OMB control number
Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Mental Health and Substance Use Disorders Programs Project
OMB 0906-0105 · HHS/HRSA.
OMB 0906-0105
This information collection will be used to evaluate the Pediatric Mental Health Care Access (PMHCA) Program and the Screening and Treatment for Maternal Mental Health and Substance Use Disorders (MMHSUD) Program. The evaluation will be used to study the efforts of PMHCA and MMHSUD programs to achieve key outcomes (e.g., increase in access to behavioral health services; HPs trained; identification of community-based resources, including counselors or family service providers) and to measure whether and to what extent awardee programs are associated with changes in these outcomes. The evaluation will examine changes over time within and/or across PMHCA and MMHSUD programs, regarding PMHCA- and MMHSUD-enrolled/participating HPs’ and practices’ (1) capacity to address patients’ behavioral health and access to behavioral health care, through screening, assessment, treatment, and referral for behavioral health conditions, and (2) use of program services (i.e., consultation, care coordination, training).
The latest form for Evaluation of the Maternal and Child Health Bureau Pediatric Mental Health Care Access and Screening and Treatment for Maternal Mental Health and Substance Use Disorders Programs Project expires 2027-12-31 and is listed under ICR 202505-0906-005.
Latest Forms, Documents, and Supporting Material
Form 1O 1O_MCHB_0906-0105_MCHB_PMHCA Program Implementation SSI_Redline
Attachment A42 - Program Implementation SSI Reminder Email - JBS_Final.docx
Program Implementation Semi-Structured Interview (SSI)All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202505-0906-005 | No material or nonsubstantive change to a currently approved collection | 2025-06-02 | ||
| 202410-0906-001 | New collection (Request for a new OMB Control Number) | 2024-10-10 | Approved without change |
OMB Details
Health Professional Survey
Federal Enterprise Architecture: Health - Health Care Services
| Form | Name | Electronic access | Type |
|---|---|---|---|
| Form 1E | 1E_MCHB_0906-0105_MMHSUD Health Professional Survey_Redline | Fillable Fileable | Form and instruction |
| Form 1E | Attachment 1E - Health Professional Survey MMHSUD | Fillable Fileable | Form and instruction |
| Form 1M | Attachment 1M - Health Professional Survey PMHCA | Fillable Fileable | Form and instruction |
| Form 1M | 1M_MCHB_0906-0105_MCHB_PMHCA Health Professional Survey_Redline | Fillable Fileable | Form and instruction |
Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.