Information Collection

GenIC #43 (Extension w/o change): Section 223 Demonstration Programs to Improve Community Mental Health Services

IC 229713 under ICR 201712-0938-019 · 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⚠️ Notice: This information collection may be referencing outdated material.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
43 - CCBHC Cost Report Instructions 508c 11 10 15.pdf	Instruction
43 - State Demonstration Proposal Application and Guidance_100515f_revised 101515_submitted (3).pdf	Instruction
43 - Supporting Statement Demonstration Programs CLEAN.docx #43 - Supporting Statement	IC Document

IC Title:

GenIC #43 (Extension w/o change): Section 223 Demonstration Programs to Improve Community Mental Health Services

Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			43 - State Demonstration Proposal Application and Guidance_100515f_revised 101515_submitted (3).pdf		No		Printable Only
Instruction			43 - CCBHC Cost Report Instructions 508c 11 10 15.pdf		No		Printable Only

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records

Title:

FR Citation:

Number of Respondents: 97

Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	121	121
Annual IC Time Burden (Hours)	7,490	7,490
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
#43 - Supporting Statement	43 - Supporting Statement Demonstration Programs CLEAN.docx	01/11/2018

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