OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

SUD Placement Criteria Survey

OMB 0990-0474 ยท HHS/HHSDM.

OMB 0990-0474

The Assistant Secretary for Planning and Evaluation (ASPE) is requesting clearance for a one-time survey of state agencies regarding the use of substance use disorder (SUD) patient placement criteria and assessment tools. This survey is one component of a larger project to assess the feasibility of gathering and utilizing needs assessment data to identify and address unmet patient needs by levels of care. Respondents will be two state officials in each of the 50 states and the District of Columbia and will take approximately 10 minutes to complete.

The latest form for SUD Placement Criteria Survey expires 2021-08-31 and is listed under ICR 202002-0990-001.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
4. Attachment B - Introductory Cover Letter 7-23-2020 CLEAN.docx Supplementary Document
1. 0990-SS_A Patient Placement May12020 revised 7 24 clean.docxSupporting Statement A
60-Day FRN 0990- Patient Placement Survey - 2 7 20.docx Supplementary Document
4. Attachment B - Introductory Cover Letter 1-9-2020.docx Supplementary Document
2. SUD placement criteria survey OMB_Part B 1-14-2020 lljk edits.docxSupporting Statement B
Survey Other-survey

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202002-0990-001 New collection (Request for a new OMB Control Number) 2020-05-01 Approved with change