[Federal Register Volume 75, Number 101 (Wednesday, May 26, 2010)]
[Notices]
[Pages 29551-29552]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2010-12643]
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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) 276-1243.
Project: FASD Diagnosis and Intervention Programs in the Fetal Alcohol
Spectrum Disorder (FASD) Center of Excellence--New
Since 2001, SAMHSA's Center for Substance Abuse Prevention has been
operating a Fetal Alcohol Spectrum Disorder (FASD) Center of Excellence
which addresses FASD mainly by providing trainings and technical
assistance and developing and supporting systems of care that respond
to FASD using effective evidence-based practices and interventions.
Currently the integration of evidence-based practices into service
delivery organizations is being accomplished through subcontracts. One
such intervention which integrates diagnosis and intervention
strategies into existing service delivery organizations is the FASD
Diagnosis and Intervention programs targeting children 0-18 years of
age. The Diagnosis and Intervention programs use the following 11 data
collection tools.
Description of Instruments/Activity for the Diagnosis and Intervention
Programs
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Instrument/Activity Description
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Screening and Diagnosis Tool........... The purpose of the screening
and diagnosis tool is to
determine eligibility to
participate in the SAMHSA FASD
Center Diagnosis and Treatment
Intervention. The form
includes demographic,
screening, and diagnostic
data.
Positive Monitor Tracking.............. The Positive Monitor Tracking
form is to monitor the outcome
of placing a child (ages 0-3
years) on a positive monitor.
Services Child is Receiving at the time The Services Child is Receiving
of the FASD Diagnosis. at the time of the FASD
Diagnosis form is to record
services the child is
receiving at the time of an
FASD diagnosis.
Services Planned and Provided based on The Services Planned and
Diagnostic Evaluation. Provided based on Diagnostic
Evaluation form is to record
services planned and received
based on the diagnostic
evaluation.
Services Delivery Tracking Form........ The Services Delivery Tracking
form is for the services
provided during every visit.
End of Intervention/Program Improvement The End of Intervention/Program
Measure--Case Manager. Improvement Measure--Case
Manager form is for the case
manager to report on the
overall improvement in the
child as a result of receiving
services.
End of Intervention/Program Improvement The End of Intervention/Program
Measure--Parent/Guardian. Improvement Measure--Parent/
Guardian form is for the
parent/guardian to report on
the overall improvement in the
child as a result of receiving
services.
End of Intervention/Program Customer The End of Intervention/Program
Satisfaction with Service. Customer Satisfaction with
Service form is to determine
customer satisfaction
(parents) with the SAMHSA FASD
Center Diagnosis and
Intervention project.
Outcome Measures (Children 0-7 years).. The Outcome Measures (Children
0-7 years) form is an outcomes
measure checklist used to
record measures every six
months from start of service
to end of service, at end of
intervention, at 6 months
follow-up, and 12 months
follow-up.
Outcome Measures (Children 8-18 years). The Outcome Measures (Children
8-18 years) form is an
outcomes measure checklist
used to record measures every
six months from start of
service to end of service, at
end of intervention, at 6
months follow-up, and 12
months follow-up.
Lost to follow-up...................... The Lost to follow-up form is
used if the child is no longer
accessible for follow-up.
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Eight subcontracts were awarded in February 2008 to integrate the
FASD Diagnosis and Intervention program within existing service
delivery organization sites. Using an integrated service delivery model
all sites are screening children using an FASD screening tool,
obtaining a diagnostic evaluation, and providing services/interventions
as indicated by the diagnostic evaluation. Specific interventions are
based upon the individual child's diagnosis. Six of the sites are
integrating the FASD Diagnosis and Intervention projects either in a
child mental health provider setting or in a dependency court setting
and serve children ages 0-7 years. Two of the sites are delinquency
courts and serve children 10-18 years of age. Data collection at all
sites involves administering the screening and diagnosis tool,
recording process level indicators such as type and units of service
provided; improvement in functionality and outcome measures such as
school performance, stability in housing/placement, and adjudication
measures (10-18 yrs only). Data will be collected at baseline, monthly,
every six months from start of service to end of service, at end of
intervention, at 6 months follow-up, and 12 months follow-up.
Estimated Annualized Burden Hours
[[Page 29552]]
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Number of Average Total burden
Instrument/Activity Number of responses per Total number burden per hours per
respondents respondent of responses response collection
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Client Surveys: Children 0-7:
Screening and Diagnosis Tool 1400 1 1400 0.17 238
Positive Monitor Tracking... 450 1 450 0.03 14
Services Child is Receiving 750 1 750 0.17 128
at the time of the FASD
Diagnosis..................
Services Planned and 750 1 750 0.33 248
Provided based on
Diagnostic Evaluation......
Services Delivery Tracking 750 12 9000 0.08 720
Form.......................
End of Intervention/Program 750 1 750 0.02 15
Improvement Measure--Case
Manager....................
End of Intervention/Program 750 1 750 0.02 15
Improvement Measure--Parent/
Guardian...................
End of Intervention/Program 750 1 750 0.03 23
Customer Satisfaction with
Service....................
Outcome Measures (Children 0- 750 5 3750 0.08 300
7 years)...................
Lost to follow-up........... 135 1 135 0.03 4
Client Surveys: Children 8-18:
Screening and Diagnosis Tool 100 1 100 0.17 17
Services Child is Receiving 50 1 50 0.17 9
at the time of the FASD
Diagnosis..................
Services Planned and 50 1 50 0.33 17
Provided based on
Diagnostic Evaluation......
Services Delivery Tracking 50 12 600 0.08 48
Form.......................
End of Intervention/Program 50 1 50 0.02 1
Improvement Measure--Case
Manager....................
End of Intervention/Program 50 1 50 0.02 1
Improvement Measure--Parent/
Guardian...................
End of Intervention/Program 50 1 50 0.03 2
Customer Satisfaction with
Service....................
Outcome Measures (Children 8- 50 5 250 0.08 20
18 years)..................
Lost to follow-up........... 15 1 15 0.03 1
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TOTAL................... 7,700 49 19,700 .............. 1,821
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Written comments and recommendations concerning the proposed
information collection should be sent by June 25, 2010 to: SAMHSA Desk
Officer, Human Resources and Housing Branch, Office of Management and
Budget, New Executive Office Building, Room 10235, Washington, DC
20503; due to potential delays in OMB's receipt and processing of mail
sent through the U.S. Postal Service, respondents are encouraged to
submit comments by fax to: 202-395-5806.
Dated: May 17, 2010.
Elaine Parry,
Director, Office of Program Services.
[FR Doc. 2010-12643 Filed 5-25-10; 8:45 am]
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