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GenIC #60 (New): SUPPORT Act Survey of Housing-Related Supports and Services Under Medicaid to Individuals with Substance Use Disorders

IC 241474 under ICR 201712-0938-019 · OMB 0938-1148.

Documents and Forms
Document Name
Document Type
Form and Instruction
Instruction
Other-Cover Letter
Form and Instruction
IC Document
IC Document
Information Collection (IC) Details

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GenIC #60 (New): SUPPORT Act Survey of Housing-Related Supports and Services Under Medicaid to Individuals with Substance Use Disorders CMCS
 
New
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction CMS-10398 #60 State Technical Assistance Needs Assessment Survey 60 - Attachment A.1 State Technical Assistance Needs Assessment (version 2).docx Yes Yes Fillable Fileable
Instruction 60 - Attachment A.2 Glossary of Terms_04_05_20.docx Yes No Printable Only
Other-Cover Letter 60 - Attachment A.3— Cover Letter_04_05_20.docx No   Printable Only

Health Health Care Services

 

51 0
   
State, Local, and Tribal Governments
 
   100 %

  Approved Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 51 0 51 0 0 0
Annual IC Time Burden (Hours) 26 0 26 0 0 0
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Generic Supporting Statement 60 - Generic Supporting Statement (2020 version 3).docx 04/22/2020
Supporting Statement B 60 - Supporting Statement B (2020 version 2).docx 04/22/2020
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.