[Federal Register Volume 89, Number 158 (Thursday, August 15, 2024)]
[Notices]
[Pages 66427-66429]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-18253]


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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, the Substance Abuse and Mental Health 
Services Administration (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 through the use of automated collection techniques or other 
forms of information technology.

Proposed Project: SAMHSA Certified Community Behavioral Health Clinic--
Expansion (CCBHC-E) Grant Program Evaluation (OMB No. 0930-XXXX)--New 
Collection

    In FY 2022, SAMHSA awarded two new cohorts of its CCBHC-Expansion 
program, one for clinics interested in becoming CCBHCs that need 
planning and support to come into compliance with CCBHC Certification 
Criteria, and another for established CCBHCs seeking to expand, 
improve, and advance their services. The purpose of the CCBHC-E grants 
is to address problems of access, coordination, and quality of 
behavioral health care by establishing a standard definition and 
criteria for organizations certified as CCBHCs to ensure that all 
service recipients have access to a common set of comprehensive, 
coordinated services, with the ultimate goal of decreasing disparities 
in care and outcomes across communities.
    SAMHSA is requesting clearance for eleven data collection 
instruments and forms related to the implementation and impact studies 
to be conducted as part of an evaluation of these cohorts. Data 
collected in this evaluation will help SAMHSA assess the degree to 
which activities at the clinic level and systems level affect the 
development, implementation, and sustainment of CCBHCs consistent with 
the certification criteria and the impacts of model adoption on client 
outcomes.
    1. SAMHSA has developed a grantee web survey that will be 
administered twice to all 298 grant project directors, once during a 
first option year and again during a third option year. The survey 
consists of 76 questions the first time it is administered and 68 
questions the second time it is administered. The survey includes 
mostly binary or multiple-choice response options and a limited number 
of open-ended questions. The survey will enable respondents to complete 
the data collection instrument at a location and time of their choice, 
and its built-in editing checks and programmed skips will reduce 
response errors. SAMHSA estimates the web survey will take no more than 
45 minutes to complete and expects a 100 percent response rate, for a 
total of 298 completed grantee surveys at each time of administration. 
Grantees will provide valuable insights into their experience with the 
CCBHC model; if they are not conducted, SAMHSA will not have adequate 
information to evaluate the extent to which Planning, Development, and 
Implementation (PDI) grantees come into full compliance with the 
certification criteria and Improvement and Advancement (IA) grantees 
sustain the model in a manner that is consistent with the CCBHC 
certification criteria.
    2. SAMHSA has developed a protocol for annual interviews with all 
26 grantee Government Project Officers (GPOs) during three option 
years. Interviews will last approximately one hour and focus on the 
types of support grantees need to successfully implement the model in 
the future and identify specific components of the certification 
criteria that were challenging for grantees to implement. SAMHSA will 
offer to conduct individual interviews or meet with groups of GPOs 
during regularly scheduled meetings. GPOs will provide valuable 
insights into CCBHC model implementation and factors that facilitate or 
impede implementation; if they are not conducted, SAMHSA will not glean 
essential insights into contextual factors that affect implementation 
of the CCBHC model, including adaptations grantees make to the model to 
align with their local service delivery system, grantee characteristics 
that might contribute to successful implementation, and the types of 
support grantees need to successfully implement the model in the future 
and the specific components of the certification criteria that were 
challenging for grantees to implement.
    3. SAMHSA has developed a protocol for interviews with 
representatives from 50 organizations that support adults, youth, and 
family members with lived experience over the course of the first three 
option years. Interviews will last approximately one hour. State 
consumer, youth, and family member organizations will provide valuable 
insights into their own involvement in the planning and development of 
the model in respective states, and the perspectives of adults and 
youth who received CCBHC services and their families on various aspects 
of the CCBHC model; if they are not conducted, SAMHSA will not 
adequately understand how these organizations contributed to the 
planning and development of the model, how CCBHCs tailored services to 
the diverse needs of communities, and how people with lived experience 
might refine the model to fill gaps in care.
    4. SAMHSA has developed a protocol for interviews with a sample of 
120 grantee project directors during option years 1 and 3 (i.e., 
approximately 60 interviews in each year). Interviews will last 
approximately one hour. Grantees will provide valuable insights into 
CCBHC model implementation nuances that cannot be captured via the 
grantee survey alone; if they are not conducted, SAMHSA will not 
adequately understand how grantees initially plan to use funding to 
develop or improve CCBHC program-specific activities in response to the 
community needs assessment, and successes and challenges expanding 
services and increasing access to care, and how they eventually 
progress toward meeting the goals of Continuous Quality Improvement 
(CQI) efforts and plans for sustainability.

[[Page 66428]]

    5. SAMHSA has developed a protocol for interviews with clinic 
leadership from a sample of 50 strategically selected grantees for site 
visits during the first three option years. Positions of leadership 
include project directors, medical directors, and/or quality 
improvement directors. Interviews will last approximately one hour. 
Clinic leaders will provide valuable insights into understanding their 
experiences and perspectives as they implement the CCBHC model; if they 
are not conducted, SAMHSA will not adequately understand the more 
granular, on-the-ground impacts of model implementation.
    6. SAMHSA has developed a protocol for interviews with frontline 
clinic staff from a sample of 50 strategically selected grantees for 
site visits. Clinic staff positions include mental health and substance 
use providers, case managers, and peer mentors/support personnel. 
Interviews will last approximately one hour. Clinic staff will provide 
valuable insights into understanding their experiences and perspectives 
as the site implements the CCBHC model; if they are not conducted, 
SAMHSA will not adequately understand the impacts of model 
implementation from the perspective of the clinic staff.
    7. SAMHSA has developed a protocol for interviews with 
representatives of CCBHC partners from a sample of 50 strategically 
selected grantees for site visits, including designated collaborating 
organizations (DCOs) and Opioid Treatment Programs (OTPs). Interviews 
will last approximately one hour. Clinic partner organizations will 
provide valuable insights into understanding their experiences and 
perspectives; if they are not conducted, SAMHSA will not adequately 
understand how partnerships with DCOs and OTPs function, how care is 
coordinated between entities, and how CCBHCs maintain clinical 
responsibility for DCO services.
    8. SAMHSA has developed a protocol for focus groups with people 18 
and older who receive CCBHC services from a sample of 50 strategically 
selected grantees for site visits. Focus groups will last approximately 
one hour and consist of 8-10 adult clients, who will provide valuable 
insights into understanding their experience of CCBHC services; if they 
are not conducted, SAMHSA will not be able to adequately synthesize and 
present similar or different perspectives among diverse stakeholders 
from a common clinic.
    9. SAMHSA has developed a protocol for focus groups with people 
under 18 who receive CCBHC services. Focus groups will last 
approximately one hour and consist of 8-10 youth clients, who will 
provide valuable insights into understanding their experience of CCBHC 
services; if they are not conducted, SAMHSA will not be able to 
adequately synthesize and present similar or different perspectives 
among diverse stakeholders from a common clinic.
    10. SAMHSA has developed a protocol for focus groups with parents 
and caregivers of youth who receive CCBHC services. Focus groups will 
last approximately one hour and consist of 8-10 parents and caregivers 
of youth clients, who will provide valuable insights into understanding 
their experience of CCBHC services; if they are not conducted, SAMHSA 
will not be able to adequately synthesize and present similar or 
different perspectives among diverse stakeholders from a common clinic.
    11. SAMHSA has developed a protocol for in-person interviews with a 
sample of clients who receive CCBHC services. The interview consists of 
33 questions and will take place on no more than three occasions at the 
same time as National Outcome Measures (NOMs) data collection. 
Interviews will last approximately 15 minutes. If they are not 
conducted, the evaluation team will not have adequate information to 
evaluate longitudinal changes in client-level outcomes pertaining to 
substance use, mental health symptomology and functioning, and 
recovery, as these dimensions are not captured in the NOMs data with 
sufficient sensitivity to detect change over time. It is essential to 
obtain information directly from the clients of CCBHC services to 
understand how implementation of the model affects their access to care 
and experiences with care.
    The estimated response burden is as follows:

--------------------------------------------------------------------------------------------------------------------------------------------------------
                                                                                    Number      Average burden     Total                    Total hour
                        Type of respondent                          Number of    responses per   per response      burden      Average      cost burden
                                                                   respondents    respondent      (in hours)       hours     hourly wage        \a\
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Grantee survey...................................................          298               2            0.75          447       $59.07      $26,404.29
GPO interviews...................................................           26               3               1           78        45.85        3,576.30
Consumer & family member organization interviews.................           50               1               1           50        29.14        1,457.00
Grantee phone/virtual interviews.................................          120               1               1          120        59.07        7,088.40
Clinic leadership interviews.....................................      \b\ 150               1               1          150        59.07        8,860.50
Clinic staff interviews..........................................      \c\ 250               1               1          250        49.19       12,297.50
Clinic partner interviews........................................      \d\ 150               1               1          150        61.26        9,189.00
Adult client focus groups........................................      \e\ 500               1               1          500        22.26       11,130.00
Youth client focus groups........................................      \f\ 400               1               1          400          N/A             N/A
Parents/caregivers of youth clients focus groups.................      \g\ 400               1               1          400        22.26        8,904.00
Client interview.................................................       45,700               3            0.25       34,275        22.26      762,961.50
                                                                  --------------------------------------------------------------------------------------
    Total........................................................   \h\ 47,999  ..............  ..............       36,820  ...........      851,868.50
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\a\ Total respondent cost is calculated as number of respondents x number of responses per respondent x average burden per response in hours x average
  hourly wage.
\b\ 3 respondents per site x 50 site visits = 150 total respondents.
\c\ 5 respondents per site x 50 site visits = 250 total respondents.
\d\ 3 respondents per site x 50 site visits = 150 total respondents.
\e\ 10 respondents per site x 50 site visits = 500 total respondents.
\f\ 8 respondents per site x 50 site visits = 400 total respondents.
\g\ 8 respondents per site x 50 site visits = 400 total respondents.
\h\ Estimated number of total unique respondents; some respondents, such as project directors, will overlap across the data collection activities.


[[Page 66429]]

    Send comments to SAMHSA Reports Clearance Officer, Room 15E-57A, 
5600 Fishers Lane, Rockville, MD 20857 OR email a copy to 
[email protected]. Written comments should be received by 
October 15, 2024.

Alicia Broadus,
Public Health Advisor.
[FR Doc. 2024-18253 Filed 8-14-24; 8:45 am]
BILLING CODE 4162-20-P