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

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 2 Practice Level Survey	Form and Instruction	New	Available
Form 2 PMHCA Practice Level Survey	Form and Instruction	New	Repair queued
Form 1 HP Survey	Form and Instruction	New	Available
Form 1 HP Survey 2021	Form and Instruction	New	Repair queued
Supporting Statement A_final.docx	Supporting Statement A	Uploaded 2022-10-31	Repair queued
Supporting Statement B_final.docx	Supporting Statement B	Uploaded 2022-10-27	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
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	Practice Level Survey
256694	PMHCA Practice Level Survey	Form and Instruction	New
256687	HP Survey 2021	Form and Instruction	New	HP Survey
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

OMB Control No: 0906-0074	ICR Reference No: 202210-0906-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/HRSA	Agency Tracking No:
Title: 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
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/29/2022
Retrieve Notice of Action (NOA)	Date Received in OIRA: 11/02/2022
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2025	36 Months From Approved
Responses	11,337	0	0
Time Burden (Hours)	8,476	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This notice describes information collection requests for two of HRSA’s Maternal and Child Health programs: the Pediatric Mental Health Care Access (PMHCA) program and the Screening and Treatment for Maternal Depression and Related Behavioral Disorders (MDRBD) program. Both of these programs aim to increase identification of behavioral health conditions by providing support for screening of specified populations (e.g., children, adolescents, young adults, and pregnant and postpartum women, especially those living in rural, isolated, and/or undeserved areas); providing clinical behavioral health consultation, care coordination support (i.e.,communication/collaboration, accessing resources, referral services), and training to health professionals (HP); 1 and increasing access to clinical interventions, including by telehealth. HP education and training will support the knowledge and skills acquisition needed to accomplish this goal. The informationwill be collected with recipients of awards that were issued in 2018 (PMHCA and MDRBD), 2019 (PMHCA), and 2021 (PMHCA). The 2018, 2019, and 2021 PMHCA programs are authorized by 42 U.S.C § 254c–19 (§ 330M of the Public Health Service Act), using Section 2712 of the American Rescue Plan Act of 2021 (P.L.117–2) for 2021 awardees. The 2018 MDRBD program is authorized by 42 U.S.C. 247b–13a (§ 317L–1 of the Public Health Service Act). To evaluate progress made toward the programs’ goals, this data collection will use eight instruments: the HP Survey, Practice-Level Survey, Program Implementation Survey, Program Implementation Semi-Structured Interview (SSI), Champion SSI, Champion Focus Group Discussion (FGD), Community Resources SSI, and Care Coordinator SSI.

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Authorizing Statute(s): US Code: 42 USC 254c-19 Name of Law: Public Health Service Act
   PL: Pub.L. 117 - 2 2712 Name of Law: American Rescue Plan Act of 2021
   US Code: 42 USC 247b-13a Name of Law: Public Health Service Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 39841	07/05/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	87 FR 65089	10/27/2022
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 8

table that charts list of burden

IC Title	Form No.	Form Name
2018/2019 PMHCA/2018 MDRBD Care Coordinator SSI
2021 PMHCA Care Coordinator SSI
2021 PMHCA Program Implementation SSI
2021 PMHCA Program Implementation Survey
Champion and Community Resources SSI
FGD
HP Survey 2021	1	HP Survey
PMHCA Practice Level Survey	2	Practice Level Survey

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ICR Summary of Burden

table that charts list 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	11,337	0	0	11,337	0	0
Annual Time Burden (Hours)	8,476	0	0	8,476	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: This is a new ICR package.

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Annual Cost to Federal Government: $804,666

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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? Yes

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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: 11/02/2022

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