Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV)

Forms and Documents

Document Name	Status
Form Attachment 7 - Ins Collaborators/Partners Form and Instruction	New
Form Attachment 6 - Con Direct Service - Dosage Form and Instruction	New
Form Attachment 5 - Ins Direct Service - Staff Form and Instruction	New
Form Attachment 3 - Ins Administrator - PD/PM Form and Instruction	New
Form Attachments 1a and Client FG Form and Instruction	New
Form Attachments 1a and Client Survey Form and Instruction	New
TCE-HIV_OMB_Supporting_Statement_07-14-2010_FINAL.docx Supporting Statement B	2010-07-14
Attachment 8.pdf Supplementary Document	2010-08-02
Attachment 4.pdf Supplementary Document	2010-08-02
Attachments 2a, 2b, 2c, and 2d.pdf Supplementary Document	2010-08-02
Attachments 2a, 2b, 2c, and 2d.pdf Supplementary Document	2010-08-02
TCE-HIV_OMB_Supporting_Statement_07-14-2010_FINAL.docx Supporting Statement A	2010-07-14

IC Document Collections

IC ID	Document Title	Status
194046	Collaborators/Partners Form and Instruction	New
194045	Direct Service - Dosage Form and Instruction	New
194044	Direct Service - Staff Form and Instruction	New
194043	Administrator - PD/PM Form and Instruction	New
194042	Client FG Form and Instruction	New
194041	Client Survey Form and Instruction	New

ICR Details

OMB Control No: 0930-0317	ICR Reference No: 201008-0930-001
Status: Historical Inactive	Previous ICR Reference No:
Agency/Subagency: HHS/SAMHSA	Agency Tracking No:
Title: Targeted Capacity Expansion Program for Substance Abuse Treatment and HIV/AIDS Services (TCE-HIV)
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 10/20/2010
	Date Received in OIRA: 08/03/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved
Responses	0	0	0
Time Burden (Hours)	0	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: This data collection is to study the risk and protective factors related to substance use and HIV. The primary purpose of the Project is to conceptualize, plan, and implement a multi-site valuation to investigate the process, outcome, and effect of substance abuse treatment and HIV/AIDS services provided by 48 SAMHSA grantees. The grantees' focus is on enhancing and expanding substance abuse treatment and/or outreach and pretreatment services in conjunction with HIV/ AIDS services in African American, Hispanic/Latino, and other racial and ethnic minority communities.

---

Authorizing Statute(s): US Code: 5 USC 509 Name of Law: Priority Substance Abuse Treatment Needs of Regional and National Significance
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 54830	10/23/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 35818	06/23/2010
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
Client Survey	Attachments 1a and 1b - Instruments	Attachments 1a and 1b - Instruments
Client FG	Attachments 1a and 1b - Instruments	Attachments 1a and 1b - Instruments
Administrator - PD/PM	Attachment 3 - Instruments	Attachment 3 - Instruments
Direct Service - Staff	Attachment 5 - Instruments, Attachment 6 - Consent Form	Attachment 5 - Instruments ,   Attachment 6 - Consent Form
Direct Service - Dosage	Attachment 6 - Consent Form	Attachment 6 - Consent Form
Collaborators/Partners	Attachment 7 - Instruments	Attachment 7 - Instruments

---

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new data collection.

---

Annual Cost to Federal Government: $2,531,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 08/03/2010

---