TEDS MHCLD Tools

Treatment Episode Data Set (TEDS)

Documents and Forms

Document Name Document Type
Form MH-CLD State Cross TEDS MHCLD Tools Form and Instruction
MH-CLD State Cross MH-CLD State Crosswalk Attachment D_MH-CLD State Crosswalk 2024.xlsx Form and Instruction
MH-CLD Data Elemen MH-CLD Data Elements Attachment C_MH-CLD Data Elements 2024.xlsm Form and Instruction
TEDS MH-TEDS State TEDS MH-TEDS State Crosswalk Attachment B_TEDS MH-TEDS State Crosswalk 202412.xlsx Form and Instruction
TEDS MH-TEDS Data TEDS MH-TEDS Data Elements Attachment A_TEDS MH-TEDS Data Elements 202412.xlsx Form and Instruction
MHBG Application U MHBG Application URS Tables Attachment 3_MHBG Application URS Tables.xlsx Form and Instruction
TEDS State Reporti TEDS State Reporting Characteristic Attachment 1_TEDS State Reporting Characteristics.docx Form and Instruction
TEDS State Reporti TEDS State Reporting Characteristics Attachment 1_TEDS State Reporting Characteristics.docx Form and Instruction
0930-0335 TEDS Supporting Statement 202412.docx TEDS Supporting Statement A IC Document

Information Collection (IC) Details

IC Title:	TEDS MHCLD Tools	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	MH-CLD State Crosswalk	MH-CLD State Crosswalk	Attachment D_MH-CLD State Crosswalk 2024.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	MH-CLD Data Elements	MH-CLD Data Elements	Attachment C_MH-CLD Data Elements 2024.xlsm	Yes	Yes	Fillable Fileable
Form and Instruction	TEDS MH-TEDS State Crosswalk	TEDS MH-TEDS State Crosswalk	Attachment B_TEDS MH-TEDS State Crosswalk 202412.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	TEDS MH-TEDS Data Elements	TEDS MH-TEDS Data Elements	Attachment A_TEDS MH-TEDS Data Elements 202412.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	MHBG Application URS Tables	MHBG Application URS Tables	Attachment 3_MHBG Application URS Tables.xlsx	Yes	Yes	Fillable Fileable
Form and Instruction	TEDS State Reporting Characteristic	TEDS State Reporting Characteristic	Attachment 1_TEDS State Reporting Characteristics.docx	Yes	Yes	Fillable Fileable
Form and Instruction	TEDS State Reporting Characteristics	TEDS State Reporting Characteristics	Attachment 1_TEDS State Reporting Characteristics.docx	Yes	Yes	Fillable Fileable

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: TEDS	FR Citation: 75 FR 28264

Number of Respondents: 317	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Requested	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	6,657	6,657
Annual IC Time Burden (Hours)	38,329	38,329
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
TEDS Supporting Statement A	0930-0335 TEDS Supporting Statement 202412.docx	12/17/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.