[Federal Register Volume 89, Number 176 (Wednesday, September 11, 2024)]
[Notices]
[Pages 73666-73668]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-20435]


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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.

Project: Zero Suicide in Health Systems Evaluation--New Package

    The Substance Abuse and Mental Health Services Administration 
(SAMHSA) is requesting clearance for the new data collection associated 
with the Evaluation of the SAMHSA Zero

[[Page 73667]]

Suicide in Health Systems (Zero Suicide Evaluation). Per the Public 
Health Services Act (42 U.S.C. 290bb-43), SAMHSA is required to 
evaluate the Zero Suicide grant, specifically (1) ``evaluate the 
activities supported by grants awarded, disseminate, as appropriate, 
the findings from the evaluation; and (2) provide appropriate 
information, training, and technical assistance, as appropriate, to 
eligible entities that receive a grant under this section, in order to 
help such entities to meet the requirements of this section, including 
assistance with selection and implementation of evidence.''
    The goal of the Zero Suicide program is reduction of suicide and 
suicide attempts across America, focusing on individuals who are 25 
years and older. The purpose of this program is to implement the Zero 
Suicide intervention and prevention model for adults throughout a 
health system or systems. The Zero Suicide model is a comprehensive, 
multi-setting approach to suicide prevention in health. To accomplish 
this critical, lifesaving work, it is essential that the effectiveness 
of these programs be evaluated on an ongoing basis, with implementation 
of suicide prevention programs continually informed by high-quality 
evaluation results. SAMHSA will use this data to reduce suicide 
ideation, suicide attempts, and deaths due to suicide.
    SAMHSA has awarded new grants and continued funding to 25 grantees, 
Cohort 5 (15 grantees) with project period of Sept 30, 2023, to Sept 
29, 2028; and Cohort 4 (10 grantees; includes one tribal organization) 
with project period of March 31, 2021, to March 30, 2026. SAMHSA has 
requested funding for 11 grantees to be funded as Cohort 6 in the 
President's fiscal year 2025 budget.
    The Zero Suicide Evaluation is designed to evaluate the 
implementation, effectiveness, and overall impact of the Zero Suicide 
program upon grantees in the United States. The evaluation will assess 
Zero Suicide program activities implemented by grantees and ultimately 
provide SAMHSA with the information needed to understand and document 
program effectiveness on reducing suicide morbidity and mortality, 
specifically among those who encounter the healthcare system. While 
acknowledging the lack of evidence for cultural adaptations to 
evidence-based and empirically supported treatments and interventions, 
and that research has not been conducted with historically marginalized 
and underserved communities (e.g., Black, Asian, Autistic, Lesbian, 
Gay, Bisexual, Transgender, Queer, and Intersex plus (LGBTQI+), and 
others), Zero Suicide pushes systems to ensure that clients' cultural 
contexts are considered and honored in what treatments are offered and 
how those treatments are adapted. Thus, with behavioral health equity 
as a central component woven throughout the Zero Suicide Framework, the 
proposed evaluation will ensure that each study includes specific 
behavioral health equity tenets to ensure a culturally specific 
understanding of Zero Suicide implementation, outcomes, and impacts.
    The Zero Suicide Evaluation includes four studies: Systems Change, 
Workforce, Consumer Experience, and Impact. The Systems Change Study is 
designed to understand how grantees are implementing the Zero Suicide 
Program in accordance with the Zero Suicide Framework, the core 
activities accomplished, and indicators of sustainable systems change 
(i.e., policy and practice changes, infrastructure changes, 
organizational culture). The Systems Change Study will leverage two 
surveys: the Prevention Strategies Inventory (PSI), and the Behavioral 
Health Provider Survey (BHPS). Additionally, the Systems Change Study 
will be informed through Case Studies and Cost Sub-Studies, using Key 
Informant Interviews to gather information.
    The purpose of the Workforce Study is to document staff awareness 
and perceptions associated with the Zero Suicide activities implemented 
by Zero Suicide-participating Healthcare Organizations (HCOs). This 
study also seeks to understand the utilization, outcomes, and 
sustainment of training programs intended to increase the knowledge, 
confidence, and skills among staff to address suicide, both in the 
short and long-term. The Workforce Study will be informed by several 
surveys: the Workforce Survey (WS), the Training Activity Summary Page 
(TASP), and the Training Utilization and Preservation Survey (TUPS).
    The Consumer Experience Study will assess the relationship between 
Zero Suicide activities and key clinical outcomes (i.e., suicide risk, 
depression), along with consumer perceptions of care, access to care, 
services received, and treatment adherence. The Consumer Experience 
Study will be informed by the BHPS, Consumer Experience Survey (CES), 
Clinical Outcomes Form (COF), and Grantee Performance Data. The CES and 
the COF target and follow those receiving services through a Zero 
Suicide grantee from the point when they enroll in services to when 
they discharge from services.
    The Impact Study will use secondary data and quasi-experimental 
designs to develop a control group and estimate the causal impact of 
the Zero Suicide Program on suicide morbidity and mortality.
    Ultimately, the purpose of the Zero Suicide Evaluation is to build 
the program's knowledge base of effectiveness by thoroughly describing 
the implementation, outcomes, and impact of a program meant to reduce 
deaths by suicide.
    The total annualized burden is an estimated 15,504 respondents for 
the Zero Suicide instruments, with a combined hourly estimate to be 
4,902 hours. Burden estimates are based on the data collection 
requirements and the number of respondents. The estimated response 
burden to collect this information associated with the Zero Suicide 
Evaluation annualized over the requested 3-year clearance period is 
presented below:

                                                                 Total and Annualized Averages: Respondents, Responses and Hours
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                                                                                     Number of                                      Burden per
              Type of respondent                              Form                  respondents    Responses per   Total number      response      Annual burden    Hourly wage     Total cost
                                                                                     per year       respondent     of responses       (hours)         (hours)          rate
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Project Evaluator 1...........................  PSI.............................              40               4             160               1             160          $61.53          $9,845
Grantee/HCO administrator 2...................  BHPS............................              47               1              47             0.5              24           61.53           1,477
Grantee/HCO administrator 2...................  KII-Case Studies................               7               1               7               1               7           61.53             431
HCO Staff 3...................................  KII-Case Studies................              27               1              27               1              27           26.81             724
Grantee/HCO administrator 2...................  KII-Cost Sub studies............               2               1               2               1               2           61.53             123
HCO Staff 3...................................  WFS.............................           9,400               1           9,400            0.25           2,350           26.81          63,004
Project Evaluator1............................  TASP............................              40              10             400            0.25             100           36.67           3,667

[[Page 73668]]

 
HCO Staff 3...................................  TUPS-Baseline...................           3,334               1           3,334            0.25             834           26.81          22,360
HCO Staff 3...................................  TUPS-6 month....................             252               1             252             0.5             126           26.81           3,378
HCO Staff 3...................................  TUPS-12 month...................             189               1             189             0.5              95           26.81           2,547
Clinicians....................................  C-SIF...........................             180             8.3           1,494            0.25             374           57.21          21,397
Consumer......................................  CES-Baseline....................           1,128               1           1,128             0.4             451            7.25           3,270
Consumer......................................  CES-6-month.....................             843               1             843             0.4             337            7.25           2,443
Consumer......................................  C-KII...........................              15               1              15               1              15            7.25             109
                                                                                 ---------------------------------------------------------------------------------------------------------------
    Total.....................................  ................................          15,504  ..............          17,298  ..............           4,902  ..............         134,773
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Abbreviation: HCO=Healthcare Organization
\1\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Survey Researchers (code 19-3022); https://www.bls.gov/oes/cuSeetrrent/naics5_541720.htm
\2\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Medical and Health Services Managers (code 11-9111); https://www.bls.gov/oes/current/oes119111.htm
\3\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Community and Social Service Occupations (code 29-1000); https://www.bls.gov/oes/current/oes210000.htm
\4\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates average annual salary for Health Diagnosing and Treating Practitioners (code 29-1000); https://www.bls.gov/oes/current/oes_nat.htm#29-0000
\5\ BLS OES May 2022 Characteristics of minimum wage workers, 2022; https://www.bls.gov/opub/reports/minimum-wage/2022/
  home.htm#:~:text=In%202022%2C%2078.7%20million%20workers,wage%20of%20%247.25%20per%20hour.

    Send comments to SAMHSA Reports Clearance Officer, 5600 Fisher 
Lane, Room 15E45, Rockville, MD 20852 OR email him a copy at 
[email protected]. Written comments should be received by 
November 12, 2024.

Alicia Broadus,
Public Health Advisor.
[FR Doc. 2024-20435 Filed 9-10-24; 8:45 am]
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