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 202302-0906-002 · OMB 0906-0074 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form 2 PMHCA Practice Level Survey Form and Instruction Unchanged Available
Form 2 PMHCA Practice Level Survey Form and Instruction Unchanged Missing upstream
Form 1 HP Survey 2021 Form and Instruction Unchanged Available
Form 1 HP Survey 2021 Form and Instruction Unchanged Repair queued
HRSA MCHB 2022 PMHCA Awardee Change Memo OMB Request for Non-Substantive Change 1-30-23 hc.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-02-13 Available
HRSA MCHB 2022 PMHCA Awardee Change Memo OMB Request for Non-Substantive Change 1-30-23 hc.docx Justification for No Material/Nonsubstantive Change Uploaded 2023-02-13 Repair queued
Supporting Statement A_final.docx Supporting Statement A Uploaded 2022-10-31 Available
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 Available
Supporting Statement B_final.docx Supporting Statement B Uploaded 2022-10-27 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
256701 2021 PMHCA Program Implementation SSI Other-Semi Structured Interview Unchanged
256696 FGD Other- Unchanged
256695 2021 PMHCA Program Implementation Survey Other- Unchanged
256694 PMHCA Practice Level Survey Form and Instruction Unchanged
256694 PMHCA Practice Level Survey Form and Instruction Unchanged
256687 HP Survey 2021 Form and Instruction Unchanged
256687 HP Survey 2021 Form and Instruction Unchanged
256686 2018/2019 PMHCA/2018 MDRBD Care Coordinator SSI Other-Semi Structured Interview Unchanged
256685 2021 PMHCA Care Coordinator SSI Instruction Unchanged
256680 Champion and Community Resources SSI Other-Semi Structured Interveiw Unchanged
ICR Details
StatusActive
Agency/SubagencyHHS/HRSA
OMB Control No0906-0074
Type of Information CollectionNo material or nonsubstantive change to a currently approved collection
Previous ICR Reference No202210-0906-004
Date Submitted to OIRA2023-02-13
Requested Expiration Date1969-12-31