View Information Collection (IC)

View Information Collection (IC)

IC Title:	GenIC #48 - Section 223 Demonstration Programs to Improve Community Mental Health Services	Agency IC Tracking Number:

IC Status: New

Obligation to Respond: Mandatory

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Instruction			BHCMeasureSpecificationsVol1(508).pdf		No		Fillable Fileable
Instruction			BHCQMAppendicesVol2(508).pdf		No		Fillable Fileable
Form and Instruction	CMS-10398 (#48)	Quality Measurement Data Reporting Templates	Demonstration223Templates(508) OMB and CMS #.xlsx		Yes	Yes	Fillable Printable

Federal Enterprise Architecture Business Reference Module

Line of Business: Health

Subfunction: Health Care Services

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 24	Number of Respondents for Small Entity: 0

Affected Public: State, Local, and Tribal Governments

Percentage of Respondents Reporting Electronically: 100 %

	Approved	Program Change Due to New Statute	Program Change Due to Agency Discretion	Change Due to Adjustment in Agency Estimate	Change Due to Potential Violation of the PRA	Previously Approved
Annual Number of Responses for this IC	528	0	528	0	0	0
Annual IC Time Burden (Hours)	22,192	0	22,192	0	0	0
Annual IC Cost Burden (Dollars)	0	0	0	0	0	0

Documents for IC

Title	Document	Date Uploaded
GenIC #48 - Supporting Statement (2)	# 48 - Section 223 Demonstration Programs to Improve Community Mental Health [rev 06-02-2016 by OSORA PRA] -- CLEAN.docx	06/09/2016

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.