------------------------
 
Online Performance Monitoring                 62              12            0.60             446             149
 Report (OPMR)..................
Sustainability Survey for                     62               3            0.28              52              17
 Currently--Funded Centers......
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                                       NCTSI and Non-NCTSI Administrators
----------------------------------------------------------------------------------------------------------------
 
Evidence-based Practice (EBP)            \9\ 186               2            0.30             112              37
 and Trauma Informed Systems
 Change Survey (ETSC)--
 Administrator Version..........
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                                                 NCTSI Trainers
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Training Summary Form...........        \10\ 124               5             0.2             124              41
----------------------------------------------------------------------------------------------------------------
                                   Service Providers Trained by NCTSI Centers
----------------------------------------------------------------------------------------------------------------
 
Evidence-based Practice (EBP)           \11\ 496               3             0.3             446             149
 and Trauma Informed Systems
 Change Survey (ETSC)--Provider
 Version........................
----------------------------------------------------------------------------------------------------------------
                                              Training Participants
----------------------------------------------------------------------------------------------------------------
 
Training Sign-In Sheet (TSIS)...     \12\ 12,400               1             .02             248              83
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[[Page 53141]]

 
      Mental Health and Non-Mental Health Professionals from State and National Child Serving Organizations
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NCTSI National Reach Survey.....           4,000               1             0.5           2,000             667
----------------------------------------------------------------------------------------------------------------
                                         Affiliate Center Administrators
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Sustainability Survey--                       45               3             .28              38              19
 Affiliate Centers..............
                                 -------------------------------------------------------------------------------
    Total summary...............          71,857              66  ..............  ..............          63,957
                                 -------------------------------------------------------------------------------
        Total annual summary....          23,952              22  ..............  ..............          21,319
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1. On average, 75 percent of centers participate in the Core Data Set (47 of 62 centers), with an average of 69
  baseline visits per year.
2. On the basis of the children enrolled in the Core Data Set through September 30, 2010, the average length of
  time in treatment is 9 months, yielding an average of 4 assessments per child.
3. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 76% of
  the children in the Core Data Set will be ages 7 and older.
4. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 28% of
  the children in the Core Data Set will be between the ages of 3 and 7.
5. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 60% of
  the children in the Core Data Set will be aged 12 and under. We estimate that approximately 50% of centers
  will use this optional instrument, leading to an estimate of 30% of children in the Core Data Set.
6. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 63% of
  the children in the Core Data Set will be between the ages of 8 and 16.
7. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 44% of
  the children in the Core Data Set will between the ages of 7 and 18, and will have depression indicated as a
  potential problem at baseline. We estimate that approximately 50% of centers will use this optional
  instrument, leading to an estimate of 22% of children in the Core Data Set.
8. On the basis of the children enrolled in the Core Data Set through September 30, 2010, approximately 41% of
  the children in the Core Data Set will be aged 12 and older.
9. Respondents will be administrators from 62 currently funded NCTSI centers and administrators from two child
  serving systems that each NCTSI center trains.
10. Respondents will be center trainers or evaluation staff. On average, 5 Training Summary Forms may be
  completed by 124 trainers.
11. Respondents are NCTSI center employed clinicians and center trained providers. It is estimated that on
  average from the 62 centers, four center-employed clinicians and four center trained providers will take the
  survey three times.
12. It is expected that at least two trainers per center will provide five trainings and on an average there
  will be twenty participants per training.

    Written comments and recommendations concerning the proposed 
information collection should be sent by September 26, 2011 to the 
SAMHSA Desk Officer at the Office of Information and Regulatory 
Affairs, Office of Management and Budget (OMB). To ensure timely 
receipt of comments, and to avoid potential delays in OMB's receipt and 
processing of mail sent through the U.S. Postal Service, commenters are 
encouraged to submit their comments to OMB via e-mail to: [email protected]. Although commenters are encouraged to send 
their comments via e-mail, commenters may also fax their comments to: 
202-395-7285. Commenters may also mail them to: Office of Management 
and Budget, Office of Information and Regulatory Affairs, New Executive 
Office Building, Room 10102, Washington, DC 20503.

    Dated: August 18, 2011.
Elaine Parry,
Director, Office of Management, Technology and Operations.
[FR Doc. 2011-21713 Filed 8-24-11; 8:45 am]
BILLING CODE 4162-20-P