[Federal Register Volume 87, Number 249 (Thursday, December 29, 2022)]
[Notices]
[Pages 80191-80194]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-28403]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Substance Abuse and Mental Health Services Administration


Agency Information Collection Activities: Proposed Collection; 
Comment Request

    In compliance with section 3506(c)(2)(A) of the Paperwork Reduction 
Act of 1995 concerning opportunity for public comment on proposed 
collections of information, SAMHSA will publish periodic summaries of 
proposed projects. To request more information on the proposed projects 
or to obtain a copy of the information collection plans, call the 
SAMHSA Reports Clearance Officer on (240) 276-0361.
    Comments are invited on: (a) whether the proposed collections of 
information are necessary for the proper performance of the functions 
of the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
proposed collection of information; (c) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (d) ways 
to minimize the burden of the collection of information on respondents, 
including leveraging automated data collection techniques or other 
forms of information technology.

Proposed Project: Community Mental Health Services Block Grant and 
Substance Abuse Prevention and Treatment Block Grant FY 2024-2025 Plan 
and Report Guidance and Instructions (OMB No. 0930-0168)

    SAMHSA is requesting approval from the Office of Management and 
Budget (OMB) for an extension of the 2024-2025 Community Mental Health 
Services Block Grant (MHBG) and Substance Abuse Prevention and 
Treatment Block Grant (SABG) Application Plan and Report Guidance and 
Instructions.
    Currently, the SABG and the MHBG differ on a number of their 
practices (e.g., data collection at individual or aggregate levels) and 
statutory authorities (e.g., method of calculating MOE, stakeholder 
input requirements for planning, set asides for specific populations or 
programs, etc.). Historically, the Centers within SAMHSA that 
administer these block grants have had different approaches to 
application requirements and reporting. To compound this variation, 
states have different structures for accepting, planning, and 
accounting for the block grants and the prevention set aside within the 
SABG. As a result, how these dollars are spent and what is known about 
the services and clients that receive these funds varies by block grant 
and by state.
    SAMHSA has conveyed that block grant funds must be directed toward 
four purposes: (1) to fund priority treatment and support services for 
individuals without insurance or who cycle in and out of health 
insurance coverage; (2) to fund those priority treatment and support 
services not covered by Medicaid, Medicare, or private insurance 
offered through the exchanges and that demonstrate success in improving 
outcomes and/or supporting recovery; (3) to fund universal, selective 
and targeted prevention activities and services; and (4) to collect 
performance and outcome data to determine the ongoing effectiveness of 
behavioral health prevention, treatment and recovery support services 
and to plan the implementation of new services on a nationwide basis. 
SAMHSA's five priorities (Preventing Overdose; Enhancing Access to 
Suicide Prevention and Crisis Care; Promoting Resilience and Emotional 
Health for Children, Youth and Families; Integrating Behavioral and 
Physical Health Care; and Strengthening the Behavioral Health 
Workforce) are highlighted and states are encouraged to incorporate

[[Page 80192]]

them into their systems improvement efforts.
    States will need help to meet future challenges associated with the 
implementation and management of an integrated physical health, mental 
health, and addiction service system. SAMHSA has established standards 
and expectations that will lead to an improved system of care for 
individuals with or at risk of mental and substance use disorders. 
Therefore, this application package continues to fully exercise 
SAMHSA's existing authority regarding states', territories' and the Red 
Lake Band of the Chippewa Indians' (subsequently referred to as 
``states'') use of block grant funds as they fully integrate behavioral 
health services into the broader health care continuum.
    Consistent with previous applications, the FY 2024-2025 application 
has required sections and other sections where additional information 
is requested. The FY 2024-2025 application requires states to submit a 
face sheet, a table of contents, a behavioral health assessment and 
plan, reports of expenditures and persons served, an executive summary, 
and funding agreements and certifications. In addition, SAMHSA is 
requesting information on key areas that are critical to the states' 
success in addressing health care equity. Therefore, as part of this 
block grant planning process, states should identify promising or 
effective strategies as well as technical assistance needed to 
implement the strategies identified in their plans for FYs 2024 and 
2025. A narrative was added to discuss the Bipartisan Safter 
Communities Act funding for MHBG.
    Pursuant to the supplemental funding appropriations for the MHBG 
and the SABG found in the Consolidated Appropriations Act, 2021 [Pub. 
L. 116-260] and the American Rescue Plan Act, 2021 [Pub. L. 117-2], 
SAMHSA has made changes to the Block Grant Plan and Report requirements 
for FFY 2024 and 2025. These changes are necessary to ensure that funds 
are spent in an appropriate and timely manner. Adjustments were made to 
pre-existing tables in the plan and report.
    On the SABG narrative portion of the Block Grant Plan document 
major changes include the removal of words and terms with negative 
connotations and addition of those that are more appropriate. Examples 
include changing the word ``abuse'' to ``use'' and ``Medication 
Assisted Treatment'' to ``Medication for Opioid Use Disorder'' 
throughout the document. Language is included regarding the promotion 
of recovery for those who are in recovery, or who are receiving 
recovery support services, but who may not have participated in 
treatment in any fashion. The section regarding the Consolidated 
Appropriations Act (COVID-19) has been removed as it is no longer 
applicable after FY 2023. Additionally, there is a new narrative 
section outlining the concept of health equity and how Single State 
Authorities can work within their states to promote equitable promotion 
and use of resources. A new section on Harm Reduction efforts was added 
to illustrate that this work will be instrumental in SUD Prevention and 
Treatment moving forward. The SABG MOE requirements, Women's MOE 
requirements, Tuberculosis screening requirements, and restrictions on 
funding sections have been revamped for a better understanding of 
program requirements.
    For the planning tables, changes were made to tables 10, 14, and a 
slight change to table 15. Updated information regarding the requesting 
of waivers under table 10, section 11 was added to reflect relevant 
sections of the PHS Act. Considerable updates to the narrative in 
question 14 regarding Medication for Opioid Use disorder reflect not 
only the new change in terminology but advances in the field. Lastly, 
table 15 ``Crisis Services'' has been listed as requested for future 
SABG applications.
    On the MHBG report there are changes with the addition of one new 
table to the performance indicators and accomplishments section (Table 
19b on the MHBG). With the addition of this new table, the original 
MHBG table 19b has been relabeled 19c. All MHBG tables that collect 
gender and race information have been updated to include transgender, 
Two-Spirt for the AI/AN population, and Some Other Race. In addition, 
MHBG tables have been updated to make age groups consistent across all 
applicable tables (Table 8a/b, 9, 11, 13a/b, 14, 15a, 18, 19, 19a, 19b, 
19c, 20, 23a/b, 24 on the MHBG). A column was added to the MHBG tables 
for the Bipartisan Safter Communities Act funding. The additional 
tables should not require excessive effort as all data will already be 
collected by the states for the additional funding efforts.
    Similarly, modifications to SABG reports were made to allow for the 
accurate capture of information for the FY 2024/FY 2025 reporting 
period and SABG priorities. A new table, 10b, was added to assess the 
number of persons served by SABG funds who receive recovery support 
services. The table also captures client characteristics, specifically 
age and gender. Although SABG reporting will allow for applicable 
grantees to continue to report data on COVID-19 expenditures and 
persons served using those funds, reporting requirements were 
streamlined with the elimination of table 2b. Reports were modified to 
more capture information on grantees' harm reduction activities. 
Namely, table 3a was modified to capture SABG expenditures on Narcan 
and Fentanyl Test Strips. Modifications to table 12 were also made to 
request the number of persons at risk for HIV/AIDS that were referred 
for PrEP services. Lastly, minor modifications were made to prior 
tables to clarify information previously requested or to address a 
missing category. For example, tables 11a and 11b, were modified to add 
an ``other self-gender identities' to ensure that individuals who are 
non-gender conforming would be captured in the estimate of the number 
of persons served.
    While the statutory deadlines and block grant award periods remain 
unchanged, SAMHSA encourages states to turn in their application as 
early as possible to allow for a full discussion and review by SAMHSA. 
Applications for the MHBG-only are due no later than September 1, 2023. 
The application for SABG-only is due no later than October 1, 2023. A 
single application for MHBG and SABG combined is due no later than 
September 1, 2023.

Estimates of Annualized Hour Burden

    The estimated annualized burden for the uniform application will 
increase to 33,493 hours to account for recording of the additional 
supplemental funding efforts (approximately 2 hours per state agency). 
Burden estimates are broken out in the following tables showing burden 
separately for Year 1 and Year 2. Year 1 includes the estimates of 
burden for the uniform application and annual reporting. Year 2 
includes the estimates of burden for the recordkeeping and annual 
reporting. The reporting burden remains constant for both years.

[[Page 80193]]



                                            Table 1--Estimates of Application and Reporting Burden for Year 1
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                               Substance Abuse Prevention and Treatment and Community Mental Health Services Block Grants
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                                                                                                             Number of       Number of
     Authorizing legislation SABG       Authorizing legislation  Implementing regulation     Number of     responses per     hours per      Total hours
                                                 MHBG                                       respondent         year          response
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Reporting:
    Standard Form and Content........  ........................  .......................  ..............  ..............  ..............  ..............
    42 U.S.C. 300x-32(a).............  ........................  .......................  ..............  ..............  ..............  ..............
SABG:
    Annual Report....................  ........................  .......................  ..............  ..............  ..............          11,190
    42 U.S.C. 300x-52(a).............  ........................  45 CFR 96.122(f).......              60               1  ..............  ..............
    42 U.S.C. 300x-30-b..............  ........................  .......................               5               1  ..............  ..............
    42 U.S.C. 300x-30(d)(2)..........  ........................  45 CFR 96.134(d).......              60               1  ..............  ..............
MHBG:
    Annual Report....................  ........................  .......................  ..............  ..............  ..............          11,003
                                       42 U.S.C. 300x-6(a).....  .......................              59               1  ..............  ..............
                                       42 U.S.C. 300x-52(a)....  .......................  ..............  ..............  ..............  ..............
                                       42 U.S.C. 300x-4(b)(3)B.  .......................              59               1  ..............  ..............
    State Plan (Covers 2 years)......
SABG elements:
    42 U.S.C. 300x-22(b).............  ........................  45 CFR 96.124(c)(1)....              60               1  ..............  ..............
    42 U.S.C. 300x-23................  ........................  45 CFR 96.126(f).......              60               1  ..............  ..............
    42 U.S.C. 300x-27................  ........................  45 CFR 96.131(f).......              60               1  ..............  ..............
    42 U.S.C. 300x-32(b).............  ........................  45 CFR 96.122(g).......              60               1             120           7,230
MHBG elements:.......................  42 U.S.C. 300x-1(b).....  .......................              59               1             120           7,109
                                       42 U.S.C. 300x-1(b)(2)..  .......................              59               1  ..............  ..............
                                       42 U.S.C. 300x-2(a).....  .......................              59               1  ..............  ..............
    Waivers..........................  ........................  .......................  ..............  ..............  ..............           3,240
    42 U.S.C. 300x-24(b)(5)(B).......  ........................  .......................              20               1  ..............  ..............
    42 U.S.C. 300x-28(d).............  ........................  45 CFR 96.132(d).......               5               1  ..............  ..............
    42 U.S.C. 300x-30(c).............  ........................  45 CFR 96.134(b).......              10               1  ..............  ..............
    42 U.S.C. 300x-31(c).............  ........................  .......................               1               1  ..............  ..............
    42 U.S.C. 300x-32(c).............  ........................  .......................               7               1  ..............  ..............
    42 U.S.C. 300x-32(e).............  ........................  .......................              10  ..............  ..............  ..............
                                       42 U.S.C. 300x-2(a)(2)..  .......................              10  ..............  ..............  ..............
                                       42 U.S.C 300x-4(b)(3)...  .......................              10  ..............  ..............  ..............
                                       42 U.S.C 300x-6(b)......  .......................               7  ..............  ..............  ..............
Recordkeeping:
    42 U.S.C. 300x-23................  42 U.S.C. 300x-3........  45 CFR 96.126(c).......           60/59               1              20           1,200
    42 U.S.C. 300x-25................  ........................  45 CFR 96.129(a)(13)...              10               1              20             200
    42 U.S.C 300x-65.................  ........................  42 CFR Part 54.........              60               1              20           1,200
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        Combined Burden..............  ........................  .......................  ..............  ..............  ..............          42,373
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Report:
300x-52(a)--Requirement of Reports and Audits by States--Report.
300x-30(b)--Maintenance of Effort (MOE) Regarding State Expenditures--Exclusion of Certain Funds (SABG).
300x-30(d)(2)--MOE--Noncompliance--Submission of Information to Secretary (SABG).
State Plan--SABG:
300x-22(b)--Allocations for Women.
300x-23--Intravenous Substance Abuse.
300x-27--Priority in Admissions to Treatment.
300x-29--Statewide Assessment of Need.
300x-32(b)--State Plan.
State Plan--MHBG:
42 U.S.C. 300x-1(b)--Criteria for Plan.
42 U.S.C. 300x-1(b)(2)--State Plan for Comprehensive Community Mental Health Services for Certain Individuals--Criteria for Plan--Mental Health System
  Data and Epidemiology.
42 U.S.C. 300x-2(a)--Certain Agreements--Allocations for Systems Integrated Services for Children.
Waivers--SABG:
300x-24(b)(5)(B)--Human Immunodeficiency Virus--Requirement regarding Rural Areas.
300x-28(d)--Additional Agreements.
300x-30(c)--MOE.
300x-31(c)--Restrictions on Expenditure of Grant--Waiver Regarding Construction of Facilities.
300x-32(c)--Certain Territories.
300x-32(e)--Waiver amendment for 1922, 1923, 1924 and 1927.
Waivers--MHBG:
300x-2(a)(2)--Allocations for Systems Integrated Services for Children.
300x-6(b)--Waiver for Certain Territories.
Recordkeeping:
300x-23--Waiting list.
300x-25--Group Homes for Persons in Recovery from Substance Use Disorders.
300x-65--Charitable Choice.


[[Page 80194]]


                        Table 2--Estimates of Application and Reporting Burden for Year 2
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                                                                     Number of       Number of
                                                     Number of     responses per     hours per      Total hours
                                                    respondent         year          response
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Reporting:
    SABG........................................              60               1             187          11,220
    MHBG........................................              59               1             187          11,033
Recordkeeping...................................           60/59               1              40           2,360
                                                 ---------------------------------------------------------------
        Combined Burden.........................  ..............  ..............  ..............          24,613
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    The total annualized burden for the application and reporting is 
33,493 hours (42,373 + 24,613 = 66,986/2 years = 33,493).
    Link for the application: http://www.samhsa.gov/grants/block-grants.
    Send comments to Carlos Graham, SAMHSA Reports Clearance Officer, 
5600 Fisher Lane, Room 15E57A, Rockville, MD 20852 OR email him a copy 
at [email protected]. Written comments should be received by 
February 27, 2023.

Alicia Broadus,
Public Health Advisor.
[FR Doc. 2022-28403 Filed 12-28-22; 8:45 am]
BILLING CODE 4162-20-P