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Pediatric Mental Health Care Access Program National Impact Study

OMB 0906-0097 · HHS/HRSA.

OMB 0906-0097

The PMHCA Program aims to promote behavioral health integration into pediatric primary care by supporting the development of state, regional, and tribal pediatric mental health care teleconsultation access programs. The PMHCA Program supports pediatric health professionals (HPs) in their delivery of high-quality and timely screening, assessment, treatment, and referrals for children and adolescents with behavioral health conditions through the provision of teleconsultation, care coordination support/navigation (e.g., resource identification and referrals), and training and education. Additionally, the PMHCA Program focuses on achieving health equity related to racial, ethnic, and geographic disparities in access to care, especially in rural and other underserved areas.

The latest form for Pediatric Mental Health Care Access Program National Impact Study expires 2027-07-31 and can be found here.

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All Historical Document Collections
 No material or nonsubstantive change to a currently approved collection 2025-03-28
Approved with change
 New collection (Request for a new OMB Control Number) 2024-05-01
OMB Details

Family/Caregiver Demographic Questionnaire

Federal Enterprise Architecture: Health - Health Care Services

Form 3_RevisedFamily Caregiver Demographic Questionaire Update 02.25.2025)Fillable FileableForm and instruction

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