Notice2023-12460
Agency Information Collection Activities: Proposed Collection; Comment Request
Primary source
Metadata and text below are from the Federal Register, a public-domain U.S. government work. Always verify the official published version before relying on it for any legal matter.
Published
June 12, 2023
Issuing agencies
Health and Human Services DepartmentSubstance Abuse and Mental Health Services Administration
Full Text
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<title>Federal Register, Volume 88 Issue 112 (Monday, June 12, 2023)</title>
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[Federal Register Volume 88, Number 112 (Monday, June 12, 2023)]
[Notices]
[Pages 38070-38073]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-12460]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Substance Abuse and Mental Health Services Administration
Agency Information Collection Activities: Proposed Collection;
Comment Request
In compliance with section 3506(c)(2)(A) of the Paperwork Reduction
Act of 1995 concerning opportunity for public comment on proposed
collections of information, SAMHSA will publish periodic summaries of
proposed projects. To request more information on the proposed projects
or to obtain a copy of the information collection plans, call the
SAMHSA Reports Clearance Officer on (240) 276-0361.
Comments are invited on: (a) whether the proposed collections of
information are necessary for the proper performance of the functions
of the agency, including whether the information shall have practical
utility; (b) the accuracy of the agency's estimate of the burden of the
proposed collection of information; (c) ways to enhance the quality,
utility, and clarity of the information to be collected; and (d) ways
to minimize the burden of the collection of information on respondents,
including leveraging automated data collection techniques or other
forms of information technology.
Proposed Project: Protection and Advocacy for Individuals With Mental
Illness (PAIMI)--Revised Annual Program Performance Report (PPR)--
Office of Management and Budget (OMB) No. 0930-0169--Revision
SAMHSA is requesting approval from the OMB for changes to the
Annual PPR, PPR Instructions, and the ACR for the PAIMI program. The
OMB clearance for the current 2022-2023 PPR, PPR Instructions, and ACR
(0930-0169) will expire on June 30, 2023.
Additionally, SAMHSA is requesting Terms of Clearance from OMB to
use the current 2022-2023 PPR, PPR Instructions, and ACR (0930-0169)
for the fiscal year (FY) 2023-2024 reporting period due on January 1,
2024. The reasons for this special request are the PAIMI grantees (1)
have been serving and tracking PAIMI client statistics for six months
of the 2023-2024 reporting period and to require them to adjust the
counting, tracking, and documenting of the PAIMI work at this time
would create an administrative and excessive burden; (2) need adequate
time to update their statistical tracking systems that are used to
gather the correct information and obtain training and technical
assistance to ensure proper data collection is occurring; and (3) asked
SAMHSA to consider not implementing the proposed changes and revisions
to the current 2022-2023 PPR, PPR Instructions, and ACR (0930-0169)
until the 2023-2024 reporting period due on January 1, 2025.
The protection and advocacy (P&A) systems were established under
the Developmental Disabilities Act of 1975 [42 U.S.C. 15001 et seq., as
amended in 2000]. The amendments of 2000 require the Secretary of
Health and Human Services submit a biennial report on disabilities to
the President, Congress, and the National Council on Disability. The
Secretary's report is prepared by the Administration on Intellectual
and Developmental Disabilities (AIDD), within the Administration on
Community Living. The PPR, which includes an ACR, contains information
from the PAIMI grantees on the types of activities and services they
provided on behalf of PAIMI-eligible individuals. SAMHSA aggregates
this information into a biennial summary report that AIDD includes in
an appendix to the Secretary's biennial report on disabilities.
The PAIMI Act at 42 U.S.C. 10805(7) requires that each P&A system
prepare and transmit a report to the Secretary HHS and to the head of
its State mental health agency on January 1. This report describes the
activities, accomplishments, and expenditures of the system during the
most recently completed fiscal year, including a section prepared by
the advisory council (the PAIMI Advisory Council or PAC), that
describes the activities of the council and its independent assessment
of the operations of the system.
The Protection and Advocacy for Individuals with Mental Illness
(PAIMI) Act at 42 U.S.C. 10801 et seq., authorized funds to the same
protection and advocacy (P&A) systems created under the Developmental
Disabilities Assistance and Bill of Rights Act of 1975, known as the DD
Act (as amended in 2000, 42 U.S.C. 15001 et seq.]. The DD Act supports
the Protection and
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Advocacy for Developmental Disabilities (PADD) Program administered by
the Administration on Intellectual and Developmental Disabilities
(AIDD) within the Administration on Community Living. AIDD is the lead
Federal P&A agency. The PAIMI Program supports the same governor-
designated P&A systems established under the DD Act by providing legal-
based individual and systemic advocacy services to individuals with
significant (severe) mental illness (adults) and significant (severe)
emotional impairment (children/youth) who are at risk for abuse,
neglect and other rights violations while residing in a care or
treatment facility.
In 2000, the PAIMI Act amendments created a 57th P&A system--the
American Indian Consortium (the Navajo and Hopi Tribes in the Four
Corners region of the Southwest). The Act, at 42 U.S.C. 10804(d),
states that a P&A system may use its allotment to provide
representation to individuals with mental illness, as defined by
section 42 U.S.C. 10802 (4)(B)(iii), residing in the community,
including their own home, only if the total allotment under this title
for any fiscal year is $30 million or more, and in such cases, an
eligible P&A system must give priority to representing PAIMI-eligible
individuals, as defined by 42 U.S.C. 10802(4)(A) and (B)(i).
The Children's Health Act of 2000 (CHA) also referenced the Ftate
P&A system authority to obtain information on incidents of seclusion,
restraint, and related deaths [see, CHA, part H at 42 U.S.C. 290ii-1].
PAIMI Program formula grants awarded by SAMHSA go directly to each of
the 57 governor-designated P&A systems. These systems are located in
each of the 50 States, the District of Columbia, the American Indian
Consortium, American Samoa, Guam, the Commonwealth of the Northern
Mariana Islands, the Commonwealth of Puerto Rico, and the U.S. Virgin
Islands.
The Substance Abuse Mental Health Services Administration (SAMHSA)
proposes the following revisions to its annual PAIMI Program
Performance Report (PPR), PPR Instructions, and ACR:
1. All questions related to Race; added the following choices of
Some other race and Race unknown;
2. All questions related to Gender; added the following choices of
Transgender (Trans Woman and Trans Man), Two-Spirit for American
Indian/Alaska Native (AIAN), Gender Non-Conforming, Other, and Prefer
not to say;
3. All questions related Sexual Orientation; added the following
choices of Lesbian or gay, Straight (not lesbian or gay), Bisexual,
Other, and Prefer not to say;
4. Demographic Composition of PAIMI Governing Board, Advisory
Council and Program Staff; the following was added for clarification,
``Transgender is someone whose gender identity is incongruent with
their sex assigned at birth. A trans woman or a transgender woman is a
woman who was assigned male at birth. A trans man or a transgender man
is a man who was assigned female at birth. Two-Spirit is a term by and
for Indigenous peoples and is culturally anchored with a particular
meaning and, potentially, social status, it is not appropriate for use
by non-Indigenous populations. Gender Non-Conforming refers to people
who do not follow other people's ideas or stereotypes about how they
should look, or act based on the female or male sex they were assigned
at birth. Lesbian is a woman who has a romantic and/or sexual
orientation toward women. Gay is a man who has a romantic and/or sexual
orientation toward men. Straight (not lesbian or gay) is a heterosexual
person; someone having a romantic and/or sexual orientation to persons
of the opposite sex. Bisexual is an individual who has the capacity to
form enduring physical, romantic, and/or emotional attractions to those
of the same gender or to those of another gender. Other is someone who
does not identified exclusively in one of the categories for gender or
sexual orientation and is identified with a different term.'';
5. Number of Mental Health Professionals on the Advisory Council;
the following was added for clarification, Other (Identify the
professional in the Footnotes);
6. All questions related to Age; added the clarification ``would
not disclose'' to ``Prefer not to say'';
7. Gender and Sexual Orientation of PAIMI-eligible Individuals
Served; the following was added for clarification, ``Enter the number
of individuals served by the indicated categories of gender and sexual
orientation. Individuals should not be included in more than one of the
categories. The total for both tables should be an unduplicated total
of persons served based on gender and sexual orientation.'';
8. In the Living Arrangements Section, the following definitions
were added in the PPR Instructions for clarification:
Community residential home for children/youth up to 18 yrs.: Group
and residential live-in care placement in which staff are trained to
work with children and youth whose specific needs are best addressed in
a highly structured environment. These placements offer a higher level
of structure and supervision than what can be provided in the youth's
or child's home. For examples, this includes group homes where youth or
children live with each other in a community-based setting, attend
local schools and participate in community, cultural and social
opportunities; and community-based residential homes that meet the Home
and Community Based Services settings rule.
Community residential home for adults: A broad category of
community based residential options for adults with serious mental
illness, including group homes, supported or supportive housing, and
other non-inpatient or institutional settings. For example, this
includes community-based supported or supportive homes where staff are
trained to work with adults with significant (serious) mental illness.
Non-medical community-based residential facility for children/
youth: Facilities where 5 or more unrelated children/youth reside and
care, treatment, services are above the level of room and board but
less than skilled nursing care. Such care, treatment or services is
provided as a primary function of such facility.
Foster care: This arrangement (also known as out-of-home care) is a
temporary service provided by States for children who cannot live with
their families. Children in foster care may live with relatives or with
unrelated foster parents.
Nursing homes, including skilled nursing facilities: Facilities for
the residential care of elderly or disabled people. They may also be
referred to as care homes or long-term care facilities. Often, the
terms have slightly different meanings to indicate whether the
institutions are public or private, and whether they provide mostly
assisted living, or nursing care and emergency medical care. Nursing
homes are used by people who do not need to be in a hospital but cannot
be cared for at home.
Intermediate care facilities (ICF): Long term care facilities that
provide nursing and supportive care to residents on a non-continuous
skilled nursing care basis, under a physician's direction. ICFs are
designed to provide custodial care for those who are unable to care for
themselves because of mental disability or declining health. ICFs are
typically regarded as a lower-level nursing care facility when compared
to a skilled nursing facility, but its residents require more care and
attention than those in a
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residential care facility for elderly or an adult residential care
facility.
Public and Private general hospital involving emergency rooms: A
public hospital is owned and funded by the government. Whereas a
private hospital is owned by an individual or group of people.
Public institutional living arrangement: This is a broad category
to cover all public institutional living that do not fit into other
living arrangement categories. For examples, this includes assisted
living facilities, adult homes, residential schools, juvenile justice
facilities, and residential care facilities that are owned and funded
by the government.
Private institutional living arrangement: This is a broad category
to cover all private institutional living that do not fit into other
living arrangement categories. For example, this includes assisted
living facilities, adult homes, residential schools, juvenile justice
facilities, and residential care facilities that are owned by an
individual or group of people.
Psychiatric hospitals (public/private): The term ``psychiatric
hospital'' means an institution, which is primarily engaged in
providing, by or under the supervisor of a Doctor of Medicine or
Osteopathy, psychiatric services for the diagnosis and treatment of
individuals with mental illness. Some psychiatric hospitals are
designated as ``forensic hospitals'' to serve individuals who are in
the custody of penal authorities.
Jails: Correctional institutions used to detain persons who are in
the lawful custody of the government as either accuse person awaiting
trial or convicted person serving a sentence. Jails typically refers to
smaller, local facilities, in which people are incarcerated for a short
period of time.
State prisons: Institutions under State jurisdiction for
confinement of persons convicted or serious crimes.
Federal detention centers: Facilities that hold individuals prior
to or during court proceedings, as well as those serving brief
sentences or ICE immigration detention facilities that house
noncitizens to secure their presence for immigration proceedings or
removal from the U.S. Another name for the centers is Federal Bureau
Prisons.
Federal prisons: Institutions under Federal jurisdiction for
confinement of persons convicted or serious crimes.
Veterans' Administration hospital/clinic: Provides primary care,
specialized care, and related medical and social support services to
American veterans.
Other Federal facility: This includes the Department of Homeland
Security (DHS) and Health and Human Services (HHS) facilities used
temporarily to house child migrants.
Homeless: An individual with no permanent living arrangement or no
fixed place of residence.
Independent (in the community & PAIMI-eligible): This implies the
person is living in his or her own home.
Parental or other family home & PAIMI-eligible: Parental home is a
home that a child or young adult shares with a parent, guardian; a
person acting in the capacity of a parent or guardian; or the home of
one's parents or guardians. Other family home is a home maintained by
persons biologically related by biology, adoption, marriage, or common
law, to a person.
Unknown: Living arrangement was not provided.
9. In the Complaints/Problems of PAIMI-eligible Individuals of
Abuse, Neglect, and Rights Violations Section, the following
dispositions were added;
e. Other indicators of success or outcomes that resulted from P&A
involvement.
h. P&A withdrew due to conflict of interest or other reasons.
10. In Areas of Alleged Rights Violations Section, the following
choices were added for clarification;
w. The denial of access to personal possessions
x. Failure to comply with commitment regulations
y. Failure to comply with commitment time frames
11. The choice A/N I--Abuse/Neglect Investigation was added to the
Intervention Strategies for clarification;
12. In the Reasons for Closing Individual Advocacy Case File
Section, the following choices were either reorganized or added for
clarification;
Client's objective was partially or fully met.
Case or investigation lacked merit.
Case withdrawn or terminated by the client.
Issue favorably resolved.
Issue not favorably resolved.
Other success or outcomes due to P&A involvement (i.e., provided self-
advocacy assistance)
Other representation found.
Services not needed due to client's death or relocation.
P&A withdrew due to conflict of interest or other reasons (i.e., client
would not cooperate).
13. In the Death Investigation Activities Section, the following
was added for clarification, ``if zero means the P&A did not receive
any death reports from CMS for investigation, please note this in the
Footnotes'';
14. In the Interventions on behalf of groups of PAIMI-eligible
Individuals Section, Group Advocacy the term ``non-litigation'' was
corrected;
15. Changed the Section ``End Outcomes of P&A Activities'' to
``Performance Measures of P&A Activities''; changed the word
``Outcome'' to ``Specific Measures''; either revised or add the
following measures for clarification;
(a) PAIMI-eligible individuals who access community-based mental health
or health care services that resulted in community integration and
independence or are better able to advocate to do so;
(b) PAIMI-eligible individuals who access benefits or services or are
better able to advocate to do so;
(c) PAIMI-eligible individuals who live in a healthier, safer,
improved, or more integrated settings or are better able to advocate to
do so;
(d) PAIMI-eligible individuals are able to stay in their own home or
better able to advocate to do so;
(e) PAIMI-eligible individuals who can secure or maintain employment
and/or are not subject to workplace discrimination or are better able
to advocate for to do so;
(f) PAIMI-eligible individuals who receive appropriate educational
services and supports and/or are not subject to discrimination in
educational settings or are better able to advocate for those outcomes;
(g) PAIMI-eligible individuals who go to school in safe and more humane
conditions;
(h) PAIMI-eligible children (individuals) who receive appropriate
services in the most integrated settings;
(i) PAIMI-eligible individuals who were not subject to discrimination
in government benefits/services, housing, public accommodations, etc.
or are better able to advocate for such outcomes;
(j) PAIMI-eligible individuals who were not subject to abuse, neglect,
or rights violations or are better able to advocate for to do so;
(k) PAIMI-eligible individuals who can make their own decisions to the
maximum extent feasible or are better able to advocate to do so;
(l) PAIMI-eligible individuals who had their rights enforced, retained,
restored and/or expanded or are better able to advocate for to do so;
and
(m) PAIMI-eligible individuals who were more able to participate in the
voting process or are better able to advocate for to do so.
16. Tables and instructions were added the Budget Section for
clarification; and
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17. In the Statement of Priorities (Goals) Section, removed the
words ``Expected Target'' and revised the following information for
clarification:
Report on Previous FY Statement of Priorities and Objectives (SPO)
The Priority and Objectives target population and expected outcome
fields will be pre-populated by the information submitted with the
PAIMI application. The number of pre-populated items will reflect the
number submitted in the application. A. Please indicate an actual
outcome for each expected outcome. B. Please indicate strategies to
implement goals and priorities. C. Provide a narrative (500-word limit)
of P&A activities for each of the accomplishments related to each
priority. D. Other Qualitative Narrative related to each priority:
Provide a narrative (500 words limit) of significant activity for which
there were no quantifiable results.
The current report formats will be effective for the FY 2023 PPR
reports due on January 1, 2024.
Estimates of Annualized Hour Burden
The estimated annual burden for the PAIMI Annual PPR is summarized
below:
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Number of
Number of responses per Hours per Total hour
respondents respondent response burden
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Program Performance Report...................... 57 1 20 1,140
Advisory Council Report......................... 57 1 10 570
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Total....................................... 114 .............. .............. 1,710
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* Based on past estimates and the fact that changes being made do not measurably impact response burden.
Written comments and recommendations for the proposed information
collection should be sent within 30 days of publication of this notice
to <a href="http://www.reginfo.gov/public/do/PRAMain">www.reginfo.gov/public/do/PRAMain</a>. Find this particular information
collection by selecting ``Currently under 30-day Review--Open for
Public Comments'' or by using the search function.
Alicia Broadus,
Public Health Advisor.
[FR Doc. 2023-12460 Filed 6-9-23; 8:45 am]
BILLING CODE 4162-20-P
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This is legal information, not legal advice. Laws vary by jurisdiction and change frequently. Always verify current law with official sources and consult a licensed attorney in your jurisdiction for advice on your specific situation.