05202025 1_NonSubstantive Change Memo - OMB 0906-0105_HRSA Clean_051620255002

DATE: June 3, 2025

TO: Dan Cline, Desk Officer, Office of Management and Budget

FROM: Samantha Miller, Information Collection Clearance Officer, Office of Planning, Analysis and Evaluation, Health Resources and Services Administration

______________________________________________________________________________

Request: The Health Resources and Services Administration’s (HRSA), Maternal and Child Health Bureau (MCHB) requests approval for changes to the HRSA Evaluation of the MCHB Pediatric Mental Health Care Access (PMHCA) and Screening and Treatment for Maternal Mental Health and Substance Use Disorders (MMHSUD) Programs (OMB 0906-0105, expiration date December 31, 2027).

Purpose: HRSA is requesting to revise language to align with Executive Order (E.O.) 14168 (Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government), and E.O. 14151 (Ending Radical and Wasteful Government DEI Programs and Preferencing). HRSA is also making non-substantive changes to ensure the package is up-to-date. This memo explains the changes.

Changes: This request updates terminology used in the following MMHSUD and PMHCA instruments to be in accordance with E.O. 14168 and E.O. 14151:

• Behavioral Health Consultation Provider Semi-Structured Interview (SSI) (Form A for MMHSUD, Form I for PMHCA)

• Care Coordinator SSI (Form B for MMHSUD, Form J for PMHCA)

• Champion SSI (Form C for MMHSUD, Form K for PMHCA)

• Community-Based and Other Resources SSI (Form D for MMHSUD, Form L for PMHCA)

• Health Professional Survey (Form E for MMHSUD, Form M for PMHCA)

• Practice-Level Survey (Form F for MMHSUD, Form N for PMHCA)

• Program Implementation SSI (Form G for MMHSUD, Form O for PMHCA)

• Program Implementation Survey (Form H for MMHSUD, Form P for PMHCA)

This request involves the following revisions:

• Instrument introductory text

• Section headings

• Section introductory text

• Existing question stems

• Existing question probes

• Existing question response options

Changes are outlined in detail in the table below and in a track changes version of each SSI and survey instrument.

Time Sensitivity: HRSA requests approval by June 2, 2025, to avoid delay to data collections under 0906-0105.

Burden: The proposed changes are not expected to have any impact on burden.

PROPOSED CLARIFICATIONS AND NON-SUBSTANTIVE CHANGES:

Form: Behavioral Health Consultation Provider SSI (Forms 1A, 1I)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1A) PMHCA (1I)	Update instrument introductory text under “Background for Interviewers”	The behavioral health consultation provider interviews will cover the following topics:   Program involvement Clinical behavioral health consultation processes Clinical behavioral health consultation requests Health equity Program usefulness	The behavioral health consultation provider interviews will cover the following topics:   Program involvement Clinical behavioral health consultation processes Clinical behavioral health consultation requests Optimal Access to Behavioral Health Care Program usefulness
MMHSUD (1A)	Update section introductory text under “Clinical Behavioral Health Consultation Processes”	Next, I would like to ask you about the MMHSUD program’s consultation processes, including the use of telehealth. For this interview, the term “client” refers to the pregnant and postpartum people in need of services and their families.	Next, I would like to ask you about the MMHSUD program’s consultation processes, including the use of telehealth. For this interview, the term “client” refers to the pregnant and postpartum women in need of services and their families.
MMHSUD (1A) PMHCA (1I)	Update section header	Health Equity (6 minutes)	Optimal Access to Behavioral Health Care (6 minutes)
MMHSUD (1A) PMHCA (1I)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the overall [MMHSUD/PMHCA] program is improving health equity related to social determinants of health (SDOH) and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. As defined in Healthy People 2030, SDOH include economic stability, neighborhood and built environment, health care access and quality, social and community context, and education access and quality. Health equity refers to the state in which everyone has a fair and just opportunity to attain the highest level of health. The following question will be used to inform the goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1A) PMHCA (1I)	Update SSI guide question number 8 stem and probe	8. How do you think the [MMHSUD/PMHCA] program is addressing SDOH by supporting access to behavioral health care? PROBE: Have you observed changes over time in consultation requests related to SDOH or health disparities? Please explain.	8. How do you think the [MMHSUD/PMHCA] program is addressing community health factors by supporting access to behavioral health care? PROBE: Have you observed changes over time in consultation requests related to community health or demographic factors? Please explain.

Form: Care Coordinator SSI (Forms 1B, 1J)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1B) PMHCA (1J)	Update instrument introductory text under “Instructions to Interviewers”	The care coordinator interviews will cover the following topics: Program involvement Community-based and other resource connections Community-based and other resource referrals Health equity Change over time Lessons learned	The care coordinator interviews will cover the following topics: Program involvement Community-based and other resource connections Community-based and other resource referrals Optimal access to behavioral health care Change over time Lessons learned
MMHSUD (1B)	Update section introductory text under “Community Based and Other Resource Connections”	Next, we’d like to discuss the community-based and other resources, hereafter referred to as resources, you’ve connected with to help clients, including any related challenges and facilitators. For this interview, a client refers to pregnant and postpartum people in need of resources and their families.	Next, we’d like to discuss the community-based and other resources, hereafter referred to as resources, you’ve connected with to help clients, including any related challenges and facilitators. For this interview, a client refers to pregnant and postpartum women in need of resources and their families.
MMHSUD (1B) PMHCA (1J)	Update SSI guide question number 2 stem	2. With what types of resources has the [MMHSUD/PMHCA] program connected with to support social determinants of health, or SDOH, for clients. For example, resources related to behavioral health, which includes mental illness and substance use treatment services, as well as housing, food, transportation, and financial assistance.	2. With what types of resources has the [MMHSUD/PMHCA] program connected with to support community health factors for clients. For example, resources related to behavioral health, which includes mental illness and substance use treatment services, as well as housing, food, transportation, and financial assistance.
MMHSUD (1B) PMHCA (1J)	Update section header	Health Equity (8 minutes)	Optimal Access to Behavioral Health Care (8 minutes)
MMHSUD (1B) PMHCA (1J)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to SDOH and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following questions will be used to inform the goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1B) PMHCA (1J)	Update SSI guide question number 12 stem	12. How do you think the [MMHSUD/PMHCA] program is addressing SDOH, including supporting access to behavioral health care?	12. How do you think the [MMHSUD/PMHCA] program is supporting access to behavioral health care?
MMHSUD (1B) PMHCA (1J)	Remove SSI guide question number 13 stem and probe	13. Do clients request resource service providers with similar backgrounds, cultures, and/or demographics? PROBE 1: How has the [MMHSUD/ PMHCA] program supported clients in accessing representative resource service providers?	Question stem and probe removed.

Form: Champion SSI (Forms 1C, 1K)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1C) PMHCA (1K)	Update instrument introductory text under “Instructions to Interviewers”	The champion interviews will cover the following topics: Program involvement Overall interactions Program implementation Health equity Program Outcomes	The champion interviews will cover the following topics: Program involvement Overall interactions Program implementation Optimal access to behavioral health care Program outcomes
MMHSUD (1C)	Update SSI guide question number 5 stem	5. Based on your interactions with primary care health professionals who provide care for pregnant and postpartum people, how receptive are they to providing behavioral health care services?	5. Based on your interactions with primary care health professionals who provide care for pregnant and postpartum women, how receptive are they to providing behavioral health care services?
MMHSUD (1C) PMHCA (1K)	Update section header	Health Equity (4 minutes)	Optimal Access to Behavioral Health Care (4 minutes)
MMHSUD (1C) PMHCA (1K)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to social determinants of health (SDOH) and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following question will be used to inform the goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1C) PMHCA (1K)	Update SSI guide question number 9 stem	9. How do you think the [MMHSUD/PMHCA] program is addressing SDOH, including supporting access to behavioral health care?	9. How do you think the [MMHSUD/PMHCA] program is supporting access to behavioral health care?

Form: Community-Based and Other Resources SSI (Forms 1D, 1L)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1D) PMHCA (1L)	Update instrument introductory text under “Instructions to Interviewers”	The community resources partner interviews will cover the following topics: Organization description Collaboration with the [MMHSUD/PMHCA] program Collaboration impacts Health equity	The community resources partner interviews will cover the following topics: Organization description Collaboration with the [MMHSUD/PMHCA] program Collaboration impacts Optimal access to behavioral health care
MMHSUD (1D) PMHCA (1L)	Update section header	Health Equity (6 minutes)	Optimal Access to Behavioral Health Care (6 minutes)
MMHSUD (1D) PMHCA (1L)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to social determinants of health (SDOH) and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following questions will be used to inform our goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1D) PMHCA (1L)	Update SSI guide question number 9 stem	9. What SDOH needs, or populations impacted by health disparities, does your organization prioritize to address health equity?	9. What community health or demographic factors does your organization prioritize to address optimal access to behavioral health care?
MMHSUD (1D) PMHCA (1L)	Remove SSI guide question number 10 stem and probe	10. Do clients request community-based or other resource service providers with similar backgrounds, cultures, and/or demographics? PROBE 1: How has your organization supported clients in accessing representative resource service providers?	Question stem and probe removed.

Form: Health Professional Survey (Forms 1E, 1M)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1E) PMHCA (1M)	Update survey question number 5 stem	5. In the last 12 months, my [state’s/location’s] [MMHSUD/PMHCA] program provided training on the impact of discrimination, stereotyping, and stigma on the behavioral health of [pregnant and postpartum patients and their families/ pediatric patients and their families].	5. In the last 12 months, my [state’s/ location’s] [MMHSUD/PMHCA] program provided training on the impact of stigma on the behavioral health of [pregnant and postpartum patients and their families pediatric patients and their families].
MMHSUD (1E)	Update survey question number 9 response option	9. What patient issue(s) prompted you to contact the MMHSUD clinical behavioral health consultation service? Select all that apply. Comorbid medical conditions Behavioral health conditions High-risk pregnancy Housing or food insecurity Intimate partner violence Complications at delivery Premature birth Substance-exposed infant Social determinants of health (SDOH)/family environment Other (specify)	9. What patient issue(s) prompted you to contact the MMHSUD clinical behavioral health consultation service? Select all that apply. Comorbid medical conditions Behavioral health conditions High-risk pregnancy Housing or food insecurity Intimate partner violence Complications at delivery Premature birth Substance-exposed infant Community health factors/family environment Other (specify)
PMHCA (1M)	Update survey question number 9 response option	9. What patient issue(s) prompted you to contact the Pediatric Mental Health Care Team? Select all that apply. Comorbid medical conditions Behavioral health conditions Developmental delay School performance Behavioral concerns Child in foster care Adverse childhood events Parent/Caregiver mental health/SUD Social determinants of health (SDOH)/family environment Other (Specify.)	9. What patient issue(s) prompted you to contact the Pediatric Mental Health Care Team? Select all that apply. Comorbid medical conditions Behavioral health conditions Developmental delay School performance Behavioral concerns Child in foster care Adverse childhood events Parent/Caregiver mental health/SUD Community health factors/family environment Other (Specify.)
MMHSUD (1E) PMHCA (1M)	Update survey question number 14 response options	14. In the last 12 months, my interaction with the [MMHSUD/PMHCA] clinical behavioral care consultation service informed my: Assessments of [pregnant and postpartum patients/ pediatric patients] Formulations of diagnoses Use of pharmacotherapy Referrals to social services Referrals to counseling services Ability to address health disparities Ability to address disparities in access to behavioral health care	14. In the last 12 months, my interaction with the [MMHSUD/PMHCA] clinical behavioral care consultation service informed my: Assessments of [pregnant and postpartum patients/ pediatric patients] Formulations of diagnoses Use of pharmacotherapy Referrals to social services Referrals to counseling services Ability to address barriers to optimal access to behavioral health care
MMHSUD (1E) PMHCA (1M)	Update section header	Health Equity	Optimal Access to Behavioral Health Care
MMHSUD (1E) PMHCA (1M)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to SDOH and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following questions will be used to inform our goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1E) PMHCA (1M)	Update survey question number 34 stem and response options	34. In the last 12 months, how often have you engaged in the following activities to support health equity in access to behavioral health care for your patients as a result of participating in your [state’s/location]’s [MMHSUD/PMHCA] program? Assess SDOH (e.g., food insecurity, housing insecurity) Provide referrals to community resources to address SDOH-related needs Make culturally and linguistically appropriate recommendations to promote behavioral health	34. In the last 12 months, how often have you engaged in the following activities to support optimal access to behavioral health care for your patients as a result of participating in your [state’s/location’s] [MMHSUD/PMHCA] program? Assess community health factors (e.g., food insecurity, housing insecurity) Provide referrals to community resources to address needs related to community health factors Make culturally and linguistically appropriate recommendations to promote behavioral health
MMHSUD (1E) PMHCA (1M)	Update survey question number 35 stem	35. As a result of participating in my [state’s/location]’s [MMHSUD/PMHCA] program, I am better able to address health disparities in access to behavioral health care.	35. As a result of participating in my [state’s/location’s] [MMHSUD/PMHCA] program, I am better able to address barriers to optimal access to behavioral health care.
MMHSUD (1E) PMHCA (1M)	Update survey question number 36 stem	36. As a result of participating in my [state’s/location’s] [MMHSUD/PMHCA] program, I have incorporated telehealth services in my practice to reduce health disparities in access to behavioral health care.	36. As a result of participating in my [state’s/location’s] [MMHSUD/PMHCA] program, I have incorporated telehealth services in my practice to improve optimal access to behavioral health care.

Form: Practice-Level Survey (Forms 1F, 1N)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1F)	Update survey question number 3 response option	3. Which staff administer behavioral health screening tools in your practice? Select all that apply. Obstetricians/Gynecologists Pediatricians Family physicians Nurse midwives/Advanced practice nurses/Nurse practitioners Physician assistants Registered nurses Licensed practical nurses Counselors Social workers Medical assistants Patient care navigators Not applicable – Self-administered by caregiver/youth Other (Specify.)	3. Which staff administer behavioral health screening tools in your practice? Select all that apply. Obstetricians/Gynecologists Pediatricians Family physicians Nurse midwives/Advanced practice nurses/Nurse practitioners Physician assistants Registered nurses Licensed practical nurses Counselors Social workers Medical assistants Patient care navigators Not applicable – Self-administered by patient/patient representative Other (Specify.)
MMHSUD (1F) PMHCA (1N)	Update survey question number 14 response option	14. How easy was it for your practice to incorporate these telehealth mechanism(s) listed above for consulting with the [MMHSUD/PMHCA] clinical behavioral health consultation service? Very Difficult Difficult Neutral Easy Very Easy	14. How easy was it for your practice to incorporate these telehealth mechanism(s) listed above for consulting with the [MMHSUD/PMHCA] clinical behavioral health consultation service? Very Difficult Difficult Neutral Easy Very Easy Not Applicable
MMHSUD (1F) PMHCA (1N)	Update survey question number 21 response options	21. Which one factor did you expect would be most challenging in implementing screening, assessment, and treatment for behavioral health conditions in your practice? Select one. Insufficient time Health professional/Staff acceptance Communication and coordination Institutional policies Leadership and support from a champion Staffing Reimbursement by payers Telehealth technology Workflow Addressing social determinants of health (SDOH)-related needs Staff knowledge and skills Impact of public health emergency (e.g., COVID-19) Other (Specify.)	21. Which one factor did you expect would be most challenging in implementing screening, assessment, and treatment for behavioral health conditions in your practice? Select one. Insufficient time Health professional/Staff acceptance Communication and coordination Institutional policies Leadership and support from a champion Staffing Reimbursement by payers Telehealth technology Workflow Addressing needs related to community health factors Staff knowledge and skills Impact of public health emergency Other (Specify.)
MMHSUD (1F) PMHCA (1N)	Update survey question number 22 response options	22. Which one factor actually presented the greatest challenge to implementing screening, assessment, and treatment of behavioral health conditions in your practice? Select one. Insufficient time Health professional/Staff acceptance Communication and coordination Institutional policies Leadership and support from a champion Staffing Reimbursement by payers Telehealth technology Workflow Addressing SDOH-related needs Staff knowledge and skills Impact of public health emergency (e.g., COVID-19) Other (Specify.)	22. Which one factor actually presented the greatest challenge to implementing screening, assessment, and treatment of behavioral health conditions in your practice? Select one. Insufficient time Health professional/Staff acceptance Communication and coordination Institutional policies Leadership and support from a champion Staffing Reimbursement by payers Telehealth technology Workflow Addressing needs related to community health factors Staff knowledge and skills Impact of public health emergency Other (Specify.)
MMHSUD (1F) PMHCA (1N)	Update survey question number 23 response options	23. Which one factor do you expect will be most challenging in sustaining screening, assessment, and treatment for behavioral health conditions in your practice when HRSA MCHB [MMHSUD/ PMHCA] grant-funded support is no longer available? Select one. Insufficient time Health professional/Staff acceptance Communication and coordination Institutional policies Leadership and support from a champion Staffing Reimbursement by payers Telehealth technology Workflow Addressing SDOH-related needs Staff knowledge and skills Impact of public health emergency (e.g., COVID-19) Other (Specify.)	23. Which one factor do you expect will be most challenging in sustaining screening, assessment, and treatment for behavioral health conditions in your practice when HRSA MCHB [MMHSUD/ PMHCA] grant-funded support is no longer available? Select one. Insufficient time Health professional/Staff acceptance Communication and coordination Institutional policies Leadership and support from a champion Staffing Reimbursement by payers Telehealth technology Workflow Addressing needs related to community health factors Staff knowledge and skills Impact of public health emergency Other (Specify.)
MMHSUD (1F) PMHCA (1N)	Update section header	Health Equity	Optimal Access to Behavioral Health Care
MMHSUD (1F) PMHCA (1N)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to SDOH and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following questions will be used to inform our goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1F) PMHCA (1N)	Update survey question number 30 stem	30. In the last 12 months, as a result of participation in my [state’s/location’s] [MMHSUD/PMHCA] program, my practice increased provision of resources to [pregnant and postpartum patients/ pediatric patients and their caregivers] to address the following SDOH-related needs:	30. In the last 12 months, as a result of participation in my [state’s/location’s] [MMHSUD/PMHCA] program, my practice increased provision of resources to [pregnant and postpartum patients/ pediatric patients and their caregivers] to address the following needs:
MMHSUD (1F) PMHCA (1N)	Update survey question number 31 stem	31. In the last 12 months, as a result of participation in my [state’s/location’s] [MMHSUD/PMHCA] program, my practice has incorporated telehealth services to reduce health disparities in access to behavioral health care.	31. In the last 12 months, as a result of participation in my [state’s/location’s] [MMHSUD/PMHCA] program, my practice has incorporated telehealth services to improve optimal access to behavioral health care.
MMHSUD (1F) PMHCA (1N)	Update survey question number 32 stem	32. In the last 12 months, my [state’s/location’s] [MMHSUD/PMHCA] program provided training on the impact of discrimination, stereotyping, and stigma on the behavioral health of [pregnant and postpartum patients/ pediatric patients and their families].	32. In the last 12 months, my [state’s/location’s] [MMHSUD/PMHCA] program provided training on the impact of stigma on the behavioral health of [pregnant and postpartum patients/pediatric patients and their families].
MMHSUD (1F) PMHCA (1N)	Update survey question number 33 stem	33. Please describe steps your practice has taken to improve health equity in access to behavioral health care for [pregnant and postpartum patients and their families/pediatric patients and their families], as a result of participation in your [state’s/location’s] [MMHSUD/PMHCA] program.	33. Please describe steps your practice has taken to improve optimal access to behavioral health care for [pregnant and postpartum patients and their families/ pediatric patients and their families], as a result of participation in your [state’s/location’s] [MMHSUD/PMHCA] program.
MMHSUD (1F) PMHCA (1N)	Update survey question number 34 stem	34. To what extent is the ethnicity and/or race of health professionals employed by your practice representative of the ethnicity and/or race of the [pregnant and postpartum patients/pediatric patients and their families] your practice treats?	34. To what extent do the health professionals employed by your practice have similar backgrounds to the [pregnant and postpartum patients/ pediatric patients and their families] your practice treats?

Form: Program Implementation SSI (Forms 1G, 1O)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1G) PMHCA (1O)	Update instrument introductory text under “Instructions to Interviewers”	The program implementation interviews will cover the following topics: Program involvement Program implementation Program outreach and promotion Health professional/Practice recruitment and enrollment/participation Health professional training Health equity priorities Sustainability Program implementation successes and lessons learned	The program implementation interviews will cover the following topics: Program involvement Program implementation Program outreach and promotion Health professional/Practice recruitment and enrollment/participation Health professional training Optimal access to behavioral health care Sustainability Program implementation successes and lessons learned
MMHSUD (1G) PMHCA (1O)	Update instrument introductory text under “Program Implementation Interview Introduction to Interviewee”	We would also like to gain insight into the degree to which program outreach, training, telehealth capacity building, health equity, and sustainability plans have developed through the course of your program’s operations.	We would also like to gain insight into the degree to which program outreach, training, telehealth capacity building, activities to address optimal access to behavioral health care, and sustainability plans have developed through the course of your program’s operations.
MMHSUD (1G) PMHCA (1O)	Update section introductory text under “Partnerships”	We would also like to discuss any partnerships that have developed over the course of your [MMHSUD/ PMHCA] program. By partnership, we mean relationships with other organizations [for example, American Academy of Pediatrics] to promote the program or implement program components. This excludes community-based or other resource organizations that provide social determinants of health-related services.	We would also like to discuss any partnerships that have developed over the course of your [MMHSUD/PMHCA] program. By partnership, we mean relationships with other organizations [for example, American Academy of Pediatrics] to promote the program or implement program components. This excludes community-based or other resource organizations that provide services related to community health factors.
MMHSUD (1G) PMHCA (1O)	Update SSI guide question number 15 stem	15. Please describe any training activities your program offers to address health equity.	15. Please describe any training activities your program offers to address optimal access to behavioral health care.
MMHSUD (1G) PMHCA (1O)	Update section header	Health Equity (8 minutes)	Optimal Access to Behavioral Health Care (8 minutes)
MMHSUD (1G) PMHCA (1O)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to social determinants of health and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following questions will be used to inform our goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1G) PMHCA (1O)	Update SSI guide question number 18 stem	18.What social determinants of health needs, or populations impacted by health disparities, does your program prioritize to address health equity?	What community health or demographic factors does your organization prioritize to address optimal access to behavioral health care?
MMHSUD (1G) PMHCA (1O)	Update SSI guide question number 19 stem	19. How has your program facilitated health equity in access to behavioral health care?	19. How has your program facilitated optimal access to behavioral health care?
MMHSUD (1G) PMHCA (1O)	Update SSI guide question number 20 stem	20. How has your [MMHSUD/PMHCA] program supported health professionals' and/or practices’ capacity to incorporate telehealth services to address health equity? Telehealth includes the use of technology, such as email, telephone, text messaging, video conferencing, and screensharing, for provider-to-provider or provider-to-client communication.	20. How has your [MMHSUD/PMHCA] program supported health professionals' and/or practices’ capacity to incorporate telehealth services to address optimal access? Telehealth includes the use of technology, such as email, telephone, text messaging, video conferencing, and screensharing, for provider-to-provider or provider-to-client communication.

Form: Program Implementation Survey (Forms 1H, 1P)

Program Form	Type of Change	Question/Item	Requested Change
MMHSUD (1H) PMHCA (1P)	Update survey question number 12 response option	12. What challenges did you encounter while implementing health professional training? Select all that apply. Lack of health professional acceptance Inability to offer CME/CE credits Infrastructure challenges (e.g., facilities, technology, staffing) Lack of champion support Lack of community resource partner support (whether informal or formal) Lack of participant engagement Scheduling Length of training/training sessions Training format Training promotion Impact of public health emergency (e.g., COVID-19) Other (Specify.) None	12. What challenges did you encounter while implementing health professional training? Select all that apply. Lack of health professional acceptance Inability to offer CME/CE credits Infrastructure challenges (e.g., facilities, technology, staffing) Lack of champion support Lack of community resource partner support (whether informal or formal) Lack of participant engagement Scheduling Length of training/training sessions Training format Training promotion Impact of public health emergency Other (Specify.) None
MMHSUD (1H) PMHCA (1P)	Update section header	Health Equity	Optimal Access to Behavioral Health Care
MMHSUD (1H) PMHCA (1P)	Update section introductory text under what will now be “Optimal Access to Behavioral Health Care”	A goal of the [MMHSUD/ PMHCA] program is to focus on achieving health equity related to social determinants of health and racial, ethnic, and geographic disparities in access to behavioral health care, especially in rural and other underserved areas. The following questions will be used to inform our goal of improving health equity.	A goal of the overall [MMHSUD/PMHCA] program is to address barriers to optimal access to behavioral health care related to community health factors and demographic factors. Optimal access is intended to result in healthy outcomes for all. The following question will be used to inform the goal of improving access.
MMHSUD (1H) PMHCA (1P)	Update survey question number 17 stem	17. To what extent, if any, has your [MMHSUD/ PMHCA] program encountered or identified health disparities in access to behavioral health care?	17. To what extent, if any, has your [MMHSUD/ PMHCA] program encountered or identified differences in access to behavioral health care?
MMHSUD (H) PMHCA (1P)	Update survey question number 18 stem	18. Please describe an example of how your program worked to achieve health equity related to behavioral health care access to address racial, ethnic, and geographic disparities.	18. Please describe an example of how your program worked to achieve optimal access to behavioral health care by addressing community health and demographic factors.
MMHSUD (1H) PMHCA (1P)	Update survey question number 19 stem and response options	19. On what health equity-related topics has your [MMSHUD/PMHCA] program provided training for health professionals? Select all that apply. Barriers to health care Foundational knowledge of health equity and health disparities Implicit biases Systemic racism Sensitivity to patients’ race, ethnicity, and language Impact of adversity, adverse childhood experiences, trauma, or toxic stress Trauma- and resilience-informed care Other (Specify.)	19. On what topics has your [MMSHUD/PMHCA] program provided training for health professionals to address optimal access to behavioral health care? Select all that apply. Barriers to health care Foundational knowledge of promoting fairness by addressing optimal access to behavioral health care Sensitivity to patients’ demographics and preferences Impact of adversity, adverse childhood experiences, trauma, or toxic stress Trauma- and resilience-informed care Other (Specify.)
MMHSUD (1H) PMHCA (1P)	Update survey question number 20 stem	20. To what extent have you developed an Advisory Committee, comprising interested parties and agencies, to support a statewide or regional [MMHSUD/PMHCA] program? (Key stakeholders may include mental health, public health, pediatric health, and behavioral health clinicians; human services; health insurers; education and diversity, equity, and inclusion subject matter experts; and families.)	20. To what extent have you developed an Advisory Committee, comprising interested parties and agencies, to support a statewide or regional [PMHCA/MMHSUD] program? (Key stakeholders may include mental health, public health, pediatric health, and behavioral health clinicians; human services; health insurers; and families.)
MMHSUD (1H) PMHCA (1P)	Update survey question number 21 stem	21. What supports related to health equity does your [MMHSUD/ PMHCA] program need to address racial, ethnic, and geographic disparities?	21. What supports does your [MMHSUD/ PMHCA] program need to address community health factors and demographic factors?
MMHSUD (1H) PMHCA (1P)	Update survey question number 25 stem	25. What community resources have been the most effective in addressing health disparities in access to behavioral health care in your [state/location]?	25. What community resources have been the most effective in addressing optimal access to behavioral health care in your [state/location]?
MMHSUD (1H) PMHCA (1P)	Update survey question number 26 stem	26. Please describe any goals your program has established with community [linkages/resources] to support health equity in access to behavioral health care.	26. Please describe any goals your program has established with community [linkages/resources] to support optimal access to behavioral health care.
MMHSUD (1H)	Update survey question number 39 response option	39. What factors have challenged your program implementation? Select all that apply. Lack of health professional recruitment Lack of health professional engagement Lack of stakeholder communication and coordination Lack of champion support Lack of community resource partner support (whether informal or formal) Telehealth technology Workflow Data collection/reporting Lack of Advisory Committee involvement Impact of public health emergency (e.g., COVID-19) Other (Specify.)	39. What factors have challenged your program implementation? Select all that apply. Lack of health professional recruitment Lack of health professional engagement Lack of stakeholder communication and coordination Lack of champion support Lack of community resource partner support (whether informal or formal) Telehealth technology Workflow Data collection/reporting Lack of Advisory Committee involvement Impact of public health emergency Other (Specify.)
PMHCA (1P)	Update survey question number 39 response option	39. What factors have challenged your program implementation? Select all that apply. Lack of health professional recruitment Lack of health professional engagement Lack of stakeholder communication and coordination Lack of champion support Lack of community resource partner support (whether informal or formal) Telehealth technology Workflow Data collection/reporting Advisory Committee involvement Impact of public health emergency (e.g., COVID-19) Other (Specify.)	39. What factors have challenged your program implementation? Select all that apply. Lack of health professional recruitment Lack of health professional engagement Lack of stakeholder communication and coordination Lack of champion support Lack of community resource partner support (whether informal or formal) Telehealth technology Workflow Data collection/reporting Lack of Advisory Committee involvement Impact of public health emergency Other (Specify.)

Attachment:

1. 0906-0105_MCHB_PMHCA BH Consultation Provider SSI_Redline_5-9-25

2. 0906-0105_MCHB_PMHCA Care Coordinator SSI_Redline_5-9-25

3. 0906-0105_MCHB_PMHCA Champion_Redline SSI_5-9-25

4. 0906-0105_MCHB_PMHCA Community Resources SSI_Redline_5-9-25

5. 0906-0105_MCHB_PMHCA Health Professional Survey_Redline_5-9-25

6. 0906-0105_MCHB_PMHCA Practice Level Survey_Redline_5-9-25

7. 0906-0105_MCHB_PMHCA Program Implementation SSI_Redline_5-9-25

8. 0906-0105_MCHB_PMHCA Program Implementation Survey_Redline_5-9-25

9. 0906-0105_MCHB_MMHSUD BH Consultation Provider SSI_Redline_5-9-25

10. 0906-0105_MCHB_MMHSUD Care Coordinator SSI_Redline_5-9-25

11. 0906-0105_MCHB_MMHSUD Champion_Redline SSI_5-9-25

12. 0906-0105_MCHB_MMHSUD Community Resources SSI_Redline_5-9-25

13. 0906-0105_MCHB_MMHSUD Health Professional Survey_Redline_5-9-25

14. 0906-0105_MCHB_MMHSUD Practice Level Survey_Redline_5-9-25

15. 0906-0105_MCHB_MMHSUD Program Implementation SSI_Redline_5-9-25

16. 0906-0105_MCHB_MMHSUD Program Implementation Survey_Redline_5-9-25