Information Collection

GenIC #48 - Section 223 Demonstration Programs to Improve Community Mental Health Services

IC 221450 under ICR 201410-0938-016 · OMB 0938-1148.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0938-1148 can be found here:

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
BHCMeasureSpecificationsVol1(508).pdf	Instruction
BHCQMAppendicesVol2(508).pdf	Instruction
CMS-10398 (#48) Quality Measurement Data Reporting Templates Demonstration223Templates(508) OMB and CMS #.xlsx	Form and Instruction
# 48 - Section 223 Demonstration Programs to Improve Community Mental Health [rev 06-02-2016 by OSORA PRA] -- CLEAN.docx GenIC #48 - Supporting Statement (2)	IC Document

IC Title:

GenIC #48 - Section 223 Demonstration Programs to Improve Community Mental Health Services

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			BHCMeasureSpecificationsVol1(508).pdf	No		Fillable Fileable
Instruction			BHCQMAppendicesVol2(508).pdf	No		Fillable Fileable
Form and Instruction	CMS-10398 (#48)	Quality Measurement Data Reporting Templates	Demonstration223Templates(508) OMB and CMS #.xlsx	Yes	Yes	Fillable Printable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 24

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	528	528
Annual IC Time Burden (Hours)	22,192	22,192
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
GenIC #48 - Supporting Statement (2)	# 48 - Section 223 Demonstration Programs to Improve Community Mental Health [rev 06-02-2016 by OSORA PRA] -- CLEAN.docx	06/09/2016

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