[Federal Register Volume 90, Number 146 (Friday, August 1, 2025)]
[Notices]
[Pages 36165-36167]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-14624]
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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) 276-0361.
Proposed Project: 988 Suicide and Crisis Lifeline and Crisis Services
Program Evaluation--New Package
The Substance Abuse and Mental Health Services Administration
(SAMHSA) 988 & Behavioral Health Crisis Coordinating Office (BHCCO) is
requesting clearance for the new data collection associated with the
evaluation of the SAMHSA 988 Suicide and Crisis Lifeline and Crisis
Services Program Evaluation (988 Suicide and Crisis Lifeline
Evaluation). The collection of this information is critical to
successfully oversee the operational response and quality of service
through the 988 Suicide and Crisis Lifeline to ensure connections to
care for individuals in suicidal crisis or emotional distress
contacting in for 988 phone, chat, and text support for connecting
local, state/territory, and national outcomes and monitoring
contractual obligations for current and future 988 grant programs.
In 2020, Congress designated the three-digit number 9-8-8 for the
Suicide and Crisis Lifeline, and the Suicide and Crisis Lifeline
transitioned to the 3-digit number in July 2022. As a part of the
federal government's commitment to addressing the mental health and
opioid crises in America, unprecedented federal resources have been
invested to expand crisis centers in support of 988. Since its launch
in July 2022, the 988 Suicide & Crisis Lifeline has answered over 10
million contacts (SAMHSA, 2024). Progress recognized in 2023 continues
in all areas including crisis line features, crisis center supports,
and funding. In FY2024, nearly $500 million was allocated for new
funding opportunities to support the 988 Lifeline Administrator and
other grantees at the state, territorial, Tribal, and center levels, as
part of the commitment to strengthen crisis care nationally. In Section
1103(a)(2)(B) of the Consolidated Appropriations Act, 2023 (Pub. L.
117-328), Congress called for enhanced program evaluation, including
performance measures to assess program response and improve readiness
and performance of the service, including review of each contact to
ensure timely connection of service and quality provision in line with
evidence-based care. To meet the standards and requirements set forth
in the statute, ongoing communication of key outcomes within this OMB
request must be received and reviewed to ensure connection and quality
of care through the 988 Suicide and Crisis Lifeline.
The information collected will be used by SAMHSA to conduct an
evaluation of the 988 Suicide and Crisis Lifeline and Crisis Services,
to ensure individuals in suicidal, mental health, and/or substance use
crisis can contact 988 Suicide and Crisis Lifeline and are connected to
crisis centers providing evidence-based care and receiving critical
resource referral and linkage, including opportunities for mobile
crisis support, crisis receiving and stabilizing facilities, peer
respite centers, and withdrawal management services. The purpose of the
988 Lifeline and Crisis Services Program Evaluation is to assess the
implementation and expansion of the 988 Lifeline in the U.S. The
evaluation will provide SAMHSA, grantees, and other interested parties
with the information needed to strengthen the Behavioral Health Crisis
Services Continuum (BHCSC) for all people in crisis. The evaluation
utilizes multiple studies to conduct the evaluation of the 988 Lifeline
and Crisis Services across a 5-year period. The 988 Lifeline and Crisis
Services Program Evaluation includes three levels: system-level,
client-level, and impact. Embedded within each of the three evaluation
levels are inquiries into differences in utilization of 988 Lifeline
and BHCSC services and outcomes.
The System-level Evaluation examines the characteristics,
collaborations, and structures of the crisis services infrastructure
within states, territories, and Tribal jurisdictions that support
improved client outcomes. The Systems-level Evaluation includes two
studies: the System Composition and Collaboration Study and the System-
Level Service Utilization Study. The System Composition and
Collaboration Study examines the structure of the 988 Lifeline and the
BHCSC at the national, state, territory, and Tribal levels, and the
extent to which crisis service agencies work together. The System-level
Service Utilization Study
[[Page 36166]]
investigates whether the 988 Lifeline and BHCSC are successful in
creating a behavioral-health-system-first response to crisis events and
the resulting reduction in use of non-behavioral health crisis services
(e.g., 911, law enforcement, emergency medical services).
The Client-level Evaluation provides critical information about the
ways in which the 988 Lifeline and crisis services fulfill their
mission to connect those in crisis with the services and supports
needed to reduce crisis risk and improve overall behavioral health
outcomes. The Client-level Evaluation consists of two studies: The
Client-level Service Utilization and Outcome Study and the Client-level
Risk Reduction Study. The Client-Level Service Utilization and Outcome
Study explores the effectiveness of 988 Lifeline and BHCSCs in linking
individuals to referral services following their contact with the
crisis system and assess the relationship between engagement with
crisis services and behavioral health outcomes. The Client-Level Risk
Reduction Study assesses the efficacy of 988 Lifeline and BHSCS
contacts on immediate reductions in risks of suicide, violence toward
others, and overdose.
The Impact Evaluation informs SAMHSA's efforts to continue to build
the evidence base for suicide prevention and crisis programming.
Specifically, this evaluation will examine the impact of 988 Lifeline
and BHCSC on suicide and overdose morbidity and mortality. A quasi-
experimental interrupted time series (ITS) design using extant,
secondary data sources (e.g., CDC mortality data, Medicaid claims data,
data from Healthcare Cost and Utilization Project (HCUP), data from the
NSDUH, and SAMHSA's Performance and Accountability Reporting System
[SPARS] data) gathered across multiple years to establish longitudinal
state-level trends before and after major milestones in the
implementation of the 988 Lifeline and BHCSC.
The 988 Lifeline and Crisis Services Program Evaluation engages
with the following SAMHSA grant-funded programs that make up the core
of the crisis care continuum: 988 State/Territory; 988 Tribal nations;
Community Crisis Response Program (CCRP); Crisis Center Follow-Up
(CCFU); 988 Administrator; and Certified Community Behavioral Health
Clinics (CCBHCs). Additional grant programs which are relevant to the
BHCSC, such as the Mental Health Services Block Grant (MHBG), State
Opioid Response (SOR), Tribal Opioid Response (TOR), Substance Use
Prevention, Treatment, and Recovery Services Block Grant (SUPTRS BG),
will be included in portions of the evaluation as relevant. In
addition, crisis-providing organizations that are not SAMHSA grantees,
especially mobile crisis programs, crisis stabilization units, and
CCBHCs will also be engaged to participate in the evaluation.
Ultimately, the purpose of the 988 Lifeline and Crisis Services
Program 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 16,724 respondents for
the 988 Lifeline and Crisis Services Program Evaluation instruments,
with a combined hourly estimate to be 8,006.10 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 988 Lifeline and Crisis Services Program Evaluation
is as follows annualized over the requested 3-year clearance period is
presented below:
Total Annualized Burden Hours and Costs
[Across the 3-year clearance period]
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Hourly
Number of Responses Total Burden per Annual wage Total
Type of respondent Instrument respondents per number of response burden rate annualized
per year respondent responses (hours) (hours) ($) cost ($)
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System Composition and Collaboration Study
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Organizational Staff/Crisis System SIS....................... 73 1 73 0.75 54.75 $78.06 $4,273.79
Administrator \1\.
Organizational Staff/Crisis Agency CCPS...................... 1,034 1 1,034 1.00 1,034.00 58.80 60,799.20
Manager \2\.
Organizational Staff/Crisis Agency Staff KII-CS.................... 35 1 35 1.00 35.00 27.46 961.10
\3\.
Organizational Staff/Crisis Agency Staff KII-CS-CSS................ 13 1 13 0.50 6.50 27.46 178.49
\3\.
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Client-Level Service Utilization and Outcome Study
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Organizational Staff/Crisis Agency Staff CCDF...................... 6,000 1 6,000 0.15 900.00 27.46 24,714.00
\3\.
Parents/Caregivers \4\.................. CCDF Parent Supplement.... \5\ 1,560 1 1,560 0.10 156.00 7.25 1,131.00
Client \4\.............................. CES--Baseline............. 6,000 1 6,000 0.75 4,500.00 7.25 32,625.00
Client \4\.............................. CES--3 months............. 1,500 1 1,500 0.65 975.00 7.25 7,068.75
Client \4\.............................. CES--6 months............. 375 1 375 0.65 243.75 7.25 1,767.19
Client \4\.............................. CES--12 months............ 94 1 94 0.65 61.10 7.25 442.98
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Client-Level Risk Reduction Study
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Client \4\.............................. C-KII-DC.................. 30 1 30 1.00 30.00 7.25 217.50
Client \4\.............................. C-KII-TPC................. 10 1 10 1.00 10.00 7.25 72.50
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Total............................... .......................... 16,724 .......... ........... ........... 8,006.10 ....... 134,251.49
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\1\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates mean hourly salary for General and Operations Managers (code 11-
1021), https://www.bls.gov/oes/current/oes111021.htm.
\2\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates mean hourly salary for Social and Community Service Managers
(code 11-9151), https://www.bls.gov/oes/current/oes119151.htm.
\3\ BLS OES May 2022 National Industry-Specific Occupation Employment and Wage Estimates mean hourly salary for Counselors, Social Workers, and Other
Community and Social Service Specialists (code 21-1000), https://www.bls.gov/oes/current/naics5_541720.htm#29-0000.
[[Page 36167]]
\4\ https://www.usa.gov/minimum-wage.
\5\ This number represents an estimate based on the average distribution of monthly contacts by modality, cited in Lifeline Performance Metrics (SAMHSA,
April 2024), and assumes that 40% of all individuals who contact 988 through chat or text (as cited in Gould et al., 2021 and Pisani et al., 2022) and
20% of those who contact 988 through phone call are below the age of 18.
Written comments and recommendations for the proposed information
collection should be sent within 30 days of publication of this notice
to www.reginfo.gov/public/do/PRAMain. Find this particular information
collection by selecting ``Currently under 30-day Review--Open for
Public Comments'' or by using the search function.
Krishna Palipudi,
Social Science Analyst.
[FR Doc. 2025-14624 Filed 7-31-25; 8:45 am]
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