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.
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 can be found here.
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 Attachment A7 - Behavioral Health Consultation Provider SSI Participation Email - Awardee_Final.docxSupplementary Document |
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Attachment A40 - Program Implementation SSI Notification Email - JBS_Final.docx
Program Implementation Semi-Structured Interview (SSI) | No material or nonsubstantive change to a currently approved collection | 2025-06-02 | ||
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Approved without change |
New collection (Request for a new OMB Control Number) | 2024-10-10 |
Health Professional Survey
Federal Enterprise Architecture: Health - Health Care Services
| 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.