State Mental Institution Policy Review

ICR 202004-0960-007

OMB: 0960-0110

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2020-08-24
Supporting Statement A
2020-08-24
IC Document Collections
ICR Details
0960-0110 202004-0960-007
Received in OIRA 201701-0960-001
SSA
State Mental Institution Policy Review
Revision of a currently approved collection   No
Regular 08/24/2020
  Requested Previously Approved
36 Months From Approved 01/31/2021
68 69
68 69
0 0

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.

US Code: 42 USC 405 Name of Law: The Public Health and Welfare
   US Code: 42 USC 1383 Name of Law: The Public Health and Welfare
  
None

Not associated with rulemaking

  85 FR 26776 05/05/2020
85 FR 50862 08/18/2020
No

1
IC Title Form No. Form Name
State Mental Institution Policy Review SSA-9584-BK State Mental Instintution Policy Review

  Total Request Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 68 69 0 0 -1 0
Annual Time Burden (Hours) 68 69 0 0 -1 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
The decrease in burden hours stems from a decline in the number of State institutions participating in the onsite review program. As of December 2020, there are approximately 203 State institutions participating in the onsite review program. SSA reviews institutions triennially, reviewing one-third (68) of the 203 participating institutions each year.

$0
No
    Yes
    Yes
No
No
No
No
Faye Lipsky 410 965-8783 faye.lipsky@ssa.gov

  No

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
 
 
 
 
 
 
 
    (i) Why the information is being collected;
    (ii) Use of information;
    (iii) Burden estimate;
    (iv) Nature of response (voluntary, required for a benefit, or mandatory);
    (v) Nature and extent of confidentiality; and
    (vi) Need to display currently valid OMB control number;
 
 
 
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
08/24/2020


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