Information Collection Request

Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Depression and Related Behavioral Disorders Programs Project

ICR 202206-0906-002 · OMB 0906-0052 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 4-1 Program Implmentation Semi-Structured Interview Form and Instruction Unchanged Repair queued
Form 3-1 Program Implementation Survey Form and Instruction Unchanged Repair queued
Form 2-1 Practice-Level Survey Form and Instruction Unchanged Repair queued
Form 1-1 Health Care Provider Survey Form and Instruction Unchanged Repair queued
FINALSupporting Statement A_1-3-20 rev.docx Supporting Statement A Uploaded 2022-06-08 Repair queued
HRSA MCHB PMHCA-MDRBD Change Memo OMB Request for Non-Substantive Change_to HRSA.docx Justification for No Material/Nonsubstantive Change Uploaded 2022-06-08 Repair queued
HRSA MCHB PMHCA-MDRBD Attachment 1_tracked changes.docx Supplementary Document Uploaded 2022-06-08 Repair queued
Attachment B16 - MDRBD Program SSI Guide_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B15 - PMHCA Program SSI Guide_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B14 - MDRBD Program Implementation Survey_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B13 - PMHCA Program Implementation Survey_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B12 - MDRBD Program Practice-level Survey_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B11 - PMHCA Program Practice-level Survey_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B10 - MDRBD Program HCP Survey_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment B9 - PMHCA Program HCP Survey_Pilot Test Results 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A37 - MDRBD SSI Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A36 - PMHCA SSI Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A35-MDRBD Program Implementation Survey Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A34-PMHCA Program Implementation Survey Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A33 - MDRBD Practice Survey Followup Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A32 - PMHCA Practice Survey Followup Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Available
Attachment A31 - MDRBD HCP Survey Followup Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A30 - PMHCA HCP Survey Followup Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A29 - MDRBD Practice Survey Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A28 - PMHCA Practice Survey Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A27 - MDRBD HCP Survey Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A26 - PMHCA HCP Survey Followup Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A25 - MDRBD SSI Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A24 - PMHCA SSI Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A23-MDRBD Program Implementation Survey Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A22-PMHCA Program Implementation Survey Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A21 - MDRBD Practice Survey Participation Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A20 - PMHCA Practice Survey Participation Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A19 - MDRBD HCP Survey Participation Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A18 - PMHCA HCP Survey Participation Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A17 - MDRBD Practice Survey Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A16 - PMHCA Practice Survey Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A15 - MDRBD HCP Survey Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A14 - PMHCA HCP Survey Participation Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A13 - MDRBD SSI Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A12 - PMHCA SSI Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A11-MDRBD Program Implementation Survey Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A10-PMHCA Program Implementation Survey Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A9 - MDRBD Practice Survey Notification Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A8 - PMHCA Practice Survey Notification Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A7 - MDRBD HCP Survey Notification Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A6 - PMHCA HCP Survey Notification Email From Program 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A5 - MDRBD Practice Survey Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A4 - PMHCA Practice Survey Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A3 - MDRBD HCP Survey Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A2 - PMHCA HCP Survey Notification Email From JBS 12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Evaluation Question_Data Collection Tool Mapping_12-13-19.docx Supplementary Document Uploaded 2020-02-06 Repair queued
Program Evaluation for Pediatric Mental Healthcare Access Program and Maternal Depression 12-13-19 sh.pdf Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A38 - IRB Exempt Approval Letter.pdf Supplementary Document Uploaded 2020-02-06 Repair queued
Attachment A1 - FRN 60-Day Publication.pdf Supplementary Document Uploaded 2020-02-06 Repair queued
Supporting Statement B_12-13-19.docx Supporting Statement B Uploaded 2020-02-06 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
239854 Program Implmentation Semi-Structured Interview Form and Instruction Unchanged
239853 Program Implementation Survey Form and Instruction Unchanged
239852 Practice-Level Survey Form and Instruction Unchanged
239850 Health Care Provider Survey Form and Instruction Unchanged
ICR Details
0906-0052 202206-0906-002
Received in OIRA 202002-0906-001
HHS/HRSA
Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Depression and Related Behavioral Disorders Programs Project
No material or nonsubstantive change to a currently approved collection   No
Regular 06/08/2022
  Requested Previously Approved
06/30/2023 06/30/2023
51,712 51,712
9,828 9,828
0 0

The purpose of this project is to design and implement an evaluation of HRSA’s MCHB PMHCA Program and MDRBD Program. Activities for this project include preparing and submitting the OMB package, preparing data collection tools, administering the data collection tools, analyzing data, and disseminating findings. Respondents will include health care providers and practices as well as awardee project directors/principal investigators.

PL: Pub.L. 114 - 255 10005 Name of Law: 21st Century Cures Act (Screening and treatment for maternal depression)
   PL: Pub.L. 114 - 255 10002 Name of Law: 21st Century Cures Act (Increasing access to pediatric mental health care)
  
None

Not associated with rulemaking

  84 FR 55579 10/17/2019
85 FR 3059 01/17/2020
Yes

  Total Request 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 51,712 51,712 0 0 0 0
Annual Time Burden (Hours) 9,828 9,828 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
This is a new ICR, so burden is increasing from zero (0).

$491,363
No
    Yes
    Yes
No
No
No
No
Joella Roland 301 945-0232 [email protected]

  No

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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/08/2022