Survey Of Sec. 2176 Home & Community Based Medicaid Waiver Programs (survey For The Developmentally Disabled & Chronically Mentally Ill) - Survey Of The Ie Or Other Pdp

SURVEY OF SEC. 2176 HOME & COMMUNITY BASED MEDICAID WAIVER PROGRAMS (SURVEY FOR THE DEVELOPMENTALLY DISABLED & CHRONICALLY MENTALLY ILL) - SURVEY OF THE IE OR OTHER PDP

Documents and Forms

Document Name Document Type

no available documents/forms check other ICs listed under this ICR

Information Collection (IC) Details

IC Title:	SURVEY OF SEC. 2176 HOME & COMMUNITY BASED MEDICAID WAIVER PROGRAMS (SURVEY FOR THE DEVELOPMENTALLY DISABLED & CHRONICALLY MENTALLY ILL) - SURVEY OF THE IE OR OTHER PDP	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Migrated

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form	HCFA-431				No	No

Line of Business:

Subfunction:

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 83	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Change Due to Adjustment in Agency Estimate
Annual Number of Responses for this IC	83	83
Annual IC Time Burden (Hours)	3,984	3,984
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.