National Council for Behavioral Health's Information Technology Survey

National Council for Behavioral Health’s Information Technology Survey

Documents and Forms

Document Name Document Type
Attachment 2- Survey Question Crosswalk to Research Questions_4.12.17.docx Other-survey
Attachment 3- Behavioral Health IT and Interoperability Survey as of 04.13.17 .docx Other-survey
Attachment 1 - Definitions of Key Terms and Concepts.docx key term IC Document
Attachment 4-Grantee Letter and BHITS Survey Message to grantees.doc Grantee letter IC Document
Attachment 5- Survey Data Collection Strategy ONC BH_4.13.17.docx survey strategy IC Document
Attachment 7- Federal Register, Volume 82 Issue 31 (Thursday, February 16, 2017).htm 60 day FRN IC Document
Federal Register, Volume 82 Issue 77 (Monday, April 24, 2017).htm 30-day FRN IC Document

Information Collection (IC) Details

IC Title:	National Council for Behavioral Health's Information Technology Survey	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

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
Other-survey			Attachment 2- Survey Question Crosswalk to Research Questions_4.12.17.docx		Yes	Yes	Fillable Fileable
Other-survey			Attachment 3- Behavioral Health IT and Interoperability Survey as of 04.13.17 .docx		Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 533	Number of Respondents for Small Entity: 0

Affected Public: Private Sector	Private Sector: Businesses or other for-profits, Not-for-profit institutions

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	533	533
Annual IC Time Burden (Hours)	178	178
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
key term	Attachment 1 - Definitions of Key Terms and Concepts.docx	04/28/2017
Grantee letter	Attachment 4-Grantee Letter and BHITS Survey Message to grantees.doc	04/28/2017
survey strategy	Attachment 5- Survey Data Collection Strategy ONC BH_4.13.17.docx	04/28/2017
60 day FRN	Attachment 7- Federal Register, Volume 82 Issue 31 (Thursday, February 16, 2017).htm	04/28/2017
30-day FRN	Federal Register, Volume 82 Issue 77 (Monday, April 24, 2017).htm	04/28/2017

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