Information Collection Request

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

ICR 202210-0906-004 · OMB 0906-0074 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 2 PMHCA Practice Level Survey Form and Instruction New Repair queued
Form 1 HP Survey 2021 Form and Instruction New Repair queued
Supporting Statement A_final.docx Supporting Statement A Uploaded 2022-10-31 Missing upstream
Supporting Statement B_final.docx Supporting Statement B Uploaded 2022-10-27 Missing upstream
IC Document Collections
IC IDCollectionTypeStatusForm
256701 2021 PMHCA Program Implementation SSI Other-Semi Structured Interview New
256696 FGD Other- New
256695 2021 PMHCA Program Implementation Survey Other- New
256694 PMHCA Practice Level Survey Form and Instruction New
256687 HP Survey 2021 Form and Instruction New
256686 2018/2019 PMHCA/2018 MDRBD Care Coordinator SSI Other-Semi Structured Interview New
256685 2021 PMHCA Care Coordinator SSI Instruction New
256680 Champion and Community Resources SSI Other-Semi Structured Interveiw New
ICR Details
StatusReceived in OIRA
Agency/SubagencyHHS/HRSA
OMB Control No0906-0074
Type of Information CollectionNew collection (Request for a new OMB Control Number)
Date Submitted to OIRA1969-12-31
Requested Expiration Date1969-12-31