OMB control number

State Mental Institution Policy Review

OMB 0960-0110 · SSA.

OMB 0960-0110

SSA makes annual grants to the Protection and Advocacy Agencies (P&A) in each state to conduct, for SSA, all representative payee reviews. The collection of this information is mandatory for the completion of onsite reviews of State mental institutions. The P&As use Form SSA-9584-BK to collect information during State mental institutions onsite reviews. The P&As use the SSA-9584-BK to: (1) to determine if the policies and practices of a State mental institution acting as a representative payee for SSA beneficiaries conform to SSA’s regulations in the use of benefits; (2) to confirm that institutions are performing other duties and responsibilities required of representative payees; and (3) as the basis for conducting onsite reviews of the Institutions and preparing subsequent reports of findings. The respondents are State mental institutions serving as representative payees for Social Security beneficiaries and Supplemental Security Income (SSI) recipients.

The latest form for State Mental Institution Policy Review expires 2026-11-30 and is listed under ICR 202004-0960-007.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
Document	Type
Form SSA-9584-BK State Mental Instintution Policy Review	Form
Addendum - 0110.docx	Supplementary Document
Addendum - 0110.docx	Supplementary Document
Supporting Statement -0960- 0110 (Final).docx	Supporting Statement A
Supporting Statement - 0110.docx	Supporting Statement A
State Mental Institution Policy Review	Form
State Mental Institution Policy Review	Other-Revised PA & PRA Statements

All Historical Document Collections

Historical document collections
Reference	Filing	Received	Action
202004-0960-007	Revision of a currently approved collection	2020-08-24
201701-0960-001	Revision of a currently approved collection	2017-04-28	Approved with change
201311-0960-010	Revision of a currently approved collection	2014-03-10	Approved without change
201009-0960-005	Revision of a currently approved collection	2010-12-30	Approved without change
200712-0960-009	Extension without change of a currently approved collection	2008-02-06	Approved without change
200501-0960-004	Revision of a currently approved collection	2005-01-24	Approved without change
200401-0960-005	Extension without change of a currently approved collection	2004-01-28	Approved without change
200207-0960-009	Extension without change of a currently approved collection	2002-07-29	Approved without change
199903-0960-003	Extension without change of a currently approved collection	1999-03-26	Approved without change
199604-0960-002	Revision of a currently approved collection	1996-04-29	Approved without change
199303-0960-006	Reinstatement with change of a previously approved collection	1993-03-17	Approved without change
199108-0960-004	Extension without change of a currently approved collection	1991-08-07	Approved without change
198811-0960-005	Extension without change of a currently approved collection	1988-11-10	Approved without change
198511-0960-005	Extension without change of a currently approved collection	1985-11-26	Approved without change
198303-0960-006	Revision of a currently approved collection	1983-03-15	Approved without change
198209-0960-009	Revision of a currently approved collection	1982-09-27	Approved without change
198008-0960-013	Reinstatement with change of a previously approved collection	1980-08-12	Approved without change
198005-0960-007	No material or nonsubstantive change to a currently approved collection	1980-05-29	Approved with change
197903-0960-037	No material or nonsubstantive change to a currently approved collection	1979-03-29	Approved with change
197504-0960-009	Revision of a currently approved collection	1975-04-14	Approved without change
197503-0960-004	No material or nonsubstantive change to a currently approved collection	1975-03-18	Approved with change