OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Mental Health Client/Consumer Outcome Measures and Infrastructure, Prevention and Promotion Indicators

ICR 202509-0930-011 · OMB 0930-0285 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form Client Level Measu Client Level Measures Form and Instruction Modified Available
Form Client Level Measu CMHS NOMS Data Collection Tool Form and Instruction Modified Repair queued
Form IPP Indicators IPP Indicators Form and Instruction Modified Available
Form IPP Indicators Infrastructure, Prevention, and Promotion Indicators Form and Instruction Modified Repair queued
202404 C_CMHS IPP Results Form.docx Supplementary Document Uploaded 2025-09-23 Repair queued
202404 C_CMHS IPP Results Form.docx Supplementary Document Uploaded 2025-09-23 Repair queued
0930-0285 No Material or Nonsubstantive Change-CMHS GPRA Tool.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-09-23 Repair queued
0930-0285 No Material or Nonsubstantive Change-CMHS GPRA Tool.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-09-23 Repair queued
202404 Supporting Statement A (SSA)_0930-0285.docx Supporting Statement A Uploaded 2024-10-01 Available
202404 Supporting Statement A (SSA)_0930-0285.docx Supporting Statement A Uploaded 2024-10-01 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
46632 CMHS NOMS Data Collection Tool Form and Instruction ModifiedClient Level Measures
46632 CMHS NOMS Data Collection Tool Form and Instruction Modified
192393 Infrastructure, Prevention, and Promotion Indicators Form and Instruction ModifiedIPP Indicators
192393 Infrastructure, Prevention, and Promotion Indicators Form and Instruction Modified
ICR Details
0930-0285 202509-0930-011
Active 202410-0930-001
HHS/SAMHSA 18877
Mental Health Client/Consumer Outcome Measures and Infrastructure, Prevention and Promotion Indicators
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved without change 11/17/2025
Retrieve Notice of Action (NOA) 09/30/2025
  Inventory as of this Action Requested Previously Approved
11/30/2027 11/30/2027 11/30/2027
456,088 0 456,088
139,178 0 139,178
0 0 0
SAMHSA and its Centers will use the data collected for annual reporting required by GPRMA, to describe and understand changes in outcomes from baseline to follow-up to discharge. SAMHSA’s report for each fiscal year will include actual results of performance monitoring for the three preceding fiscal years. Information collected through this request will allow SAMHSA to report on the results of these performance outcomes as well as be consistent with SAMHSA-specific performance domains, and to assess the accountability and performance of its discretionary grant programs. The additional information collected through this request will allow SAMHSA to improve its ability to assess the impact of its programs on key outcomes of interest and to gather vital diagnostic information about clients served by CMHS discretionary grant programs. SAMHSA is in the process of establishing a new data collection tool for client services which will be used by discretionary grants from both CMHS and the Center for Substance Abuse Treatment (CSAT). While working towards this new combined data collection, SAMHSA is requesting to extend the time period for data collection using the currently approved tools without change to the tools.
US Code: 5 USC 1105 Name of Law: GPRA
  
None
Not associated with rulemaking
  89 FR 58390 07/18/2024
89 FR 77878 09/24/2024
No
2
IC Title Form No. Form Name
CMHS NOMS Data Collection Tool Client Level Measures Client Level Measures
Infrastructure, Prevention, and Promotion Indicators IPP Indicators IPP Indicators
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 456,088 456,088 0 0 0 0
Annual Time Burden (Hours) 139,178 139,178 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$2,332,000
No
    No
    No
No
No
No
No
Alicia Broadus 240 276-0166 [email protected]
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
09/30/2025