[Federal Register Volume 81, Number 16 (Tuesday, January 26, 2016)]
[Notices]
[Pages 4322-4325]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2016-01480]


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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: Now Is the Time (NITT)--Healthy Transitions (HT) Evaluation--
New

    SAMHSA is conducting a national evaluation of the Now is the Time 
(NITT) initiative, which includes separate programs--NITT Project AWARE 
(Advancing Wellness and Resilience in Education)--State Educational 
Agency (SEA), Healthy Transitions (HT), and two Minority Fellowship 
Programs (Youth and Addiction Counselors). These programs are united by 
their focus on capacity building, system change, and workforce 
development.
    NITT-HT, which is the focus of this data collection, represents a 
response to the fourth component of President Obama's NITT Initiative: 
Increasing access to mental health services. The purpose of the NITT-HT 
program is to improve access to treatment and support services for 
youth/young adults 16-25 years that either have, or are at risk of 
developing a mental illness or substance use disorder, and are at high 
risk of suicide. NITT-HT grants were made to 17 state or local 
jurisdictions, each of which include 2-3 learning laboratories (n = 
43), which are the local communities of practice responsible for 
implementing the NITT-HT approach. The NITT-HT program aims to increase 
awareness about early signs and symptoms of mental health conditions in 
the community; identify action strategies to use when a mental health 
concern is detected; provide training to provider and community groups 
to improve services and supports for youth/young adults; enhance peer 
and family supports; and develop effective services and interventions 
for youth and young adults with a serious mental health condition and 
their families. The NITT-HT evaluation is designed to understand 
whether and how NITT-HT grantees reach these program goals by examining 
system- and grantee-level processes and system- and client-level 
outcomes. Data collection efforts that will support the evaluation are 
described below.
    The Community Support for Transition Inventory (CSTI) will assess 
systems change for communities implementing comprehensive, community-
based approaches to improve outcomes for emerging adults with serious 
mental health conditions. The CSTI is organized around seven themes: 
Community partnership, collaborative action, transition planning 
quality assurance and support, workforce, fiscal policies and 
sustainability, access to needed support and services, and 
accountability. The CSTI is a web-based survey to be completed by 1,075 
community leaders (15-25 community leaders per 43 learning 
laboratories) once during Year 2 and once during Year 4 of the grant 
period. Community leaders include members of the local advisory or 
steering committee, staff of the NITT-HT program, staff of agencies 
providing portions of the services, and young adult and family members' 
advocates.
    The State Support for Transition Inventory (SSTI) will assess state 
support for systems change and is organized around six themes 
(partnership, collaborative action, workforce, fiscal policies & 
sustainability, access to needed supports & services, and 
accountability). The SSTI is a web-based survey to be

[[Page 4323]]

completed by 425 state leadership members (20-25 state leaders per 17 
grantees) once during Year 2 and once during Year 4 of the grant 
period. State leadership members include administrators or staff from 
state agencies responsible for aspects of services to youth/young 
adults (e.g., mental health, child welfare, education), youth/young 
adult and adult allies who are active in promoting, planning, or 
overseeing services at the state level, as well as other members of 
state-level advisory groups or governing bodies.
    The Collaborative Member Survey is designed to assess specific team 
processes that contribute to collaboration outcomes at the systems 
level and will be administered to a subset of CSTI respondents who 
participate in a NITT-HT grantee's Advisory Team. The Collaborative 
Member Survey emphasizes aspects of Advisory Teams' climate 
(participatory decision-making, structure, management of conflict, 
reflexivity). A maximum of 1,075 respondents (15-25 advisory team 
members per 43 learning laboratories) are expected to complete the web-
based survey once during Year 3 and once during Year 5 of the grant 
period.
    The Collaborative Self-Assessment assesses collaborative 
functioning and accomplishments, and specific tasks completed by NITT-
HT grantee stakeholders and the leadership team including progress in 
each of the primary ``functions'' for the NITT-HT grantees (i.e., 
specific, discrete achievements or steps toward strategic and fiscal 
planning, expansion of services, early identification outreach, and 
reduction of barriers to access). The web-based Collaborative Self-
Assessment Survey will be completed by one advisory team member per 
learning laboratory (n = 43) once in Year 3 and once in Year 5 of the 
grant period.
    The Project Director Web Survey will collect information on 
planning, coordination, leadership processes, fiscal planning, and 
sustainability. The brief Project Director Web Survey will be completed 
by all grantee project directors (n = 17) once during each of Years 2, 
3, and 4 of the grant period. The web survey includes prompts designed 
to assist the project director in gathering and recalling information 
to be discussed during the subsequent Project Director Telephone 
Interview. Upon completion of the web survey, the project director will 
be asked to schedule a telephone interview, which will focus on 
gathering more in depth information to complement information gathered 
via the web survey. The Project Director Telephone Interview includes 
information on state/local implementation, fiscal planning, 
coordination and organizational challenges, workforce development, 
quality assurance procedures, sustainability planning, and leadership 
and political issues. The telephone interview will also be completed by 
all grantee project directors (n = 17) once during each of Years 2, 3, 
and 4 of the grant period. The web survey and telephone interview are 
slightly different at each time point to reflect varying annual changes 
in program implementation emphasis.
    The Core Staff Web Survey will be administered to core NITT-HT 
staff to assess characteristics of person-centered practice and 
barriers to this practice. ``Core staff'' are defined as staff members 
serving as primary providers of planning, case management and 
coordination services to youth/young adults (``life coaches,'' 
``transition facilitators,'' or ``transition specialists''). A maximum 
of 430 core staff (no more than 10 core staff per 43 learning 
laboratories) are expected to complete the Core Staff Survey once 
during the grant period.
    In the Multi-Media Project, youth/young adults will be invited to 
voluntarily provide information about their experiences working with or 
being served by NITT-HT grantee communities using multi-media outlets. 
Youth/young adult involvement is a priority both for the NITT-HT 
national evaluation and for NITT-HT grantees. Consequently, it will be 
important to offer youth/young adults opportunities to participate in 
national evaluation activities in developmentally-appropriate and 
engaging ways. These outlets could include videos, photos, blogs, or 
poems (at the choice of the participating youth/young adult). Youth/
young adults will be given informational probes (e.g., what keeps you 
involved in NITT-HT activities?) in grantee Years 2, 3, and 4; an 
estimated 510 youth/young adults (30 youth/young adults per 17 
grantees) will participate in the Multi-Media Project.
    The Supplemental Youth and Youth Adult Interview (SYAI) will assess 
key client-level outcomes of interest for the NITT-HT program, 
including: School/home/daily living functioning, emotional/behavioral 
health, vocation and education status, housing stability, criminal or 
juvenile justice involvement, psychotic symptoms, substance use/abuse, 
trauma symptoms, victimization experiences and propensity to commit 
violent acts. In addition to primary outcomes of interest, the SYAI 
also assesses intermediate outcomes thought to be critical in 
influencing change in behavioral health and functioning, including: 
Self-efficacy (mental health, school, career and social), and 
perceptions of social support, person-centered care, and service 
alliance. The SYAI includes standardized instruments as well as 
project-developed items and does not duplicate the client-level data 
collection required separately by SAMHSA (OMB No. 0930-0346). The SYAI 
will be conducted with 90 service recipient youth/young adults per 
NITT-HT grantee (n = 17), for a total of 1,530 youth/young adults, at 
program enrollment (Baseline) and 12- and 24-months after enrollment. 
These 90 cases will be evenly distributed across the grantee's 2-3 
learning laboratories. The SYAI is designed for administration as an 
audio computer-assisted self-interviewing (ACASI) survey. This mode was 
selected to offer participating youth/young adults maximum privacy 
while completing the interview and to present minimal survey 
administration burden to NITT-HT grantee staff.

Grantee Visit In-Person Interviews and Focus Group Guides

    All NITT-HT grantees (n = 17) will be visited once during the 5-
year grant period. Activities associated with the grantee visit (i.e., 
a pre-planning inventory, interviews, focus groups, and document 
review) are described below.
    Prior to the grantee visit, the Services & Supports Inventory will 
be administered one time by telephone to a representative from each of 
the NITT-HT grantees (n = 17) to identify specific providers and other 
stakeholders to participate in the grantee visit. Respondents will also 
provide information about specific services, especially evidence-based 
and evidence-informed practices being provided to youth/young adults 
through NITT-HT associated behavioral health or other professional 
agencies, and provide a preliminary assessment of the frequency and 
quality of implementation of the practice(s).
    During the one-time grantee visit, several in-person interviews and 
two client-oriented focus groups will be conducted with NITT-HT program 
staff. The Core Staff In-Person Interview will be conducted with core 
staff members (i.e., ``transitions specialists,'' ``transition 
facilitators,'' or ``life coaches'') to examine their experiences 
providing person-centered planning services to youth/young adults 
served within the NITT-HT grantee communities and ask about successes 
and challenges in creating and implementing youth/young adult service 
plans. A total of 215 core staff

[[Page 4324]]

(five core staff per 43 learning laboratories) are expected to 
participate.
    The Youth Coordinator In-Person Interview will be conducted with 
three staff members (one youth coordinator and up to two peer workers) 
to elicit staff experiences working with the NITT-HT grantee with a 
focus on the Youth Coordinator functions including participation in 
planning and coordination, outreach, mentoring, and other activities. A 
total of 129 staff members (three per 43 learning laboratories) are 
expected to participate.
    The Provider In-Person Interview will be conducted with individuals 
who provide behavioral health services/treatment directly to youth/
youth adults served within the NITT-HT community, other than the 
transition facilitators. These individuals will likely come from NITT-
HT partner organizations. Interviews will focus on two areas: (1) 
Perceptions of organizational support by the collaborative, and (2) 
implementation of evidence-based practices (e.g., general attitudes, 
types of practices being used, implementation supports). A total of 85 
key provider informants (five key providers per 17 grantees) are 
expected to participate.
    The Stakeholder In-Person Interview will be conducted with other 
key stakeholders (e.g., board members for agencies, leaders or liaisons 
for advocacy groups, leaders or advocates with religious or charitable 
organizations), as identified by grantee leadership. The interview will 
elicit experiences contributing to systems development, including 
history of involvement, their specific contributions to the systems 
development effort, and strategies, barriers and facilitators to making 
these contributions. A total of 51 community stakeholders (3 
stakeholders per 17 grantees) are expected to participate.
    Two Young Adult Focus Groups will be conducted during the grantee 
visit--one for youth/young adults directly involved in NITT-HT system 
change efforts, and one for youth/young adults who are recipients of 
NITT-HT services. The focus groups are designed to elicit perceptions 
based on youth/young adult lived experience about resources to support 
successful youth/young adult transition at NITT-HT sites, whether 
practices are well aligned to address needs and cultivate resources, 
and ideas about how to build on these achievements in the future. An 
information form will be completed by each participant to gather 
general background information (e.g., demographics, extent of 
experience with the mental health system and grantee community). A 
total of 860 youth/young adult participants (20 participants per 43 
learning laboratories) are expected to participate.
    Two Family/Adult Ally Focus Groups will be conducted during the 
grantee visit--one focused at the client-level (for family members of 
youth/young adults service recipients), and one focused at the systems 
level (for family members involved in NITT-HT grantee planning and 
systems change efforts). The focus groups will gather information about 
family member perceived needs and resources to support youth/young 
adults at the NITT-HT sites. An information form will be completed by 
each participant to gather general background information (e.g., 
demographics, extent of experience with the mental health system and 
grantee community). A total of 860 family/adult allies (20 participants 
per 43 learning laboratories) are expected to participate.
    Grantee Visit Document Review. Files or charts of a subset of 
youth/young adults participating in the SYAI will be reviewed during 
the grantee visit. This document review will be designed to ascertain 
types of standard documentation routinely completed for youth/young 
adult clients served as well as the consistency of completion of these 
documents. Information extracted from client charts will be 
programmatic only; there will be no identifying or personal information 
extracted from these client charts.

                      Annualized Burden Hours for the NITT--Healthy Transitions Evaluation
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                                     Number of    Responses  per   Total number      Hours per     Total  burden
       Instrument/activity          respondents      respondent    of responses      response          hours
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Community Support for Transition           1,075               1           1,075             0.4             430
 Inventory......................
State Support for Transition                 425               1             425            0.32             136
 Inventory......................
Collaborative Member Survey.....           1,075               1           1,075            0.25             269
Collaborative Self-Assessment                 43               1              43            0.83              36
 Survey.........................
Project Director Web Survey.....              17               1              17            0.33               6
Project Director Telephone                    17               1              17             1.5              26
 Interview......................
Core Staff Web Survey...........             430               1             430            0.33             142
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Grantee Visits:
    Services & Supports                       17               1              17            0.67              11
     Inventory..................
    Core Staff In-Person                     215               1             215            0.33              71
     Interview..................
    Youth Coordinator In-Person              129               1             129               1             129
     Interview..................
    Provider In-Person Interview              85               1              85            0.75              64
    Stakeholder In-Person                     51               1              51            0.75              38
     Interview..................
    Young Adult Focus Group.....             860               1             860            1.75           1,505
    Family/Adult Ally Focus                  860               1             860            1.75           1,505
     Group......................
    Document Review.............              43               1              43            0.25              11
Supplemental Youth & Young Adult           1,530               1           1,530            0.67           1,025
 Interview......................
Multi-Media Project Young Adult              510               1             510            0.33             168
 Probes.........................
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    Total.......................         * 5,522  ..............           7,382  ..............           5,572
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* This is an unduplicated count of total respondents.

    Written comments and recommendations concerning the proposed 
information collection should be sent by February 25, 2016 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

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their comments to OMB via email to: [email protected]. 
Although commenters are encouraged to send their comments via email, 
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.

Summer King,
Statistician.
[FR Doc. 2016-01480 Filed 1-25-16; 8:45 am]
BILLING CODE 4162-20-P