[Federal Register Volume 90, Number 224 (Monday, November 24, 2025)]
[Notices]
[Pages 52987-52988]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-20747]
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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 Office of Management and Budget (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 at (240) 276-0361.
Project: Data Resource Toolkit Protocol for the Crisis Counseling
Assistance and Training Program (OMB No. 0930-0270)--Reinstatement
The SAMHSA Center for Mental Health Services (CMHS), as part of an
interagency agreement with the Federal Emergency Management Agency
(FEMA), provides a toolkit to be used for the purposes of collecting
data on the Crisis Counseling Assistance and Training Program (CCP).
The CCP provides supplemental funding to states, territories, and
tribes for individual and community crisis intervention services after
a presidentially declared major disaster.
The CCP has provided disaster behavioral health services to
millions of disaster survivors since its inception, and, with more than
40 years of accumulated expertise, it has become an important model for
federal response to a variety of catastrophic events. Recent CCP grants
have been issued for nearly all 50 states, 5 territories, and at least
4 tribes. These grants have helped survivors of disasters such as
Hurricanes Helene and Milton in 2024; the catastrophic Maui wildfire in
2023; and other wildfires, severe storms, flooding, earthquakes, and
tornadoes in 2022 through 2025. CCPs address the short-term behavioral
health needs of communities primarily through (a) outreach and public
education, (b) individual and group counseling, and (c) referral.
Outreach and public education serve primarily to make people aware of
common disaster reactions and to engage people who may need further
care. Crisis counseling assists survivors in coping with current stress
and symptoms to return to pre-disaster functioning. Crisis counseling
relies largely on ``active listening,'' \1\ and crisis counselors also
provide education (especially about the nature of responses to
disaster, adversity, and trauma) and help participants build coping
skills. Crisis counselors \2\ typically work with a single participant
once or a few times. Because crisis counseling is time-limited,
referral is the third important function of CCPs. Counselors are
expected to refer survivors to formal treatment if they have developed
a mental and/or substance use disorder or are having difficulty in
coping with their disaster reactions.
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\1\ Active listening requires the crisis counselor to engage
fully with the survivor to understand what the survivor is
communicating. The crisis counselor engages in activities such as
asking questions, encouraging the survivor to respond candidly,
reflecting on what the survivor says, and not judging the survivor's
experiences or statements.
\2\ CCP crisis counselors are paraprofessionals (e.g., outreach
workers, community health workers, resource linkage coordinators)
trained to work with individuals, families, and groups to provide
short-term counseling and support. Crisis counselors also assess
survivors for reactions requiring referrals, and they provide
referrals as needed.
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Data about services delivered and users of services are collected
throughout the program period. The data are collected via the use of a
toolkit that relies on standardized forms. At the program level, the
data are entered quickly and easily into a cumulative database mainly
through mobile data entry or paper forms to yield summary tables for
quarterly and final reports for the program. Data entry allows for the
data to be uploaded and linked to a national database that houses data
collected across CCPs. The standardized data collection and database
allow SAMHSA CMHS and FEMA to produce summary reports of services
provided across all programs funded.
The components of the toolkit are listed and described below:
Encounter logs. These forms document all services
provided. The CCP requires crisis counselors to complete these logs.
There are three types of encounter logs: (1) Individual/Family Crisis
Counseling Services Encounter Log, (2) Group Encounter Log, and (3)
Weekly Tally Sheet.
[cir] Individual/Family Crisis Counseling Services Encounter Log.
Crisis counseling is defined as an interaction that lasts at least 15
minutes and involves participant-provided information. This form is
completed by the crisis counselor for each participant, defined as the
person or people who actively participated in the session (that is, by
engaging in conversation), not someone who was merely present. One form
may be completed for all family or household members who are actively
engaged in the visit. Information collected includes demographics,
service characteristics, risk factors, event reactions, and referral
data.
[cir] Group Encounter Log. This form is used to collect data on
either a group crisis counseling encounter or a group public education
encounter. The crisis counselor indicates in a checkbox the class of
activities (that is, counseling or education). Information collected
includes service characteristics, group identity and characteristics,
and group activities.
[cir] Weekly Tally Sheet. This form documents brief educational and
supportive encounters not captured on any other form. Information
collected includes service characteristics, daily tallies, and weekly
totals for brief educational or supportive contacts, material
distribution with no or minimal interaction, and social media activity.
Assessment and referral tools (ARTs). These tools--one for
adults and one for children and youth--can be administered at any time
if the crisis counselor feels the participant is exhibiting distress or
they would benefit from referral to other services. It is recommended
that the ARTs be administered during encounters where more than four
event reactions or certain risk categories are indicated. These tools
will typically be used beginning 3 months after the disaster and will
be completed by the crisis counselor.
Participant Feedback Survey Form. These surveys are
completed by and collected from a sample of participants, not every
participant. Sampling is done on a biannual basis 6 months and 1 year
after the disaster. Information collected includes satisfaction with
services, perceived improvements in coping and functioning, types of
exposure, and event reactions.
Service Provider Feedback Form. These surveys are
completed by and collected from the CCP service providers anonymously
at 6 months and 1 year after the disaster. The survey is coded on
several program-level as well as provider-level variables. However,
[[Page 52988]]
the program survey data are only shared with program management if more
than 10 individual provider staff members complete the survey.
There are no changes to the Weekly Tally Sheet since its last
approval. Revisions to the Individual Encounter Log include updating
the collection of adult age information to align with SAMHSA reporting
convention, race and ethnicity information to align with updates to OMB
guidance, and sex information to align with White House guidance;
removing the question about recent immigration; adding ``stress
management'' to the example for ``managing physical and emotional
reactions''; adding a separate referral option for ``FEMA-funded
programs;'' and changing ``self-help groups'' to ``self-help or support
groups.'' For the Group Encounter Log, changes include updating the
collection of race and ethnicity information to align with OMB
guidance, adding a question about primary language spoken during the
encounter, removing the question about recent immigration, and adding
``stress management'' to the example for ``managing physical and
emotional reactions.''
For the Adult and Child/Youth ARTs, edits were made to update the
collection of adult age information to align with SAMHSA reporting
convention, race and ethnicity information to align with updated OMB
guidance, and sex information to align with White House guidance; frame
demographic information collection as questions; add a graphic showing
response options, change ``self-help groups'' to ``self-help or support
groups,'' and include a separate referral option for ``FEMA-funded
programs''; and remove questions related to recent immigration and
suicidal ideation. In addition, since the diagnostic criteria for
posttraumatic stress disorder (PTSD) changed in the Diagnostic and
Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the PTSD
assessment tool within the Child/Youth ART was updated to align with
the new PTSD criteria via the validated and abbreviated University of
California at Los Angeles PTSD Reaction Index for DSM-5 (Reaction
Index-5) tool. The Child/Youth ART was also updated to use the terms
``caregiver'' and ``child or youth'' throughout, move the statement
that is read to the respondents, and add a question about whether the
primary respondent was the caregiver or child or youth.
Changes to the collection of age, race, ethnicity, sex, and
disaster-related experiences information were made to the Participant
Feedback Survey and Service Provider Feedback Forms to align with
encounter and ART forms. In addition, the Participant Feedback Survey
Form was updated to state more explicitly that the form is voluntary
and the respondent may skip questions; add ``prefer not to answer''
options; ask about referral to ``FEMA-funded programs''; add ``using/
misusing other substances'' to the examples for the ``In the past month
to what extent have you had trouble taking care of your health (e.g.,
eating poorly, not getting enough rest, smoking more, drinking more)?''
question; add a sentence noting that if the respondent was not impacted
by the disaster, they should skip the next set of questions; and update
response options for the question about education and household income.
The Service Provider Feedback Form language was further changed to
include ``resources'' when asking providers to rate ``support,
training, and resources provided to help you avoid compassion fatigue
or to cope with the stress of listening to and helping others''; update
the response options for questions about education and household
income; and add a sentence noting that if the respondent was not
impacted by the disaster, they should skip the next set of questions.
The estimates of the annualized burden hours are provided in Table 1.
Table 1--Annualized Hour Burden Estimates
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Estimated
Data collection instrument number of Responses per Total Hours per Total hour
respondents respondent responses response burden
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Individual/Family Crisis \1\ 800 \2\ 200 160,000 0.13 20,800
Counseling Services Encounter
Log............................
Group Encounter Log............. \3\ 400 \3\ 33 13,200 0.08 1,056
Weekly Tally Sheet.............. \1\ 800 \4\ 52 41,600 0.20 8,320
Adult Assessment and Referral \1\ 800 9 \5\ 7,200 0.17 1,224
Tool...........................
Child/Youth Assessment and \1\ 800 1 \5\ 800 0.08 64
Referral Tool..................
Participant Feedback Survey Form 4,000 1 4,000 0.30 1,200
Service Provider Feedback Form.. \6\ 400 1 400 0.30 120
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Total....................... 8,000 .............. 227,200 .............. 32,784
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\1\ The value for estimated number of respondents (800) is based on a typical average of 40 crisis counselors
(or 40 full-time equivalents [FTEs]) per grant with an approximate average of 20 grants per year (i.e., 40 x
20 = 800).
\2\ On average, each FTE crisis counselor completes 200 forms over 1 year.
\3\ On average, a pair of crisis counselors completes 1 form per week (i.e., 2 counselors completing 1 form =
400 crisis counselors) for 33 weeks.
\4\ The average length of a CCP grant is 52 weeks.
\5\ On average, 5% of the Individual/Family Crisis Counseling Services Encounter Logs completed result in the
use of the assessment and referral tools (i.e., 160,000 individual x 5% = 8,000, which equals the total Adult
and Child/Youth Assessment and Referral Tool responses).
\6\ On average, 50% of service providers/crisis counselors may complete or use this tool.
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 information collection
by selecting ``Currently under Review--Open for Public Comments'' or by
using the search function.
Alicia Broadus,
Public Health Advisor.
[FR Doc. 2025-20747 Filed 11-21-25; 8:45 am]
BILLING CODE 4162-20-P