Information Collection List

IC Title Status Responses Hours Dollars Document Type Form No. Form Name
Agency Director/Administrator Interview New 64 128 0 Form and Instruction Agency Director/Administrator Interview
CSC Participant Interview New 128 128 0 Form and Instruction CSC Participant Interview
CSC Staff Interview New 192 384 0 Form and Instruction CSC Staff Interview
Fidelity Interview New 256 1024 0 Form and Instruction Fidelity Interview
Possible Admin. Data Elements New 576 2880 0 Form and Instruction Possible Admin. Data Elements
Site Survey New 250 50 0 Form and Instruction Site Survey
State MH Authority Interview New 32 64 0 Form and Instruction State MH Authority Interview
Total burden requested under this ICR: 1498 4658 0  
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