Evaluation of the Extension of the Certified Community Behavioral Health Clinic (CCBHC) Demonstration Program

ICR 202208-0990-007

OMB: 0990-0485

Federal Form Document

Forms and Documents
Document
Name
Status
Supplementary Document
2022-09-06
Supporting Statement A
2022-09-06
Supplementary Document
2022-08-25
Supplementary Document
2022-09-06
Supplementary Document
2022-08-25
Supporting Statement B
2022-08-25
ICR Details
202208-0990-007
Received in OIRA
HHS/HHSDM OS-0990-new
Evaluation of the Extension of the Certified Community Behavioral Health Clinic (CCBHC) Demonstration Program
New collection (Request for a new OMB Control Number)   No
Regular 09/13/2022
  Requested Previously Approved
36 Months From Approved
101 0
201 0
0 0

The Office of the Assistant Secretary for Planning and Evaluation (ASPE) at the U.S. Department of Health and Human Services (HHS) is requesting Office of Management and Budget (OMB) approval for new qualitative and survey data collection activities to support its evaluation of the Certified Community Behavioral Health Clinic (CCBHC) demonstration program

None
None

Not associated with rulemaking

  87 FR 107 06/03/2022
87 FR 56075 09/13/2022
No

4
IC Title Form No. Form Name
CCBHC Leadership Interviews
CCBHC Survey
Client Focus Groups
State Official Interviews

  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 101 0 0 101 0 0
Annual Time Burden (Hours) 201 0 0 201 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
New

$146,209
Yes Part B of Supporting Statement
    No
    No
No
No
No
No
Kaitlyn Jones 202 205-4696 kaitlyn.jones@hhs.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.
09/13/2022


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