N-SSATS 2016 CATI N-SSATS 2016 CATI questionnaire

Attachment B5 (N-SSATS 2016 CATI questionnaire)
FORM APPROVED: OMB No. xxxx-xxxx
APPROVAL EXPIRES: xx/xx/xxxx
See OMB burden statement on last page

NATIONAL SURVEY OF SUBSTANCE ABUSE TREATMENT SERVICES
2016 N-SSATS
Hello

Hello, my name is [fill interviewer name] and I am calling
concerning the Federal Government's annual survey of substance
abuse treatment providers called N-SSATS or the National Survey
of Substance Abuse Treatment Services. The N-SSATS survey is
sponsored by SAMHSA, the Substance Abuse and Mental Health
Services Administration.

Confirm

Is this [fill facility name
[fill facility address line
[fill facility address line
[fill facility city, state,
<1>
<2>
<3>
<4>

GetDir

1 and 2] located at:
1]
2]
and zip]

INFORMATION IS CORRECT [goto GetDir]
CORRECT FACILITY, BUT NEEDS NAME/ADDRESS UPDATE
[goto GetDir]
WRONG NUMBER [goto Sorry]
HUNG UP DURING INTRODUCTION [goto ExitRemark]

May I speak with [fill director name] regarding this facility’s
2016 N-SSATS survey?
<1>
<2>
<3>
<4>

SPEAKING WITH FACILITY DIRECTOR/APPROPRIATE PERSON
[goto Intro]
CONNECTED TO FACILITY DIRECTOR/APPROPRIATE PERSON
[goto Hello2]
FACILITY DIRECTOR NOT AVAILABLE [goto Callback]
ANSWERING MACHINE [goto Message_Q]

Sorry

I'm sorry. Thank you for your time.

Hello2

Hello, my name is [fill interviewer name] and I am calling
concerning the Federal Government's annual survey of substance
abuse treatment providers called N-SSATS or the National Survey
of Substance Abuse Treatment Services. The N-SSATS survey is
sponsored by SAMHSA, the Substance Abuse and Mental Health
Services Administration.
[goto Intro]

Intro

Recently you were mailed a letter from Dr. Peter J. Delany at
SAMHSA along with a letter from your State or Federal Agency
Substance Abuse Director. Both letters requested the
participation of your facility in the 2016 N-SSATS. We are
calling at this time to complete the survey. Is this a good
time?
<1>
<2>
<3>
<4>
<5>
<6>
<7>
<8>
<9>

YES, CONTINUE [goto BeginSurvey]
SCHEDULE CALLBACK AT CONVENIENT TIME [goto Callback]
COMPLETING ON THE WEB [Thanks]
NO LONGER PROVIDES SUBSTANCE ABUSE TREATMENT [goto
BeginSurvey]
NEVER PROVIDED SUBSTANCE ABUSE SERVICES [goto
BeginSurvey]
DUPLICATE FACILITY [goto Duplicate]
MERGED WITH ANOTHER FACILITY [goto Merged]
FACILITY CLOSED/NO LONGER EXISTS [goto Thanks2]
SATELLITE FACILITY [goto Satellite]

<10>
<11>
<12>
BeginSurvey

WRONG NUMBER [goto Sorry]
COMPLETING BY MAIL [goto Thanks]
FACILITY IS A JAIL/PRISON [goto vJail]

NOTE: SINCE 2014, THE CATI INSTRUMENT ENDS AT THIS POINT.
INTERVIEWERS FOLLOW THE INSTRUCTIONS DETAILED BELOW, TO LAUNCH
THE WEB UTILITY. USING A UNIQUE INTERVIEWER URL FOR TRACKING
PURPOSES, THE TELEPHONE SURVEY IS COMPLETED WITH THE RESPONDENT
USING THE ONLINE INSTRUMENT.
Click on the three dots to connect to the Web Browser.
DO NOT CLICK THE THREE DOTS MORE THAN ONCE. IF NECESSARY, EXIT
BLAISE AND RE-OPEN THE CASE TO RECONNECT TO THE BROWSER.
YOU SHOULD HAVE ONLY ONE BROWSER WINDOW OPEN WHILE ACCESSING
THE WEB INSTRUMENT.
IF YOUR BROWSER DOES NOT APPEAR TO OPEN, CONFIRM IF THERE IS A
BROWSER WINDOW MINIMIZED AT THE BOTTOM OF YOUR SCREEN. IF
THERE IS, CLOSE IT.
WHILE IN THE WEB INSTRUMENT, DO NOT CLOSE YOUR BROWSER WINDOW
UNTIL THE CASE IS COMPLETE OR AFTER A BREAK OFF.
IF YOU ARE UNABLE TO ACCESS THE WEB INSTRUMENT, OR HAVE ANY
PROBLEMS OR QUESTIONS, CONTACT THE FLOOR SUPERVISOR
IMMEDIATELY.

Confirm2

I will be asking you questions about [fill facility name 1 and
2] located at
[fill facility address 1]
[fill facility address 2]
[fill facility City],
[fill facility State]
[fill facility zip]
[goto BeginSurvey]

BeginSurvey

NOTE: SINCE 2014, THE CATI INSTRUMENT ENDS AT THIS POINT.
INTERVIEWERS FOLLOW THE INSTRUCTIONS DETAILED BELOW, TO LAUNCH
THE WEB UTILITY. USING A UNIQUE INTERVIEWER URL FOR TRACKING
PURPOSES, THE TELEPHONE SURVEY IS COMPLETED WITH THE RESPONDENT
USING THE ONLINE INSTRUMENT.
Click on the three dots to connect to the Web Browser.
DO NOT CLICK THE THREE DOTS MORE THAN ONCE. IF NECESSARY, EXIT
BLAISE AND RE-OPEN THE CASE TO RECONNECT TO THE BROWSER.
YOU SHOULD HAVE ONLY ONE BROWSER WINDOW OPEN WHILE ACCESSING
THE WEB INSTRUMENT.
IF YOUR BROWSER DOES NOT APPEAR TO OPEN, CONFIRM IF THERE IS A
BROWSER WINDOW MINIMIZED AT THE BOTTOM OF YOUR SCREEN. IF
THERE IS, CLOSE IT.
WHILE IN THE WEB INSTRUMENT, DO NOT CLOSE YOUR BROWSER WINDOW
UNTIL THE CASE IS COMPLETE OR AFTER A BREAK OFF.

IF YOU ARE UNABLE TO ACCESS THE WEB INSTRUMENT, OR HAVE ANY
PROBLEMS OR QUESTIONS, CONTACT THE FLOOR SUPERVISOR
IMMEDIATELY.
RE1

We'll watch for that information to come in. Putting the client
information aside, it is important for every facility to answer
a few questions regarding the specific characteristics of their
facility--even if an administrative unit or parent facility
will report your client information for you. Could I ask you
these few questions now? It will only take about 15 minutes
<1>
<2>
<3>
<4>

BeginSurvey

YES
NO,
NO,
NO,

[goto BeginSurvey]
NOT A CONVENIENT TIME [goto Callback]
NOT THE PROPER PERSON TO TALK WITH [goto RE3]
WILL COMPLETE ON WEB [goto Thanks]

NOTE: SINCE 2014, THE CATI INSTRUMENT ENDS AT THIS POINT.
INTERVIEWERS FOLLOW THE INSTRUCTIONS DETAILED BELOW, TO LAUNCH
THE WEB UTILITY. USING A UNIQUE INTERVIEWER URL FOR TRACKING
PURPOSES, THE TELEPHONE SURVEY IS COMPLETED WITH THE RESPONDENT
USING THE ONLINE INSTRUMENT.
Click on the three dots to connect to the Web Browser.
DO NOT CLICK THE THREE DOTS MORE THAN ONCE. IF NECESSARY, EXIT
BLAISE AND RE-OPEN THE CASE TO RECONNECT TO THE BROWSER.
YOU SHOULD HAVE ONLY ONE BROWSER WINDOW OPEN WHILE ACCESSING
THE WEB INSTRUMENT.
IF YOUR BROWSER DOES NOT APPEAR TO OPEN, CONFIRM IF THERE IS A
BROWSER WINDOW MINIMIZED AT THE BOTTOM OF YOUR SCREEN. IF
THERE IS, CLOSE IT.
WHILE IN THE WEB INSTRUMENT, DO NOT CLOSE YOUR BROWSER WINDOW
UNTIL THE CASE IS COMPLETE OR AFTER A BREAK OFF.
IF YOU ARE UNABLE TO ACCESS THE WEB INSTRUMENT, OR HAVE ANY
PROBLEMS OR QUESTIONS, CONTACT THE FLOOR SUPERVISOR
IMMEDIATELY.

RE3

Who could answer facility-specific questions such as which
types of services are offered at this facility?
[goto RE4]

RE4

Could I please speak with that person?
<1>
<2>
<3>

RE5

YES [goto RE5]
NOT AVAILABLE - INTERVIEWER: Thank you, I will call
back. [goto Callback]
CONNECTED TO ANSWERING MACHINE [goto Message_R]

Hello, my name is [fill interviewer name] and I am calling on
behalf of the Federal Government's annual survey called the
National Survey of Substance Abuse Treatment Services. This
survey is sponsored by SAMHSA, the Substance Abuse and Mental
Health Services Administration. I have a few questions I'd like
to ask you. It will only take about 15 minutes. Is now a good
time?

<1>
<2>
<3>
BeginSurvey

YES, CONTINUE [goto BeginSurvey]
NO, NOT A CONVENIENT TIME [goto Callback]
NO, WILL COMPLETE ON WEB [goto Thanks]

NOTE: SINCE 2014, THE CATI INSTRUMENT ENDS AT THIS POINT.
INTERVIEWERS FOLLOW THE INSTRUCTIONS DETAILED BELOW, TO LAUNCH
THE WEB UTILITY. USING A UNIQUE INTERVIEWER URL FOR TRACKING
PURPOSES, THE TELEPHONE SURVEY IS COMPLETED WITH THE RESPONDENT
USING THE ONLINE INSTRUMENT.
Click on the three dots to connect to the Web Browser.
DO NOT CLICK THE THREE DOTS MORE THAN ONCE. IF NECESSARY, EXIT
BLAISE AND RE-OPEN THE CASE TO RECONNECT TO THE BROWSER.
YOU SHOULD HAVE ONLY ONE BROWSER WINDOW OPEN WHILE ACCESSING
THE WEB INSTRUMENT.
IF YOUR BROWSER DOES NOT APPEAR TO OPEN, CONFIRM IF THERE IS A
BROWSER WINDOW MINIMIZED AT THE BOTTOM OF YOUR SCREEN. IF
THERE IS, CLOSE IT.
WHILE IN THE WEB INSTRUMENT, DO NOT CLOSE YOUR BROWSER WINDOW
UNTIL THE CASE IS COMPLETE OR AFTER A BREAK OFF.
IF YOU ARE UNABLE TO ACCESS THE WEB INSTRUMENT, OR HAVE ANY
PROBLEMS OR QUESTIONS, CONTACT THE FLOOR SUPERVISOR
IMMEDIATELY.

Duplicate

Which facility is a duplicate of this one?
PRESS ENTER TO CHOOSE FROM LIST OR TO ENTER FACILITY INFO
[choose from list of facilities or goto MainFacility]

Merged

Which facility was this one merged with?
PRESS ENTER TO CHOOSE FROM LIST OR TO ENTER FACILITY INFO
[choose from list of facilities or goto MainFacility]

Satellite

Which facility is this one associated with?
For the purpose of this survey a satellite facility is one that
does not have permanent staff on location. Often times staff
will travel from another location to provide treatment on a
limited schedule.
PRESS ENTER TO CHOOSE FROM LIST OR TO ENTER FACILITY INFO
[choose from list of facilities or goto MainFacility]

MainFacility

May I have the name, address and phone number of the facility?
<1>

PhoneNumber

Continue

Please give me the telephone number, area code first?
[goto Thanks]

Message_R

*** REMINDER CALL MESSAGE ***
DID YOU LEAVE THE MESSAGE?
<1>
<2>

Message_Q

Yes
No

*** QUESTIONNAIRE CALL MESSAGE ***
DID YOU LEAVE THE MESSAGE?
<1>
<2>

Yes
No

Thanks

Thank you so much for your time. Your responses are very
important to the study and we look forward to receiving your
completed questionnaire.

Thanks2

Thank you for your time.

Callback

USE THE ‘APPOINTMENT’ TAB ABOVE TO MAKE AN APPOINTMENT.

BeginSurvey

NOTE: SINCE 2014, THE CATI INSTRUMENT ENDS AT THIS POINT.
INTERVIEWERS FOLLOW THE INSTRUCTIONS DETAILED BELOW, TO LAUNCH
THE WEB UTILITY. USING A UNIQUE INTERVIEWER URL FOR TRACKING
PURPOSES, THE TELEPHONE SURVEY IS COMPLETED WITH THE RESPONDENT
USING THE ONLINE INSTRUMENT.
Click on the three dots to connect to the Web Browser.
DO NOT CLICK THE THREE DOTS MORE THAN ONCE. IF NECESSARY, EXIT
BLAISE AND RE-OPEN THE CASE TO RECONNECT TO THE BROWSER.
YOU SHOULD HAVE ONLY ONE BROWSER WINDOW OPEN WHILE ACCESSING
THE WEB INSTRUMENT.
IF YOUR BROWSER DOES NOT APPEAR TO OPEN, CONFIRM IF THERE IS A
BROWSER WINDOW MINIMIZED AT THE BOTTOM OF YOUR SCREEN. IF
THERE IS, CLOSE IT.
WHILE IN THE WEB INSTRUMENT, DO NOT CLOSE YOUR BROWSER WINDOW
UNTIL THE CASE IS COMPLETE OR AFTER A BREAK OFF.
IF YOU ARE UNABLE TO ACCESS THE WEB INSTRUMENT, OR HAVE ANY
PROBLEMS OR QUESTIONS, CONTACT THE FLOOR SUPERVISOR
IMMEDIATELY.

Public Burden Statement: An agency may not conduct or sponsor, and a person is not required to
respond to, a collection of information unless it displays a currently valid OMB control number. The OMB
control number for this project is xxxx-xxxx. Public reporting burden for this collection of information is
estimated to average 25 minutes per respondent, per year, including the time for reviewing instructions,
searching existing data sources, gathering and maintaining the data needed, and completing and
reviewing the collection of information. Send comments regarding this burden estimate or any other
aspect of this collection of information, including suggestions for reducing this burden, to SAMHSA
Reports Clearance Officer, 1 Choke Cherry Road, Room 2-1057, Rockville, Maryland 20857.

PLEDGE TO RESPONDENTS: The information you provide will be protected to the fullest extent
allowable under Section 501(n) of the Public Health Service Act (42 USC 290aa(n)). This law permits
the public release of identifiable information about an establishment only with the consent of that
establishment and limits the use of the information to the purposes for which it was supplied. With the
explicit consent of eligible treatment facilities, information provided in response to survey questions
marked with an asterisk may be published in SAMHSA’s online Behavioral Health Treatment Services
Locator, the National Directory of Drug and Alcohol Abuse Treatment Programs, and other publically
available listings. Responses to non-asterisked questions will be published with no direct link to
individual treatment facilities.