Conditions of Participation for Community Mental Health Centers and Supporting Regulations (CMS-10506)

Forms and Documents

Document Name	Status
CMS-10506 Supporting Statement 4-17-20.docx Supporting Statement A	2020-04-27

IC Document Collections

IC ID	Document Title	Status
233176	485.914(d) Record updated assessment	Unchanged
210877	42 CFR 485.918(b)(1)(v) Organization, governance, administration of services and partial hospitalization	Unchanged
210876	42 CFR 485.917 Quality assessment and performance improvement.	Unchanged
210875	42 CFR 485.916(d) Treatment team, active treatment plan, and coordination of services	Unchanged
210874	42 CFR 485.916(c) Treatment team, active treatment plan, and coordination of services	Unchanged
210873	42 CFR 485.910(f)(4) Client Rights	Unchanged
210872	42 CFR 485.910(e)(4)(v) Client Rights	Unchanged
210871	42 CFR 485.910(d)(4) Client Rights	Unchanged
210870	42 CFR 485.910(d)(2) Client Rights	Unchanged
210869	42 CFR 485.910(a)(3) - Client Rights	Unchanged
210868	42 CFR 485.910(a)(1) - Client Rights	Unchanged

ICR Details

OMB Control No: 0938-1245	ICR Reference No: 202002-0938-016
Status: Active	Previous ICR Reference No: 201809-0938-006
Agency/Subagency: HHS/CMS	Agency Tracking No: 21616
Title: Conditions of Participation for Community Mental Health Centers and Supporting Regulations (CMS-10506)
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/27/2020
	Date Received in OIRA: 02/28/2020
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2023	36 Months From Approved	01/31/2021
Responses	22,746	0	18,586
Time Burden (Hours)	3,218	0	2,091
Cost Burden (Dollars)	0	0	0

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Abstract: The information collection requirements contained in this information collection request are among other requirements classified as (or known as) the CoPs which are based on criteria prescribed in law and are standards designed to ensure that each facility has properly trained staff to provide the appropriate safe physical environment for patients. These particular standards reflect comparable standards developed by industry organizations such as the Joint Commission. The primary users of this information will be State agency surveyors, CMS and community mental health centers (CMHCs )for the purpose of ensuring compliance with Medicare CoPs as well as ensuring the quality of care provided by CMHCs to patients.

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Authorizing Statute(s): US Code: 42 USC 1395k Name of Law: Scope of benefits; definitions
   US Code: 42 USC 1395x(ff)(3) Name of Law: Health Insurance for Aged and Disabled
   PL: Pub.L. 101 - 508 4162 Name of Law: Omnibus Budget Reconciliation Act of 1990
  

Citations for New Statutory Requirements: PL: Pub.L. 101 - 508 4162 Name of Law: Omnibus Budget Reconciliation Act of 1990
US Code: 42 USC 1395k Name of Law: SCOPE OF BENEFITS
US Code: 42 USC 1395x(ff)(3) Name of Law: Health Insurance for Aged and Disabled

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
0938-AT23	Final or interim final rulemaking	84 FR 51732	09/30/2019

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	83 FR 47686	09/20/2018
30-day Notice:	Federal Register Citation:	Citation Date:
	84 FR 51732	09/30/2019
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 11

IC Title	Form No.	Form Name
42 CFR 485.910(a)(1) - Client Rights
42 CFR 485.918(b)(1)(v) Organization, governance, administration of services and partial hospitalization
42 CFR 485.910(a)(3) - Client Rights
42 CFR 485.910(d)(2) Client Rights
42 CFR 485.910(d)(4) Client Rights
42 CFR 485.910(e)(4)(v) Client Rights
42 CFR 485.910(f)(4) Client Rights
42 CFR 485.916(c) Treatment team, active treatment plan, and coordination of services
42 CFR 485.916(d) Treatment team, active treatment plan, and coordination of services
42 CFR 485.917 Quality assessment and performance improvement.
485.914(d) Record updated assessment

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ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	22,746	18,586	0	4,160	0	0
Annual Time Burden (Hours)	3,218	2,091	0	1,127	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: These ICRs have been updated in accordance with the finalized regulations at § 485.914(d) in 84 FR 51732. These burden estimates are unchanged from what was estimated for the proposed rule, which resulted in an annual burden of 3,218 hours. There is, however, one discrepancy between these estimates and the estimates in the aforementioned final rule. In the final rule, the estimates were inadvertently changed to indicate that the requirements would impact all 161 CMHCs rather than just the approximately 52 Medicare-participating CMHCs. As a result, the number of CMHCs and burden hours may slightly differ from what was calculated in the final rule.

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(i) Why the information is being collected;

(ii) Use of information;

(iii) Burden estimate;

(iv) Nature of response (voluntary, required for a benefit, or mandatory);

(v) Nature and extent of confidentiality; and

(vi) Need to display currently valid OMB control number;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 02/28/2020

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